Progress has been made towards providing access for all to safe drinking water and basic sanitation, reports Curtis Doebbler from the Global WASH Forum in Dakar, Senegal, but most of the developing world still lags behind Lack of access to clean water and basic sanitation kills more than 3,900 children daily, according to the World Health Organisation (WHO). Most of these children are African and are dying while much of the rest of the world has made progress towards meeting these basic human needs. To address this imbalance and make greater strides towards providing more with adequate water and sanitation --one of eight United Nations Millennium Goals agreed upon by world leaders in 2000 -- the Water Supply and Sanitation Collaboration Council (WSSCC) recently convened the first Global WASH Forum in Dakar, Senegal. The forum brought together almost five hundred participants, including around 50 ministers, deputy ministers and directors of countries' water and sanitation programmes. They were joined by a host of actors from NGOs and inter- governmental organisations. The forum's message was stated succinctly by Senegalese Minister of Public Hygiene and Sanitation Lamine Bâ, who passionately impresses upon his audience that "water, sanitation and hygiene are the most important factors for ensuring the health of our and future generations." In an exclusive English-language interview for Al-Ahram Weekly, Minister Bâ stressed that the international community has now become aware "that to achieve the UN Millennium Development Goals we must put water, sanitation and hygiene at the heart of our development efforts". Minister Bâ points out that the Senegalese government's decision to create the post of minister of public hygiene and sanitation in early 2004 indicates their recognition of this truth. Senegalese Prime Minister Macky Sall echoed the same message. "It will help us achieve the Millennium Development Goals. Educating people about proper hygiene is especially important," he said. "The conference was a very important opportunity to exchange views," according to Lesotho Minister of Natural Resources Mamphono Khaketla. Five African ministers who shoulder the responsibility for water and sanitation in their respective countries repeated the same message from the forum's podium, although an equal number of ministers were missing. Among expected participants who were absent was Egypt's minister of water and irrigation, Mahmoud Abu Zeid. As the former head of the World Water Council (WWC) he was attending a WWC meeting in Japan. Despite past and present efforts, the WHO and UNICEF recently released a study that predicts that most of Africa will not achieve the Millennium Development Goal of halving the number of those who lack access to clean water and basic sanitation by 2015. In sub-Saharan Africa it is likely that just over half (58 per cent) will have access to safe water by then. Despite this being an increase of 9 per cent from 1990, at the current rate it will fall short of the goal. In general, the WHO-UNICEF report warns, "Without a sharp acceleration in the rate of progress, the world will miss the sanitation target by half a billion people." The Senegalese prime minister, citing the lack of progress made, pledges that "next year we will focus on sanitation. We will create a project to provide sanitation--with the help of the Americans--to many needy villages and cities." At present less than 20 per cent of Senegalese living outside of major cities have access to basic sanitation. Kenyan Mayor Shakeel Shabbir Ahmed is also concerned for the one million inhabitants of Kisumu, who "suffer greatly from the tons of waste that are pumped or dumped into Victoria Lake", which is a contributor to the waters of the Nile that flow through Uganda, Sudan and Egypt. "Local authorities are given the responsibility for providing facilities -- water, hygiene and sanitation -- but inadequate resources are made available," Ahmed laments, citing his complaint that, "all the donors give their money to the central government and only about 30 per cent of the resources trickle down to the local government that does 100 per cent of the work." Perhaps the most divisive issue related to access to clean water and basic sanitation is money. Who gets it? How it should be spent? And how much is needed? The question of money, however, is ignored by the WHO-UNICEF report. Another recent WHO-commissioned report estimates the investment needed at $11.3 billion per year "over and above current investments". This report also estimates the cost recovery of keeping people healthy to be about $84 billion per year. Forum participants were well aware of the money issue, but did not agree on what should be done. Anna Tibaijuka, United Nations under-secretary general and executive director of HABITAT, stressed that "water is not free. It is an expensive commodity. Someone has got to foot the bill." Ugandan Minister of Water, Land and Environment Maria Mutagamba says it is "more a matter of management than money," calling for better public education about water use and hygiene. WSSCC Executive Director Gourisankar Ghosh, former chairperson of the Conference on Sustainable Development, placed blame on developing countries as much as anyone else, while calling upon Africans to create "better government and better management of resources, before we can mobilise more funds". Jean Herivelo Rakotondrainibe, secretary-general at Madagascar's Ministry of Energy and Mines, agreed that while it is important to increase investment, "to use investment in an efficient way is more important". Dutch Ambassador-at-Large for Sustainable Development Ton Boon van Ochssee, who represented the European Union at the forum, argued that "co-financing is what the donor community is really interested in," while at the same time warning "that if actual progress is not made you will get donor fatigue". Boon van Ochssee also admitted that more developed countries need to move towards achieving the UN target of providing 0.7 per cent of their GNP to overseas development assistance. For some it seems clear that donors have already become fatigued. The mayor of Kisumu recounted one of his experiences. In 2000 the World Bank and the city of Kisumu were in discussion to set aside $8 million to renovate the city's water and sanitation facilities -- a system dating to the 1960s and intended for a city of 100,000, not one million. "The World Bank did a survey of our water and sanitation needs and determined the amount we need. They put conditionalities on the loans and grants, which we objected to but finally agreed to. To meet some of the conditions took time, so we asked the bank if we could have $300,000 of the $8 million to rehabilitate a sewage treatment plant that had fallen into disuse. This plant produced water that was sometimes one hundred times more polluted than the minimum standard. They refused," the mayor recalled. Two years passed as Kisumu worked to set up the mechanisms necessary to implement the reforms required by the bank -- like separating water supply operations. "The bank said it needed to do another study," the mayor continued, "We said 'okay,' and the bank did the study and determined we needed even more money, about $14 million," he said. "We said 'great, but can we proceed with the $8 million we already agreed on?' We even passed a resolution saying we did not want the extra money. They said no." As a consequence the city has now negotiated with the French government to provide the funds. "In the meantime our people continue to die from causes related to the lack of clean water and sanitation," the mayor sighs. Taking a more encouraging approach, José Augusto Hueb of the WHO points out that his organisation's research has shown that "every dollar invested in water and sanitation provides an economic return of between three and 34 dollars." Nevertheless, he admits that even the WHO cannot say where the seed money will come from, or exactly what investments are appropriate. Most of the delegates at the forum were wary of privatisation, though were willing to allow for private-public partnerships. They also appeared to agree with Tibaijuka's warning that "privatisation without regulation is pure corruption." There is no easy solution to the problems of financing, Hueb stressed, citing the WHO's support of the vague idea of "mixed public-private sector partnerships" based on a legal framework "supportive of improved service to the poor" in protecting health. As the forum concluded it remained to be seen if the will was formed to address one of the most basic problems that stands alongside infrastructural issues: poverty. Maurice Dioh, who lives in the Keur Massar suburb of Dakar, summed up the issue: "We struggle to do our best, but it is difficult to earn a living that permits you to maintain proper hygiene standards." The house in which Dioh lives is owned by his Senegalese employer, who himself resides in France. The property management job Dioh does for this employer is one of three jobs he holds as he tries to make ends meet. Like many of the inhabitants in Keur Massar, Maurice's dwelling lacks windows -- ostensibly to keep out mosquitoes that spread deadly malaria -- and garbage is strewn all around. Sanitation and drinkable water may well spur development, but neither one nor the other, nor combined, will change conditions for Dioh and millions like him.
