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|Safe drinking water and sanitation and human health|
4: Reduce child mortality
Freshwater and human health are intimately linked. Contaminated drinking water is one of the major causes of sickness and death. The vast majority of water-related deaths occur in developing countries and many are caused by relatively easily-treated and preventable diarrhoeal diseases. Nine out of 10 of the people affected are children under five (Prüss and others 2002).
Although direct human consumption and sanitation are among the smallest
uses of freshwater on an absolute scale, providing freshwater of the
quantity and quality required is one of humanity’s greatest continuing
challenges. The global population is now more than 6.3 billion people,
and the number is growing by about 77 million people every year (UNPD
2003). The availability of safe drinking water is critical to meeting
the goals for enhancing human well-being and security.
Freshwater distributes pollutants, and many disease-causing micro-organisms
(pathogens) and their vectors live in it. Infants and children are especially
susceptible to sickness associated with contaminated drinking water
and inadequate sanitation, particularly to diarrhoeal diseases. Lack
of safe drinking water and sanitation also has obvious implications
for maternal health and can exacerbate illnesses which affect the immune
system, such as HIV/AIDS. Improved sanitation alone could reduce related
deaths by up to 60 per cent, episodes of diarrhoea by up to 40 per cent,
and stunting of child growth by up to 50 per cent (WEHAB Working Group
Existing water and sanitation systems are inadequate for 30–60 per cent of the urban population, mainly in developing countries. The situation is most severe for the estimated 924 million people living in urban slums (UN-Habitat 2003a). There is a link between the urban population who do not have access to clean water through reliable piped water service, and poverty, partly due to the fact that low-income groups often have to buy their water from vendors at greatly inflated prices. People on a low income end up paying two to 50 times more for a litre of water than higher income groups, who are connected to often heavily subsidized water infrastructure (UN-Habitat 2003b). In some cities this difference is even higher (UNEP in press) (Figure 5). This further reduces the limited financial resources of poor people and their coping capacity. It is not surprising that many turn to water supplies that may not be clean, such as a local river, to meet their daily needs.
Privatization of water supply and sanitation is often seen as a way to improve services and lighten the burden on scarce public finances (UN-Habitat 2003b). Although the aim is to provide water and sanitation services more efficiently through market mechanisms, several high profile privatization initiatives in developing countries have actually resulted in price increases that made the cost of access to safe water and sanitation prohibitive for the poor (UN-Habitat 2003b). The more vulnerable members of society, particularly poor women, are the worst affected by such changes to water and sanitation pricing, and the stresses that they cause to people’s livelihoods (Grossman and others 2003).
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