Water and public health

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Water and public health

• Roger Aertgeerts
• Regional Adviser, Water and Sanitation

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Water is a basic human right

• Three components
• Quantity sufficient and continuous for personal
  and domestic use
• Accessible physically, economically, and
  non-discriminatory access
• Quality microbiologically, chemically and
  radiologically safe

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Equity the human right to water

• An adequate amount of safe water is necessary to
  prevent death from dehydration, to reduce the
  risk of water-related disease and to provide for
  consumption, cooking, personal and domestic
  hygiene requirements.

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Availability, quality and accessibility

• (a) Availability. The water supply for each
  person must be sufficient and continuous for
  personal and domestic uses. The quantity of water
  available for each person should correspond to
  World Health Organization (WHO) guidelines.
• (b) Quality. The water required for each personal
  or domestic use must be safe, therefore free from
  micro-organisms, chemical substances and
  radiological hazards that constitute a threat to
  a persons health. Furthermore, water should be
  of an acceptable colour, odour and taste for each
  personal or domestic use.
• (c) Accessibility. Water and water facilities and
  services have to be accessible to everyone
  without discrimination, within the jurisdiction
  of the State party.

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Accessibility defined

• i. Physical accessibility water, and adequate
  water facilities and services, must be within
  safe physical reach for all sections of the
  population. Sufficient, safe and acceptable water
  must be accessible within, or in the immediate
  vicinity, of each household, educational
  institution and workplace. All water facilities
  and services must be of sufficient quality,
  culturally appropriate and sensitive to gender,
  life-cycle and privacy requirements. Physical
  security should not be threatened during access
  to water facilities and services
• ii Economic accessibility Water, and water
  facilities and services, must be affordable for
  all. The direct and indirect costs and charges
  associated with securing water must be
  affordable, and must not compromise or threaten
  the realization of other Covenant rights
• iii Non-discrimination Water and water
  facilities and services must be accessible to
  all, including the most vulnerable or
  marginalized sections of the population, in law
  and in fact, without discrimination on any of the
  prohibited grounds and
• iv Information accessibility accessibility
  includes the right to seek, receive and impart
  information concerning water issues.

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The WHO European region
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Access to water

• EUR-A
• Universal house connection
• EUR-B
• 84 have house connection, 95 of urban and 66
  of rural areas
• EUR-C
• 83 have house connection, 92 of urban and 56
  of rural areas

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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 pop122 m
• House connection 64 m (53)
• No house connection 58 m (47)

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Health determinants

• Quality of ingested water water borne (i.e.
  cholera and other diarrhoeal diseases)
• Quality of water used for hygiene water
  washed (i.e. trachoma)
• Disease vectors depending on the aquatic
  environment vector borne (malaria)
• Absence of water (physical scarcity, cost,
  inaccessibility) hygiene related (helminths,
  nematodes)

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Many diseases are water-related
18 000 premature deaths from diarrhoeal diseases
Global causes of diarrhoeal diseases ()
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Disease burden priority diseases
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Reducing diarrhoeal diseases - how

• Improving water supply 21
• Improving sanitation 37,5
• Hand washing up to 35
• Point of disinfection 45
• Piped water supply in the house 77

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Emerging diseases
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Disease burden secondary diseases
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Comparative burden of disease

• In 2005 were registered
• 13,000 cases of AIDS
• 22,000 cases of diarrhoeal diseases
• 82,000 cases of HIV, and
• 144,000 cases of viral hepatitis A

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Economic impact

• Economic impact is underestimated if it does
  not include
• Income lost
• Cost of medical care (GP, hospital)
• Cost of pharmaceuticals
• Cost of care giver
• Cost of lost productivity
• School days lost or schooling quality lost

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Reducing diarrhoeal diseases how much

• Meeting MDG
• Cost/benefit 3.40
• Annual cost (USD million) 71
• Annual benefit (USD million) 242
• Access for all to improved water and sanitation
  services
• Cost/benefit 6.55
• Annual cost (USD million) 143
• Annual benefit (USD million) 834

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Adapting to climate change can be hard work
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Climate change adaptation in the MED

• The WTO forecasts over 300 million arrivals each
  year in the Mediterranean region
• Climate change adaptation precipitation
  decrease will make every drop count

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Protocol on water and health
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How does the Protocol function?
Meeting of the Parties (MOP)
Bureau
Compliance Committee

• Task Force Surveillance
• Task Force Targets and Monitoring
• Working Group Water and Health

Joint Secretariat WHO UNECE
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THANK YOU