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Slow progress on sanitation puts 2.6 billion people at risk
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     The world is on course to meet drinking water targets for 2015, but slow progress on sanitation means that 40% of the world's population is at risk of disease or death, a new report has warned.

    More than 2.6 billion people lack access to basic sanitation and 1.1 billion still use unsafe drinking water, says the report from the World Health Organization and Unicef, published last week.

    Collecting water from the Yellow River, China

    Credit: CHIRS STOWERS/PANOS

    Global sanitation coverage rose from 49% of the population in 1990 to 58% in 2002, but the report cautions that without a "sharp acceleration" of efforts the number of people without basic sanitation in 2015 will still be 2.4 billion.

    In September 2000 a United Nations conference set several millennium development goals and targets, one of which was to halve the proportion of people without access to drinking water and sanitation by 2015.

    The new report, which assesses progress so far, said that at the current pace sanitation will fall short of its target by 500 million people.

    It said China and India account for 1.5 billion people without sanitation. Urbanisation is marginalising poor rural people and straining services in cities and is pushing families in rural areas and urban slums into a cycle of illness and poverty, says the report, with children being the hardest hit.

    "Children are being born in a silent emergency," said Carol Bellamy, executive director of Unicef. "The growing disparity between haves and have nots in access to basic services is killing 4000 children a day."

    Basic sanitation covers only 20% of India's rural population. Last year a government report said that a lack of personal and home hygiene killed more than 400 000 children in India each year ( BMJ 2003:326: 1284). The government's "total sanitation campaign," which provides funds to build household, school, and community toilets, now covers 398 of India's 601 districts.

    South Asia shows the greatest gains in drinking water coverage, rising from 71% to 84%, but health specialists warn that water quality is worsening. "Water quality has deteriorated because of pesticides, fertilisers, and other contaminants," said Mr Alok Mukhopadhyay, chief executive of the Voluntary Health Association of India, a non-governmental organisation in New Delhi.

    In China officials say future efforts need to focus on water safety. At a conference in Beijing earlier this year Zhai Haohui, the vice minister for water resources, said that the priority was to tackle contamination of water by arsenic, fluoride, and other pollutants.

    In sub-Saharan Africa 288 million people still rely on unsafe water. Although the people at highest risk are in Africa and Asia, the report warns of "worrying trends" in industrialised countries, where coverage for clean water and basic sanitation dropped by 2% between 1990 and 2002.(Ganapati Mudur)