TAPS AND TOILETS FOR EVERYONE - SANITATION AND HYGIENE ARE CHEAP WAYS OF IMPROVING HEALTH

Sanitation and hygiene are cheap ways of improving health in developing countries With a portfolio of $20 billion in water-related projects, the World Bank is the largest external financier in the water sector The Bank is working to boost its sanitation efforts, together with the Water and Sanitation Program, a multi-donor partnership

August 18, 2008—Two out of five people worldwide lack access to a toilet. One out of six does not have access to safe drinking water. This lack contributes to two million child deaths a year, reduces school attendance, and is a fundamental deprivation of human dignity. Lack of sanitation pollutes water resources.

The costs of environmental and health degradation due to inadequate water and sanitation has been estimated at over 1% of GDP in Colombia, 0.6% in Tunisia, and 1.4% in Bangladesh. The economic costs in Southeast Asia are even higher.

This week at World Water Week in Stockholm, the international community observes the International Year of Sanitation.

The World Bank and the Water and Sanitation Program (WSP), a global multi-donor partnership, will be there to highlight successful solutions to the water and sanitation problems facing low-income communities.

The World Bank is the largest external financier in the water sector, with a portfolio of $20 billion in water-related projects under implementation in more than 100 countries. Operations focus on improving water resource management and extending water services, including water supply and sanitation, irrigation and drainage, and hydropower.

Sanitation and hygiene: a cheap and highly effective lifesaver

The World Bank and the Water and Sanitation Program work in tandem to bolster the impact of Bank lending for sanitation. For instance, in Ethiopia, the World Bank supports decentralized approaches in towns and rural communities and finances infrastructure through lending operations. At the same time, WSP is providing technical assistance on the design and implementation of a National Hygiene and Sanitation Strategy.

The most severe problems are in high-density slums, where the risk of contamination is highest. An example of a successful Bank project is the Bombay Sewage Disposal Project, which helped provided sanitation to over a quarter of a million slum dwellers through community toilet blocks.

Much of Bank investment in middle-income countries is in urban sewage and wastewater treatment, areas of special concern for these countries. For instance, in Colombia, improved urban sanitation has resulted in untreated wastewater flowing into rivers. The Bank Group supports utilities in Colombiato increase wastewater treatment and become efficient organizations using homegrown solutions.

But the Bank also supports access to basic services for the many still lacking. For instance, the Bank helped the government of Brazil launch a pilot project called PROSANEAR. After extending services to nearly one million urban poor, PROSANEAR became a national program financed fully by national funds.

In rural areas, water and sanitation projects are often part of larger, multi-sector efforts. For instance, the Yemen Social Fund for Developmentprovided water services to two million people in remote mountain communities.

Just subsidizing hardware is not the solution. The Water and Sanitation Program also focuses on changing behavior. One of its flagship programs supports projects promoting handwashing with soap in Peru, Senegal,

Tanzania, and Vietnam."Our focus is on public education to shift attitudes at the household level," says Eduardo Perez, Senior Sanitation Specialist at WSP. "We are learning about what works to trigger, scale-up, and sustain handwashing behaviors. A promotion campaign in Ghana helped increase the number of women and children that washed their hands before eating or preparing food by 34 percent."

The Bank is giving an extra push to extend access to basic sanitation and hygiene through a rapid response team of sanitation professionals that provide technical assistance and advisory support to project teams.

"This SWAT team was set up as a response to the inclusion of basic sanitation as a Millennium Development Goal," says Pete Kolsky, World Bank Senior Sanitation Specialist.

"In sanitation any improvement is a step in the right direction. The Bank is open to lower-capital, lower-cost options."