WHO and the IYS 2008

1. WHO and the IYS 2008 Roger Aertgeerts Regional Adviser, Water and Sanitation watsan@ecr.euro.who.int

2. Questions • What IS sanitation? • Why is it important to health? • How fares Europe? • Barriers to be overcome? • WHO actions • Conclusions WECF IYS 2008

3. What IS sanitation ? • XIXth century: the promotion of hygiene and prevention of disease by maintenance of sanitary conditions • XXth century: the collection, transport, treatment, and disposal or reuse of human excreta or domestic wastewater, whether through collective systems or by installations serving a single household or undertaking. • XXIth century: arrangements to protect public health, especially the provision of clean drinking water and the disposal of sewage. WECF IYS 2008

4. Why is sanitation important? • Human dignity • Health risk • Diarrhoeal diseases • Non-diarrhoeal diseases • Emerging diseases. • Environmental risk • Intestinal helminth infections • Skin and eye infections WECF IYS 2008

5. Preaching to the choir BUT is the choir reading the same hymn sheet ? • UN Water Conference in Mar del Plata 1977 • Water and Sanitation for All Decade 80s • UN Millennium Development 7/10 • International Year of Sanitation 2008 • Water for Life Decade • DID IT WORK? WECF IYS 2008

6. Sanitation in European Union (2004) • Total pop: 487 m • Urban pop: 364 m • House connection: 276 m (75.59%) • No house connection: 88 m (24.41%) • Rural pop:122 m • House connection: 64 m (53%) • No house connection: 58 m (47%) WECF IYS 2008

7. Sub-regional programmes • Barcelona Convention • Protocol on protection of the marine environment from land-based sources of pollution • Protocol on Water and Health • Article 6 on Targets and Target Setting • Children’s Environment and Health Action Plan for Europe - CEHAPE • Regional Priority Goal 1 WECF IYS 2008

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10. Looking forward to 2050 • Climate change: Function of sanitation end products in climate change adaptation strategy and integrated water management. • Tourism: Over 300 m arrivals each year. WECF IYS 2008

11. Water demand has doubled in the second half of the XXth century and is likely to increase by 25% . Renewable water exploitation index rapidly increasing expected to be 75% in Spain Temperature increase exceeding 5 C in summer at the end of the 21st century. Net decrease in precipitation in excess of 20 C on year basis with subsequent decrease in river flow and aquifer recharge. . Treated wastewater is a substantial and reliable source of water, with controllable health risks Wastewater to be reused should be judged by its quality, not its history Indirect potable reuse will be enforced by future circumstances, rather than being an option. Reuse of sanitation end products will need to be factored in as a normal component of IWM Climate change Sanitation is not stand-alone. Reuse of its end products, with due management of health and environmental risks; will need to be factored in as a component of any future WMP. WECF IYS 2008

12. Health risks • Contaminated sea food: transboundary movement of GI • Contaminated coastal recreational water: GI, skin and eye infections, VHA • Mucosesfrom contaminated sand • HARD solutions (plants) • SOFT solutions (laws, institutions, capacity building) WECF IYS 2008

13. Protocol on water and health WECF IYS 2008

14. Combined objectives DRINKING WATERQUALITY HEALTH OUTCOME LEGAL FRAMEWORK ENVIRONMENTALQUALITY WECF IYS 2008

15. Arguments for ratification • General: flexible soft law instrument • Bridging environment and health • National • Interdepartmental and intersectoral • Improved regulatory environment • Public participation • Regional • Long term European integration • Novel approaches prior to codification • Holistic approach vs. piecemeal legal approach • Global ? WECF IYS 2008

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18. Problem areas in the WHO EURO region EUR-B: • About 13 million people do not have access to water (12.2%) • about 18 million people do not have access to sanitation EUR-C: • about 9 million people do not have access to water (3.7%) • About 32 million people to not have access to sanitation WECF IYS 2008

19. CEHAPE Children’s specific needs • Country 1 • 16% of schools lacks locking or separate toilets • 21% has only intermittent water supply • 38% cannot afford soap • 96% cannot afford paper • Country 2 • School rely on wells that are not maintained and require sanitation programs. WECF IYS 2008

20. Barriers to action • National policy • Human behaviour • Perception and factual understanding • Poverty and economic barriers • Gender issues • Supply WECF IYS 2008

21. Arguments for policy-makers • Reduction of the global disease burden • National stability • Integrated water resource management • Economic arguments • Local action • Empowerment of women and minority groups WECF IYS 2008

22. Conclusions • Universal access remains a dream in the IYS • In rural areas in the European Union • More generally in the new countries • Sanitation is still often removal, but … there is no “away” to take waste to! • The scientific evidence base needs to be strengthened, notably by developing indicators and monitoring the impact of sewerage on health and environment. • More funding is needed for sanitation, especially in rural areas WECF IYS 2008

23. Conclusions • As peri-urban areas are likely to absorb most of city growth, special attention to sanitation in these areas is needed. • Funding should include O&M • Principle of subsidiarity in governance of water resources. • Promote use of available tools for cost benefit analysis of sanitation options at national and subsequently at lower levels of government. • Sanitation needs to be recognized as an integral part of WRM, and as an adaptation strategy to combat the effects of climate change. WECF IYS 2008

24. THANK YOU For more information please visit our website at: www.euro.who.int/watsan or via email at watsan@ecr.euro.who.int WECF IYS 2008