Topics
Impact of Safe Water, Sanitation on World's Poor
What are the Millennium Development Goals?
STATISTICS ON HIV/AIDS IN AFRICA
Child Poverty Facts

Impact of Safe Water, Sanitation on World's Poor

Effects Go Beyond Better Health, Experts Say

By David Brown, Washington Post Staff Writer, Monday, November 22, 2004; Page A12

Access to safe water and basic sanitation were among the "Millennium Development Goals" that 189 heads of state from around the world adopted in 2000. Specifically, they pledged that by 2015 they would reduce by at least half the proportion of people living without those two essential comforts of civilization. The year 1990 was taken as the baseline against which progress would be measured.

Reaching those goals would have profound effects on the world's poorest people -- effects far beyond better health, the most obvious one. The World Health Organization and UNICEF recently issued a report on the progress achieved as of 2002, the midpoint in that 25-year period.

In 1990, 77 percent of the globe's population had access to indoor running water, piped public taps, protected wells and rainwater. In 2002, 83 percent of people had those "improved" drinking water sources. Progress is on track to meet the target of 89 percent by 2015.

Equally impressive is the fact that 52 percent of people have the best of the "improvements": household running water. "More than half the population of the planet uses piped water at home. That is a stunning achievement," said Jamie Bertram, coordinator of WHO's water, sanitation and health program. The sanitation news is less encouraging.

"Improved" forms of sanitation include not only flush toilets, but also latrines that are used by only one household, and are ventilated and designed to isolate waste from the surrounding environment. In 1990, 49 percent of people used such facilities. By 2002, that had increased to just 58 percent.

Unless progress accelerates, the target of 75 percent coverage will not be met, with the effort falling short by about half a billion people. "The gap between the haves and the have-nots is widening," said Vanessa Tobin, UNICEF's chief of sanitation. "We need to have local solutions that are sustainable and affordable."

China and India together have the most people without safe water or improved sanitation. In the case of sanitation, 1.5 billion people in those two countries do without. Among regions, though, Africa is worst off. The entire sub-Saharan part of that continent today is only somewhat ahead of the United States of 1900.

In that year, 42 percent of Americans had access to public water and 29 percent to sewage systems. Among Africans in 2002, 58 percent had access to improved water (only 16 percent with household connections), and 36 percent had improved sanitation.

Although clean water and toilets have many benefits, some are not entirely obvious. Both improvements lead to better health, although how much each contributes has been hard to measure. That is because people's health is also affected by personal habits, methods of storing and cooking food, as well as by education and income.

Piped water reduces the incidence of typhoid fever -- an outcome seen both in contemporary studies and in historical analysis. In Philadelphia, for example, a study showed that as water filtration was brought to the city's six water districts between 1902 and 1909, typhoid mortality in each district fell. Between 1888 and 1912, deaths in German cities from that disease fell by 80 percent, with half of the decrease attributed to piped water.

But clean water by itself has relatively little effect on rates of other water-borne infections, such as childhood diarrhea. Those illnesses are mostly transmitted by the fecal contamination of food, dishes and hands. They reflect the amount of water a household has for washing and hygiene, not the quality of the water.

For that reason, bringing the source of water to the house or yard reduces the diarrhea rate by 44 percent, while water delivered to a public "standpipe" -- where someone must go with a water container -- reduces the rate only by 6 percent.

Improved sanitation cuts diarrhea incidence by a quarter to a third. Interventions that promote personal hygiene, such as hand washing, decrease it by 42 percent, according to a recent analysis of studies by Lorna Fewtrell of the University of Wales and Jack M. Colford of the University of California at Berkeley.

Traditional water-borne diseases, however, are not the only ones reduced by clean water and toilets. Trachoma is a bacterial infection of the eyelid responsible for about 6 million cases of blindness worldwide. Better water and sanitation reduces trachoma rates by an average of 27 percent. Once-a-day face washing with a handful of water is one of the four chief interventions being pushed in an international effort to eliminate trachoma.

Curiously, health benefits are far down the list of reasons that people in poor countries give for wanting better water and sanitation services. Relief from the drudgery of carrying water long distances -- a chore borne almost entirely by women and girls -- is the chief benefit that people mention.

A 2002 UNICEF study of rural households in 23 sub-Saharan countries found that a quarter of them spent 30 minutes to an hour each day collecting and carrying water, and 19 percent spent an hour or more. With closer water comes greater self-esteem, less harassment of women, and better school attendance by girls -- three things spontaneously mentioned by people in Ethiopia, Ghana, Tanzania and India in a different study.

