The Water and Sanitation Program - Environmental Health at USAID

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DRAFTThe economic cost of inaction on sanitation services goes beyond health and includesimpacts on water resources, land use, lost time, and tourism. A recent study by WSP hasestimated in four East Asian countries that the economic costs associated with inadequatesanitation range from 1.3% to as high as 7.2% of these countries’ respective GDPs, with percapita losses as shown in Figure 2.4.Figure 2.4: Economic losses due to poor sanitation35Economic losses (US$ per capita)302520151050TourismOther welfareEnvironmentWaterHealthCambodia Indonesia Philippines Vietnam• Enormous financing needs. A recent World Bank paper (Yepes et al., 2008) presentinginvestment needs for the water supply, sanitation and wastewater sector worldwide in ruraland urban areas indicates that the global need between 2008 and 2015 would be about $109billion over the period. Of this total, the lower income countries account for $53 billion, thelow-middle income countries $50 billion, and the upper middle countries only $7 billion. Thestudy shows that investments needed vary widely across regions. Sub-Saharan Africa andSouth Asia require the largest investments as a share of GDP (2.0 % and 1.7 % of thecontinents’ respective GDPs). For urban sanitation, investment needs amount to a combinedtotal of $29 billion. In rural water and sanitation, Sub-Saharan Africa and South Asia haveconsiderably higher needs than other regions ($10.4 billion and $5.6 billion, or 0.59 % and0.57 % of their respective GDPs).There is a clear need to step up investment programs. However, additional funds forsanitation are not enough. The quality and equity of spending are equally important. Thanksto recent reforms in the sanitation sector, a number of developing countries are in a positionto use and leverage additional funds effectively. The changing aid architecture, includingnew donors, as well as new modalities of aid (such as output-based aid), can lead to moreresources and effective innovation, but also puts forward new challenges to achieveeffectiveness and coherence.• Need for more sustainable solutions. A large proportion of investments in the sector gotowards ineffective uses, including:o Highly subsidized latrines that are used for other services6
DRAFTo Ineffective solutions purchased by households who do not have access to a broadrange of optionso Extension of sewerage networks without the commensurate rates of connectionsfrom householdso Wastewater treatment plants that are not operated, or even when operated, do noteffectively benefit the environment due to the existence of other pollution sourcesof greater importance.Rapidly changing new technologies bring new opportunities to change the developmentparadigm and to provide new responses to development challenges. The sanitation sectorhas unfortunately not seen the same impressive technological development of othersectors (such as the expansion of mobile phone technology and internet access).However, it will be critical to bring in new membrane technologies, innovative paradigmsfor non-water based sanitation systems, decentralized treatment (particularly for therapidly expanding peri-urban areas of large cities), new bio-treatment for small towns,and radically different approaches to reduce sludge generation from basic solutions,among many others.3. Experiences of WSP in Sanitation3.1 Evolution of Areas of Focus in SanitationSince its establishment 30 years ago, WSP has gone through three phases of support of thesanitation sector. The 1980s were characterized by an emphasis on engineering technologies,with specific focus on low-cost technologies, including the Ventilated Improved Pit (VIP),SanPlat (plastic latrine slabs), and pour flush latrines, among others. The hypothesis at the timewas that upgrades in technological innovation and their dissemination in developing countries —through a top-down and heavily subsidized infrastructure approach — was the key trigger torapidly expand access to sanitation.In the 1990s, WSP changed its focus to more strategic approaches and greater involvement in thefocus to bottom-up and community-driven options. Some of the tools used during that decadeincluded Strategic Sanitation Planning, a strong emphasis on condominium systems, and thedevelopment, testing and replication of the Participatory Hygiene and Sanitation Transformation(PHAST). This decade also saw a clear emphasis on integrated solutions that included watersupply and sanitation, rather than the traditional focus on water supply first (assuming sanitationwould follow later on which rarely happened). During that decade, about five technologiescontinued to be considered acceptable and there was an inherent, if not explicit, requirement ofminimum technical standards for sanitation. The state was seen as the main provider of sanitationinfrastructure and subsidies, with NGOs being promoters of sanitation and hygiene, generally atthe household level and through labor-intensive PHAST approaches. At that time, sanitation wasnot in the original list of MDG targets.Over the last five years, the importance given to sanitation development in WSP’s projects hasbeen steadily increasing, reaching 46% of its annual budget in 2008 (Figure 3.1). For the firsttime, the proportion of the WSP’s budget dedicated to sanitation is larger than the one dedicatedto water supply (33%).7
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Page 19 and 20: DRAFT• Scaling up Change at Local
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