Simply installing toilets where needed and ensuring safe water supplies would do more to end crippling poverty and improve world health than any other possible measure, according to an analysis released Monday by the United Nations University (UNU).

"Water problems, caused largely by an appalling absence of adequate toilets in many places, contribute tremendously to some of the world's most punishing problems, foremost among them the inter-related afflictions of poor health and chronic poverty," said Zafar Adeel, director of the U.N. University's Canadian-based International Network on Water, Environment and Health.

The UNU analysis says better water and sanitation reduces poverty by boosting individual productivity, reducing public health costs and creating new business opportunities for local entrepreneurs.

Every dollar invested in sanitation generates eight to 10 dollars in reduced costs and increased productivity Adeel told IPS.

So why is it that there are mobile phone networks and not sanitation networks?

"Experts have not done a good job of explaining the consequences of poor sanitation to the public or policy makers," Adeel said.

For that reason developing countries are more interested in generating exports or economic development and ignore the costs of poor sanitation. Donor countries and aid agencies have a similar focus, choosing to improve drug delivery or develop new drugs instead of making sanitation a top priority.

The Gates Foundation is trying to develop a cholera vaccine when the easiest, fastest way to reduce the spread of cholera is to improve water treatment, Adeel said. "That is how the developed world stopped cholera. There is a real disconnect here."

Globally, almost 900 million people lack access to safe water supplies and 2.5 billion people live without access to improved sanitation, at least 80 percent of whom live in rural areas.

Putting toilets in every community could be done at a relatively low cost, said Corinne Wallace, a leading water-health researcher at UNU-International Network on Water, Environment and Health.

"Local communities don't see this as priority because people do not make the link between safe water and disease," Wallace told IPS. "Having diarrhoea is seen as 'normal' so people don't think there is a problem."

In 2002, the total number of deaths attributed to poor water, sanitation and hygiene was over 3.5 million. Each year, some 4 billion people contract diarrhoeal diseases with 94 percent of those cases estimated to be preventable.

Poor health, especially chronic illness, can force a household below the poverty threshold, concludes the UNU analysis.

This becomes self-perpetuating as a poverty-stricken household is more prone to ill health. Low education levels and lack of knowledge further maintain this cycle, as understanding links between hygiene and waterborne diseases tend to come more easily to households with higher education levels.

Education is needed to show the direct links between safe water and sanitation to improved health and productivity, Wallace said.

Changing demographics are also making sanitation issues more urgent as people flock to urban areas, putting increased strain on old and inadequate sanitation infrastructure. This is creating conditions for future disease outbreaks far more severe than we've experienced in the past, said Adeel.

Climate change will put existing systems under even more strain through increased flooding events, higher temperatures and rise in sea level, reducing freshwater availability in coastal areas.

None of these are new problems but where help is needed most urgently remains unknown.

"It is astonishing that, despite all the attention these issues have received over decades, the world has not even properly mapped water and sanitation problems," said Adeel.

UNU water experts are working with the World Health Organisation and others to develop a global sanitation mapping tool that will pinpoint the regions most in need of improvements. The Mekong Delta is the first region to be extensively mapped and results are currently being verified on the ground.

"We hope to have global mapping completed in two years time," Adeel said.

Sanitation remains somewhat of a taboo topic. No country is championing it, and none consider it a top priority. Not surprisingly, the success of this year's U.N. International Year of Sanitation is charitably called "mixed" by Adeel. There have been meetings and some increase in awareness but no direct responses nor major commitments by anyone.

The global "sticker price" to bring clean water and sanitation to those without is estimated to be 12 to 20 billion dollars a year -- not a huge amount of money considering that the United States just committed 700 billion dollars to bail out its troubled financial sector.

"Americans spend 22 billion dollars a year going to the movies. Europeans spend 12 billion on bottled water products," Adeel pointed out by way of contrast.

"Twelve to 20 billion dollars for clean water and sanitation for 2.5 billion people is not a lot of money in the grand scheme of things," he concluded.

(END/2008)

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