Toilets are similarly liberating. In many cultures, rural women venture out to urinate and defecate only at night. In a study of 320 households in the West African nation of Benin, people were asked to rank the benefits of owning a latrine on a scale of 1 to 4. "Avoid discomforts of the bush" came in at 3.98. "Gain prestige from visitors" was 3.96. "Avoid snakes" was 3.85. "Health" was 1.27.

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STATISTICS ON HIV/AIDS IN AFRICA

The numbers on actual AIDS funding are imprecise, it appears that African countries are today spending $300 to $400 million a year for AIDS. This is less than 10 percent of what is required. In 1996-97, a total of $165 million was spent on AIDS programs in Africa. Of this, $150 million came from external sources (donor agencies, multilateral banks, and United Nations organizations), and $15 million was from African governments. Estimates suggest that external funding for AIDS in Africa may have risen to around $210 million in 1998. Further increases pushed total expenditures on AIDS to $300-400 million a year in 2000, and recent new financial commitments suggest that actual disbursements will also rise in the coming years. But a much larger "quantum leap" in funding will be needed to close the gap, which was allowed to widen in the 1990s. -- Draft Paper for the Abuja Summit on HIV/AIDS, April 16, 2001, written by staff of the UNAIDS Secretariat in Geneva, with helpful inputs from the Economic Commission for Africa

Although HIV was first detected in the South Africa largely among men who have sex with men and transfusion recipients between 1982 and 1987, the virus has moved into the heterosexual population, with the country experiencing an "explosive spread" of HIV between 1994 and 1998. Fifty percent of pregnant women in some parts of the country are HIV-positive. Vertical HIV transmission in the Western Cape has been reduced by 50 percent since 1999. -- Abdool Karim, Xinhua News Agency report, August 4, 2003

University of Natal researcher Quarraisha Abdool Karim said that national mortality rates for South African men between the ages of 20 and 40 increased by more than 150 percent since 1998, and the mortality rate for women between the ages of 20 and 35 has risen even more. Abdool Karim said that although the increasing death rates could "stabilize" the country's overall AIDS prevalence rate, it would be "premature and foolish" to believe that AIDS was "under control" in South Africa. -- Xinhua News Agency, August 4, 2003

75 percent of all people with HIV in the world live in Sub-Saharan Africa. Currently 25 million Africans are infected with HIV. -- “Country Data - 1997, 1999 & 2001,” By Maphindi Sibiya

South African officials expect 50,000 people to be on antiretroviral drugs by the end of the year and 1.4 million people to be on the drugs by 2009, at a total cost of $700 million. -- BBC News, April 1, 2004

According to a survey conducted by the Washington Post:

• 67 percent of respondents believe that HIV/AIDS in South Africa is a "crisis," 27 percent believe the disease poses a "serious problem but not a crisis," 4 percent believe the disease is a problem "but not a serious one" and 1 percent do not see HIV/AIDS as a problem in the country.
• 79 percent of all respondents were very worried about contracting HIV, compared with 86 percent of blacks, 72 percent of participants of mixed race, 66 percent of Indian respondents and 43 percent of whites.
• 28 percent of all respondents have known a close friend or relative who has died of AIDS-related complications, compared with 31 percent of blacks, 20 percent of respondents of mixed race, 8 percent of Indian participants and 17 percent of whites. -- Majority of South Africans Say Government Has Not Done Enough To Fight HIV/AIDS, Survey Shows, April 1, 2004, according to a survey conducted by the Washington Post, the Kaiser Family Foundation and Harvard University

Currently, there are about five million people living with HIV in South Africa, the most of any country in the world, the Washington Post reports. In addition, the epidemic is expected to reduce the life expectancy in the country from 68 years to 36 years by 2010. -- Majority of South Africans Say Government Has Not Done Enough To Fight HIV/AIDS, Survey Shows, April 1, 2004, according to a survey conducted by the Washington Post, the Kaiser Family Foundation and Harvard University

Botswana had the worst AIDS rate in the world; 38.8 percent of the adult population had contracted AIDS (2001). -- UNAIDS/WHO Epidemiological Fact Sheet on Botswana: 2002 Update; CIA World Factbook 2002.

