(HEMA) Initiative. - OAS

PREVIOUS DOCUMENTS Estimating economic benefits of environmental health interventions within the context of the HEMA iniciative
aggregate annual increase in water and sanitation infrastructure and services by US$ 11 billion
above current expenditures results directly in economic benefits that exceed US$ 84 billion per
annum. Assumptions used in this conclusion include calculating the cost of delivery of
decentralized, less-capital intensive water filtration systems installed at the household-level. The
main economic benefit identified is a global decline in diarrheal disease by 10 percent.
The global cost of reducing by half the number of people currently without adequate access to
these services would be US$ 11 billion per year (until 2015), with a per capita annual cost of around
US$ 5. In other words, massive gains could be made with limited amounts of investment. 30
Large variations in the cost-effectiveness of various interventions (across health hazards and
within one type of hazard, such as urban air pollution) point to the need for rigorous analysis and
skillful design of environmental health projects to maximize health benefits in a cost-effective
manner. A recently completed World Bank study of water, sanitation, and health linkages in the
State of Andhra Pradesh in India provides probably the strongest data in support of this point. The
study found that costs per DALY saved from water supply and sanitation interventions vary
greatly, depending on a complex variety of factors, including but not limited to the sociodemographic
situation in a district, the urban or rural status of the community, sanitation
coverage, and type of service delivery. 31
3.1.1 Balancing Priorities through Integrated Policies
Poverty reduction, development, and growth targets hinge, to a large degree, on the extent to
which municipalities, rural communities, agricultural and industrial practices have predictable
access to clean water, adequate wastewater treatment, and sanitation services. Despite the MDGs,
commitments of the UN Commission on Sustainable Development, the World Water Forum, and
elsewhere, national ministries of agriculture, energy, transportation, as well as local authorities
and the private sector, still look for compelling argument to justify investments in clean drinking
water and wastewater treatment services as a core component of development. Numerous studies
show that scarce resources directed at the delivery of clean water, sanitation services and
wastewater treatment accrue direct and substantial economic and social benefit return.
The rationale of integrating water management with other policy areas -including agriculture,
ecology, energy, transportation, governance and public health- has been recognized for sometime.
Integrated water resources management (IWRM) is intended to overcome problems that arise in
the management of watershed basins as a result of bifurcated or uncoordinated policies such as
large-scale hydropower projects that create environmental pressures or input subsidies for
pesticides and agrochemicals, which lead to increasingly high sources of non-point pollution. The
Global Water Partnership (GWP) defines IWRM as a process intended to promote the coordinated
development and management of water, land and related resources.
For an urban water utility, IWRM implies that the utility's water management will be an integral
part of a broader regional or river basin management strategy. The integration of water resource
management should ideally take place across a number of different dimensions, including:
• Upstream management should be integrated with downstream management, so as to ensure
that downstream needs are considered when taking upstream decisions.
• Meeting one demand for water should be balanced against the opportunity costs of not
meeting others, so as to ensure that water is allocated efficiently and equitably.
• The use of water to bear away wastes should be balanced against the impacts this may have
on its capacity to meet other human and environmental demands.
• Managing supplies should be integrated with managing demands, so as to ensure that costly
additions to supply are not undertaken when there are less costly opportunities to reduce
demands.
Meeting of Ministers of Health and Environment of the Americas | 49