waterand sanitation- part 2

8/3/2019 Waterand Sanitation- Part 2

http://slidepdf.com/reader/full/waterand-sanitation-part-2 1/21

Chapter _ 3Lecture _ 1

Water management practices

and health economics

Part 2

IWRM and Health



The legacy of the Brundtland years

Health high on the international

political agenda, with a consistentfocus on ill-health-poverty links

WHO Commission on Macro-economics and Health: safe water and adequate sanitation among themost cost-effective interventions for

lasting health gains Combined GDP of countries in sub-

Saharan Africa would be US$100 billion more had malaria beeneffectively controlled 40 years ago



Some perspectives on water, poverty and health

Africa South of the Sahara has 10% of the global population, yet 24% of the global burden of disease

linked to environmental health determinants

Water supply and sanitation coverage reaches just over half the population; 60% of the rural population lacks

both

In 2000, communicable diseases constitute the singlelargest category in terms of DALYs lost: 73.2% upfrom 65.9 in 1990



Some perspectives on water, poverty and health

The 2000 Burden of Disease estimates related to

Environmental Health determinants stand at 103million DALYs lost (29% of total)

Further analysis by income group suggests that 55% of this burden affects the poorest fifth of the population,

andthat of this segment, 81% accrues to the rural poor



A clustered approach to reducing the environmental health risks to which the poor are exposed can accelerate a reduction in their burden of disease

The Top Three Environmental Health-related

Burden of Disease clusters areTotal EH BoD in Mn of DALYs lost

Total pop. Poorest 1/5

Vector-borne diseases 40.9 25.1

Water-related diseases 25.8 14.3

Respiratory infections 24.6 13.5



A clustered approach to reducing the environmental health risks to whichthe poor are exposed can accelerate a reduction in their burden of disease

The challenges:

To effectively include health as a parameter in decision

making in IWRM To strengthen environmental health component of

health sector programmes so they have capacity torespond to the needs in IWRM

To establish cross-sectoral compatibility in terms of

boundaries, scale and level of decision-making For professionals to learn to understand each other¶s

language and to trust and respect professionals fromother disciplinary backgrounds in an open dialogue



A combination of Burden of Disease estimates and cost-effectiveness

analyses can differentiate those water supply and sanitation interventionsthat give poor largest incremental health gains for least possible costs.

Recent WHO analyses to attribute

a disease burden to water,sanitation and hygiene risk factorsshow they account for:

2.1 million deaths each year

(3.9% of total) 76 million DALYs lost each year

(5.3% of total)




analyses can differentiate those water supply and sanitation interventionsthat give the poor largest incremental health gains for least possible costs.

Maximum health gains in absolute terms:

provide the most basic water supply services to those

who have no access at all provide water supply and sewage connection to

individual households

Most cost-effective interventions:

Disinfection at point-of-use through chlorinetreatment and safe storage vessels combined withlimited hygiene education

Targeting key behavioural change (hand washing)



Annual funding per intervention

world-wide (billions of US$)

1.3 1.49.1

17.8

77.2

-

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

Disinfection Halve pop w/o

access to WS

Halve pop w /o

access to

WS&S

Improved WS

& Sanitation

Piped WS &

Sewer

Connection




analyses can differentiate those water supply and sanitation interventionsthat give the poor largest incremental health gains for least possible costs.

The challenges:

IWRM should always have a Water Supply

and Sanitation component Burden of Disease and Cost-effectiveness

criteria need to be included in the decision-making about water supply and sanitation andin IWRM

Water supply and sanitation projects need tohave a component that documents Burden of Disease reduction and health gains



A significant part of the burden of disease of poor, vulnerable communitiescan be attributed to the way we develop water resources and manage them.



A significant part of the burden of disease of poor, vulnerable communities can be attributed to the way we develop water resources and manage them.

Ethiopia, Tigray: micro dams cause a seven-fold

intensification of malaria transmission intensity Senegal, Richard Toll: irrigated rice and sugar caneschemes cause the intestinal schistosomiasis prevalencerate to explode from 0 to 90%

Sri Lanka, Mahaweli System H: Japanese encephalitis

outbreaks due to irrigation extension combined with pig rearing



A significant part of the burden of disease of poor, vulnerable

communities can be attributed to the way we develop water resources and manage them.

Environmental management measures for health

protection and promotion are a cost-effective option provided they are included at the planning and designstage ± Environmental modification

capital intensive, lasting infrastructure works

± Environmental manipulationrecurrent environmental management activities with a potential for community participation





Environmental management: design options at zero extra costs (e.g. larger diameter

of outlets in dams)

operational options at zero extra costs (e.g. flushing,reservoir management)

options with dual benefits (e.g. alternate wetting anddrying as part of rice irrigation practice: improvedyields, less vectors, less methane)

capital investment in structural improvements (e.g.self-draining hydraulic structures, canal-lining, doublespillways for dams)





The challenges:

Include training on environmental management for

health in curricula of water professionals Promote best practice in integrated planning andmanagement of water resources (cf. WorldCommission on Dams)

Convince finance ministries that including health

safeguards in water resources development projects issound economics

Mobilise NGOs to adopt similar proceduresstrategically into their development activities



A review of water resources sector policies and programmes can help identifyopportunities to improve the health status of vulnerable communities.



A review of water resources sector policies and programmes can helpidentify opportunities to improve health status of vulnerable communities.

Ethiopia¶s Water Sector Development Programme ± By 2016:

Water supply :

Urban coverage increase 74 to 98%

R ural water supply coverage from 23 to 71%.

Irrigation :

Small scale irrigation adds ~ 127,000 ha. to current 200,000 ha.

R emaining expansion ~ 147,000 ha. will be medium and large scale.

Hydropower :

Six medium-scale, 15 small-scale hydropower plants completed;

63 medium-scale, 67 small-scale hydropower plants under development.



A review of water resources sector policies and programmes can help

identify opportunities to improve the health status of vulnerablecommunities.

Ethiopia¶s Water Sector Development Programme

An estimated US$7.5 billion will be needed over the next 15 years to achieve

the objectives contained in the programme.

The breakdown by sub-sector is :

water supply and sewerage extension 39%

hydropower capacity development 26%

irrigation development 23%water resources management 9%

institution/capacity building 3%



A review of water resources sector policies and programmes can help identifyopportunities to improve the health status of vulnerable communities.

The challenges:

Use policy and programme development in the water sector as anopportunity for capacity building in integrated thinking

Educate sectoral ministries that time invested in policy reviews

for health is time well-invested



Thank You

End ± Part 2

Part 2

IWRM and Health

waterand sanitation- part 2

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