Botswana’s healthy life expectancy at birth is 36.0 for males and 35.4 for females. -- The World Health Report 2003

An estimated 5 million South Africans, including 2.7 million women, were living with AIDS, according to a UNAIDS/WHO Epidemiological Fact Sheet on South Africa: 2002 Update; CIA World Factbook 2002. It was estimated that 660,000 South African children under the age of 15 had lost their mother or father or both parents to AIDS (2001). There were 11 million episodes of Sexually Transmitted Infections (STI) reported in 1999. -- UNAIDS/WHO Epidemiological Fact Sheet on South Africa: 2002 Update; CIA World Fact book 2002

Uganda is considered the success story in Africa, regarding AIDS containment. Yet, there were an estimated 510,000 people living with HIV/AIDS, along with an estimated 84,000 deaths due to AIDS. Some 880,000 children 15 or younger had lost their mother or father or both parents to AIDS. -- UNAIDS/WHO Epidemiological Fact Sheet on Uganda: 2002 Update; CIA World Factbook 2002.

Sub-Saharan Africa is home to 29.4 million people living with HIV/AIDS. Approximately 3.5 million new infections occurred there in 2002, while the epidemic claimed the lives of an estimated 2.4 million Africans in the past year. Ten million young people (aged 15-24) and almost 3 million children under 15 are living with HIV. -- “Country Data - 1997, 1999 & 2001,” By Maphindi Sibiya

Rampant epidemics are under way in southern Africa, where in four countries, national adult HIV prevalence has risen higher than 30 percent: Botswana (38.8 percent), Zimbabwe (33.7 percent), Swaziland (33.4 percent), and Lesotho (31 percent). -- “Country Data - 1997, 1999 & 2001,” By Maphindi Sibiya

Uganda continues to provide evidence that the epidemic does yield to human intervention. HIV infection levels appear to be on the decline recently in several parts of the country — as shown by the steady drop in HIV prevalence among 15- to 19-year-old pregnant women. Trends in behavioral indicators are in line with this apparent decline in HIV incidence. -- “Country Data - 1997, 1999 & 2001,” By Maphindi Sibiya

Infection rates in Uganda have declined from 21 percent to 6 percent since 1991. -- Edward C. Green, Senior Research Scientist, Harvard Center for Population and Development Studies

Malawi had 470,000 children orphaned by AIDS at the end of 2001. – AIDS Orphans in Africa

It is projected that the number of HIV infections will peak in 2010 (at between 25 and 30 percent of the population), but the number of AIDS cases will continue to increase for another 5 to 10 years. Almost 1 million South African orphans under 15 will die of AIDS by 2005. 1 out of every 7 South African children will be an HIV/AIDS orphan by 2005. HIV prevalence is highest among South African women aged 20 – 30. Approximately 40-60 percent of all South African tuberculosis patients are HIV-positive. Life-expectancy in Africa will have plunged to 30 by the end of this decade. Currently, in Botswana it has dropped from 71 to 39. Between 28 and 45 percent of mineworkers in South Africa are HIV-positive. This has already led to a 15-percent drop in productivity at mines. Mines lose between 5 percent and 10 percent of their workers every year due to AIDS and will need to employ 20 percent more workers over the next 5 years to maintain normal production. When a worker develops full-blown AIDS, he/she will be absent from work 50 percent of the time. When at work, employees suffering with AIDS will function at 50 percent below capacity. 85 percent of Zimbabwe’s soldiers had AIDS (2000).
– “Country Data - 1997, 1999 & 2001,” By Maphindi Sibiya

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CHILD POVERTY FACTS

• According to UNICEF, 30000+ children die each day due to poverty, or over 9.8 million children a year.
• Less than one per cent of what the world spent every year on weapons was needed to put every child into school by the year 2000 and yet it didn't happen.
• The death rate for children under the age of 5 is an unbelievable 210000 week, approx 11 million a year.
• 1 billion children, every 2nd child in the world is currently in poverty.
• 640 million children go without adequate shelter.
• 400 million children do not have access to safe water.
• 270 million children have no access to health services.
• 1.4 million children die each year from lack of access to safe drinking water and adequate sanitation.
• 2.2 million children die each year because they are not immunized.
• 15 million children are orphaned yearly due to HIV/AIDS.

**Please Note: All the information above has been referenced from the following: State of the World's Children, 2005, UNICEF.

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What are the Millennium Development Goals?

The eight Millennium Development Goals (MDGs) – which range from halving extreme poverty to halting the spread of HIV/AIDS and providing universal primary education, all by the target date of 2015 – form a blueprint agreed to by all the world’s countries and all the world’s leading development institutions. They have galvanized unprecedented efforts to meet the needs of the world’s poorest.

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