London — It will take two centuries for sub-Saharan Africa to meet the Millennium Development Goal (MDG) to reduce by half the proportion of people without sustainable access to safe drinking water and basic sanitation, according to NGO WaterAid, which calls on national leaders to commit 3.5 percent of their annual budget to the sector.
Water, sanitation and hygiene (WASH) are being sidelined as governments concentrate on health and education, says the WaterAid report. Meanwhile, people's lack of access to clean water and basic sanitation services is holding back social and economic development in the region, costing around 5 percent of gross domestic product (GDP) every year.
Loss higher than development aid
Inadequate WASH services cost sub-Saharan Africa more than the whole continent receives in development aid - US$47.6 billion in 2009 - according to WaterAid.
The World Health Organization (WHO) estimated the financial impact of inadequate WASH facilities by looking at the health issues linked to poor hygiene, child mortality, waterborne tropical diseases, the time people spend collecting water; and reductions in educational achievement due to illness and girls' attendance rates at schools.
"Diarrhoea, 90 percent of which is attributable to inadequate sanitation and dirty water, is the single biggest killer of children in Africa, and yet sanitation targets are off-track," Tom Slaymaker, one of the report's authors, told IRIN.
Every day, 2,000 children die from diarrhoea in sub-Saharan Africa. Four out of 10 people do not have access to safe water, while seven out of 10 do not have appropriate sanitation facilities.
The disparity between rich and poor is stark. Poor people in sub-Saharan Africa are more than 15 times more likely to practice open defecation due to inadequate or poorly maintained toilets.
Over one billion people will miss the global MDG sanitation target if things continue unchanged
In Asia, India will not reach its MDG on sanitation before 2047, while Bangladesh, Pakistan and Nepal will not achieve the target before 2028.
Lack of access to water and sanitation costs African and Asian countries up to 6 percent of their gross domestic product (GDP) each year.
In India the shortfall in water and sanitation services cost the economy around 6.4 percent of GDP - the equivalent of US$53.8 billion in 2006, according to the World Bank.
In Ethiopia, 193,000 deaths per year are WASH-related, and 71.4 million people have no access to sanitation facilities.
Similar figures apply to Mali, Niger, Benin, Ghana and Congo, where 194,000 deaths a year are WASH-related and 49.5 million people have no access to sanitation facilities
According to WaterAid, the Côte d'Ivoire administration targeted 0.06 percent of its GDP to water and sanitation, Ghana spent 0.29 percent, Liberia 0.28 percent, Madagascar 0.28 percent, Nigeria 0.18 percent, Uganda 0.41 percent and Zambia 0.56 percent.
(Sources: World Bank; WHO/UNICEF Joint Monitoring Programme, 2010; national government documents 2008-2010; WaterAid)
"Unless this changes, we won't see educational progress and it will hold back progress on child health. If you look at development in industrialized countries, sanitation has been key to enabling economic growth and achieving acceptable living standards," said Slaymaker.
Ministries not powerful
Progress has been slow partly because WASH is not "sexy", he commented. "On one level it's just a question of political will. Sanitation is not a sexy topic - politicians much prefer to say they're opening a hospital or school, rather than building some toilets."
Most policy-makers in charge of WASH "have access to clean water and good sanitation, so they may not be motivated to address it in a distant rural part of the country," said WaterAid senior policy analyst John Garret.
Slaymaker noted that "The water ministry is generally less powerful relative to the education and health ministries - which [tend to] have more civil servants and more leverage with the ministry of finance during and after the budget process - [so] in the scramble for funds, the water ministry and sanitation organizations lose out. This all contributes to the sector being a low priority."
Water and sanitation is not an easy sector to reform, given it is usually spread across different ministries, and there is often "no single unified voice in the national budget process for sanitation", he added.
WaterAid calls on donors to double the global aid flow to WASH with an additional $10 billion per year in the run-up to 2015, the deadline for achieving the MDGs.
African governments need to commit at least 3.5 percent of GDP to sanitation and water to get back on track, Slaymaker told IRIN. Only Lesotho, Kenya, Niger and Tanzania are currently spending more than 0.9 percent of GDP on WASH. In Côte d'Ivoire, Ghana, Liberia, Madagascar, Nigeria, Uganda and Zambia, the most recent expenditure figures fall well below the original 2009 commitment of 0.5 percent of GDP.
"Despite all the political commitments, we haven't seen the finances to back it up," Slaymaker told IRIN. African heads of state met in the Rwandan capital, Kigali, earlier in 2011, and although many of their governments had made a commitment in 2009 to spend 0.5 percent of the annual budget on sanitation, "only one or two countries... realized that," he said.
Despite this challenge, Slaymaker still thinks the MDG goal can be met if politicians drastically change course. "This is the last chance to make an effort to get back on track," he told IRIN. "It's a question of... concerted partnership between donors, governments and the private sector. What's lacking at the moment is that concerted drive."
[ This report does not necessarily reflect the views of the United Nations ]