Access to Safe Water, Sanitation, and Hygiene Promotion in Developing Countries

[摘要]

The American Public Health Association,

Noting that no single intervention has greater impact on national development and public health than the provision of safe drinking water, proper sanitation, and hygiene promotion¹; and 

Alarmed that nearly 1.2 billion people in developing countries have no access to clean water and 2.4 billion have no access to sanitation,^2,3 which is projected to rise to nearly half the world’s population by 2032⁴;

Knowing that 2.2 million people in developing countries—most of them children—die every year from water-related diseases and that diseases such as cholera,⁵ guinea worm and malaria can be eliminated, and diarrheal diseases can be decreased by one-third,^6,7 with access to safe water, improved sanitation, and hygiene promotion^8,9;

Recognizing that inadequately treated sewage and disposed feces can spread numerous diseases such as hepatitis A and shigellosis through unsafe water¹⁰;

Knowing that developing countries lack adequate systems to assure safe water, improved sanitation, and hygiene promotion in both urban and rural areas¹¹ and that in Africa, for example, where water systems exist, many do not operate adequately at any given time¹²;

Disturbed by inequities in the cost of safe water, and that the poor often pay higher fees for water provided through informal commerce, while wealthy areas enjoy treated water piped to their homes at a lower charge¹³;

Recognizing that International Financing Institutions (IFIs) such as the World Bank have imposed structural adjustment programs (SAPs) as a condition of approving loans to developing countries,¹⁴ and that SAPs have imposed user fees and privatized water systems, making safe water too expensive for the poor and further exacerbating socioeconomic inequities^15-17;

Aware that the European Union intends to compete to operate privatized water systems in the U.S. and other developed nations through the General Agreement on Trade in Services (GATS), and that APHA policy¹⁸ opposes further privatization of vital human services¹⁹;

Aware that the World Summit for Children in 1990 adopted the goal of universal access to safe water and sanitation by the year 2000 to promote improved health and survival, and that the Water Supply and Sanitation Collaborative Council has endorsed Vision ²¹, targeting universal coverage of safe water, adequate sanitation, and hygiene promotion by 2025²⁰; 

Therefore the American Public Health Association:

Urges that developed nations provide sufficient technical and financial assistance to less developed nations to support the implementation of water and sanitation programs using appropriate technologies taking into account local resources, including through grants from IFIs;

Urges the U.S. Congress to oppose IFI loan or grant conditions requiring user fees or privatization of water, and to deny funding to IFIs that do not comply;

Opposes policies that treat water as a commodity governed by market forces;

Promotes policies that increase safe water through management options that include communities and local government;

Encourages policies that recognize water as a valuable and finite resource, and a key to sustainable development and public health; that manage water efficiently; and that develop progressive public financing mechanisms to assure universal access to safe water.

Recommends sufficient funding for programs aimed at developing sustainable global sanitation systems, water-related infrastructure, and hygiene promotion²¹;

Urges governments to support the following initiatives: 

• The WASH Campaign by the Water Supply and Sanitation Collaborative Council to mobilize political support and action around the world making water, sanitation and hygiene a priority^22,23;
• The Millennium Development Goals set by the UN and reaffirmed by the World Summit on Sustainable Development to “halve, by 2015, the proportion of people living in extreme poverty and…unable to reach or afford safe drinking water;”²⁴
• The U.N.’s Agenda 21, promoting schemes for rational water use through public awareness, educational programs and affordable financing of safe water so that all people have financial and geographical access to clean water by the year 2025²⁵;
• The strengthening of UN organizations to set guidelines to monitor violations and conflicts regarding safe water.

References

1. World Health Organization Water and Sanitation Fact Sheet No 112, November 1996. www.who.int/inf-fs/en/fact112.html. Downloaded 6/5/02.
2. World Health Organization and United Nations Children’s Fund Report: The Global Water Supply and Sanitation Assessment. Geneva: World Health Organization, November 2000.
3. Global Environment Facility; Global Action on Water, 2000 World Water Commission, Netherlands, March 2000.
4. Vass, A. Over half the world will face water shortages by 2032, British Medical Journal, Volume 324 (7349) June 2002.
5. World Health Organization, Cholera and the Global Task Force on Cholera Control. www.who.int/emc/disease/cholera/index.html. Downloaded 6/5/02.
6. Global Environmental Change and Human Security, Aviso Bulletin; Issue No. 8, June 2001.
7. World Health Organization and United Nations Children’s Fund, Global Water Supply and Sanitation Assessment Report, Geneva, 2000.
8. Global Environmental Change and Human Security, Aviso Bulletin; Issue No. 8, June 2001.
9. World Health Organization and United Nations Children’s Fund Report: The Global Water Supply and Sanitation Assessment. Geneva: World Health Organization, November 2000.
10. The Environmental Protection Agency: Office of Water, Status Report on the Water and Wastewater Infrastructure Program for the U.S.—Mexico Borderlands, January 2001. 
11. Mintz, E. et al, Not Just a Drop in the Bucket: Expanding Access to Point-of-Use Water Treatment Systems, American Journal of Public Health, Volume 91 (10) p 1565-70, October 2001.
12. World Health Organization/United Nations Children’s Fund Report: The Global Water Supply and Sanitation Assessment. Geneva: World Health Organization, November 2000.
13. Water Supply and Sanitation Collaborative Council Press Release. Water Supply and Sanitation Collaborative Council and United Nations-Habitat call for urgent Action to Address Water and Sanitation Crisis. New York, January 2002, http://www.water-2001.de/johannesburg/CSDPrepcomEn020129. pdf.
14. Schadler, S. et al, Experience Under the Enhanced Structural Adjustment Facility, International Monetary Fund, Occasional Paper No. 106, June 1993.
15. Arhin-Tenkorang, Dyna, Mobilizing Resources for Health: The Case for User Fees Revisited, Commission on Macroeconomics and Health Working Paper Series, Paper No. WG3-6.
16. Barlow, M. Blue Gold: The Global Water Crisis and the Commodification of the World’s Water Supply. International Forum on Globalization. June 1999.
17. Bond, P. ZMagazine. The World Bank in the time of Cholera. Johannesburg, South Africa. April 2001.
18. American Public Health Association Policy 2001-21. Threats to Global Health and Equity: The General Agreement on Trade in Services and the Free Trade Area of the Americas. http://www.apha.org/legislative/policy/01_policy.pdf.
19. The World Trade Organization, The General Agreement on Trade in Services 2000, Request from the EC and its Member States (Hereinafter the EC), March 2002.
20. World Health Organization/United Nations Children’s Fund Report: The Global Water Supply and Sanitation Assessment. Geneva: World Health Organization, November 2000.
21. International Conference on Freshwater, Bonn Recommendations for Action Report. December 2001. 
22. Water Supply and Sanitation Collaborative Council Press Release. Water Supply and Sanitation Collaborative Council and United Nations-Habitat call for urgent Action to Address Water and Sanitation Crisis. January 2002.
23. Water Supply and Sanitation Collaborative Council, Water, Sanitation, and Hygiene for All—The Wash Campaign, December 2001, http://www. johannesburgsummit.org/html/major_groups/wash_campaign_note_020125.doc
24. United Nations International Conference on Freshwater. Bonn Recommendations for Action Report. December 2001. 
25. Agenda 21: Environment and Development. Chapter 18, Protection of the Quality and Supply of Freshwater Resources. June 1992. Full document can be accessed at: http://www.unep.org/Documents/Default.asp?DocumentID=52

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[发布日期] 2002-11-13

[学科分类] 医学（综合）