Policy Brief January 2011

Water, Sanitation, and Hygiene

in Development
Problem Recommendations & Actions
Water, sanitation The Administration and Congress must prioritize and integrate WASH in its overall approach
and hygiene (WASH) to international development. This includes: creating a multi-year WASH strategy that tar-
underlies the success gets programs based on need, as required by the 2005 Senator Paul Simon Water for the
of virtually all aspects Poor Act; the integration of WASH into presidential international development initiatives;
of development. and increasing the capacity within USAID and the Department of State to implement WASH
Inadequate access programs.
to safe water and • The Administration should develop a comprehensive, multi-year WASH strategy, inte-
sanitation services, grated within a wider water strategy including water resources management and water
coupled with poor productivity with measureable indicators, benchmarks and a timetable. Develop the
hygiene practices, kills strategy using meaningful consultation with relevant stakeholders, including civil society.
and sickens thousands • Congress and White House officials should work together to ensure full funding of such
daily and leads to a strategy.
impoverishment and • USAID should integrate WASH planning and budgeting into the broader development
diminished opportunities agenda, particularly into the presidential initiatives on global health, food security and
for thousands more. climate change.
Meaningful progress on • The Administration and Congress should take the level of need into account when tar-
WASH has been limited geting WASH funding. According to relevant international donor guidelines, 70 percent
by lack of capacity and of WASH aid should target low-income countries.
strategic leadership • To increase capacity, the Administration should have senior WASH advisers at both the
and diverging political Department of State and USAID in order to increase inter-agency coordination and dem-
priorities. onstrate U.S. leadership both domestically and with international stakeholders. USAID
should continue training personnel in WASH issues to develop long-term expertise.
• The Administration should support and participate in the Sanitation and Water for All
(SWA) partnership to address gaps in policy, planning, financing and technical assistance.
• USAID should undertake an evaluation of the extent to which the funding in furtherance
of the Senator Paul Simon Water for the Poor Act has achieved its objectives, including
the requirement that funds be distributed fairly between rural, peri-urban and urban areas.

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Results
A strong strategy and increased staffing will give the U.S. Government the
tools it needs for robust leadership on safe, affordable and sustainable access
to water and sanitation globally. Integrating WASH into other U.S. develop-
ment programs will help to ensure their success. Improved coordination among
donors will support recipient governments in their efforts to achieve universal
WASH access, which will ultimately produce healthier, more stable societies
with stronger economic growth.
Background
Water, sanitation and hygiene (WASH) are crucial building
blocks for development. They improve the quality of life and
health, advance education, reduce poverty and malnutrition,
increase child and maternal survival, drive economic growth
and contribute to gender equality and dignity. Despite the
importance of WASH in virtually all development outcomes,
an estimated 884 million people still lack access to safe
drinking water, and 2.6 billion lack basic sanitation.1 With
the 2015 deadline for the Millennium Development Goals
(MDGs) quickly approaching, addressing WASH issues is
particularly critical to accelerate progress on all of the MDGs.
Water and sanitation is perhaps the world’s largest single
cause of disease. More than 25 diseases are caused by
inadequate water and sanitation, creating nearly 10 percent
of the global public health burden, killing more than 2 mil-
lion people each year (including more children than AIDS,
tuberculosis and malaria combined)2 and leading to 50 per-
cent of the world’s malnutrition.3
The cost of failing to properly address the gaps in safe
water and sanitation is significantly higher than the cost of
addressing them. Every year, lack of water and sanitation
costs sub-Saharan Africa around $23.5 billion, or 5 percent
of its GDP.4 Investments in water and sanitation are cost-
effective, with an estimated $8 returned for every dollar
invested.5
Safe water and improved sanitation provides a basic level
of human security that, once reached, enables families and
individuals to work to increase their standards of living,
educate their children and become better stewards of the
environment. Water is also a growing strategic issue whose
provision increases the likelihood of peaceful solutions to
resource allocation concerns (e.g. in water-stressed and
arid areas).
The good news is that 87 percent of the world’s popula-
tion has access to safe, affordable and sustainable drink-
ing water, while 61 percent has access to improved sanita-
tion.6 This indicates enormous progress due to the collective
efforts of governments, businesses, foundations and non-
1 2010 WHO/UNICEF Joint Monitoring Programme (JMP) for Water Sup-
ply and Sanitation, http://www.wssinfo.org/en/welcome.html
2 http://www.wateradvocates.org/media/nytimesads/Sources.pdf
3 WHO, Safer Water, Better Health, http://whqlibdoc.who.int/publica-
tions/2008/9789241596435_eng.pdf
4 UNDP, Human Development Report 2006. http://hdr.undp.org/en/me-
dia/HDR06-complete.pdf
5 WHO (2004) Evaluation of the costs and benefits of water and sanitation
improvements at the global level, by Hutton and Haller - http://www.
who.int/water_sanitation_health/wsh0404/en/
6 Improved sanitation ensures that human waste is hygienically sepa-
rated from human contact. 2010 WHO/UNICEF Joint Monitoring Pro-
gramme (JMP) for Water Supply and Sanitation, http://www.wssinfo.
org/en/welcome.html
governmental organizations. In short, effective and appropri-
ate solutions to the global water and sanitation problem are
proven and are available. The most sustainable ones include
not just water supply solutions (e.g. boreholes, rainwater
harvesting) but also sanitation provisions (e.g. pit latrines)
and hygiene training to promote frequent hand washing.
The biggest challenges to achieving universal access to
safe water and sanitation and good hygiene are a lack of
global awareness of the issue, a lack of operational scale in
the sector and a lack of the collective political will needed
to properly and quickly channel the necessary financial,
human and technical resources. Other significant chal-
lenges include developing culturally-appropriate strategies
to promote needed behavior changes, as well as improved
management systems and governance. Environmental deg-
radation and finite water resources limit the ability to expand
water supplies indefinitely. Policy changes that promote
conservation and set more appropriate water use rates are
also essential to sustainability. Although developing coun-
tries bear most of the responsibility for funding water and
sanitation improvements in their countries, the developed
world can and should offer financial, human and technical
assistance to speed up and support this ongoing process.
Congress has shown strong leadership on WASH issues
by creating the Senator Paul Simon Water for the Poor Act
in 2005.7 This act, passed with overwhelming bipartisan sup-
port, made the provision of safe drinking water and sanitation
in countries of greatest need a priority of U.S. foreign policy.
The State Department and USAID also increasingly rec-
ognize the importance of WASH to international develop-
ment outcomes and U.S. national security. In her 2010
World Water Day speech, Secretary of State Hillary Clinton
said, “Water represents one of the great diplomatic and
development opportunities of our time. It’s not every day
you find an issue where effective diplomacy and develop-
ment will allow you to save millions of lives, feed the hun-
gry, empower women, advance our national security inter-
est, protect the environment, and demonstrate to billions of
people that the United States cares, cares for you and your
welfare. Water is that issue.”8
As the international community works toward the MDG
target of halving the number of people without safe water
and sanitation, both developing and developed countries
must increasingly prioritize the provision of safe water and
adequate sanitation. Safe drinking water and sanitation are
not a luxury. Without them, progress on other development
priorities cannot be sustained.9
7 The Senator Paul Simon Water for the Poor Act of 2005, P.L. 109-121,
http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=109_
cong_public_laws&docid=f:publ121.109.pdf
8 http://www.state.gov/secretary/rm/2010/03/138737.htm
9 Kyoto Water Forum, “The Contribution of Water for Achieving the
MDGs” http://www.unsgab.org/docs/biblioteca/I-1.12.pdf