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Water Supplies (Developing World)

Volume 520: debated on Wednesday 15 December 2010

Motion made, and Question proposed, That this House do now adjourn.—(Miss Chloe Smith.)

After many years of campaigning on water, sanitation and hygiene, I am grateful for this opportunity to debate the topic. Far too many people in the world lack safe clean water. Globally, just short of a billion people struggle without access to it. That is more than the population of Europe. In places such as Zambia, Ethiopia, Tanzania and Mozambique, I have seen personally that when clean water is not available there are minimal opportunities for good health, gaining an education, looking after crops or animals, or developing a business. If a major part of the day is taken up with walking many miles to collect water, there is no time for a child to get an education, and no time for a parent to earn a living.

Similarly, far too many people do not have decent sanitation or hygiene provision. The figures are frightening. Whereas the number of those who lack safe water is dreadful, 2.6 billion people go without access to decent sanitation. That is twice the population of China. Without decent sanitation or hygiene, the chances of a healthy life are minimal. Diarrhoea is the biggest child killer in Africa. On that continent alone, almost a million children aged under five died from diarrhoea in 2008. Worldwide, some 1.3 million infants die as a result of diarrhoea every year. Ninety per cent. of those cases are down to inadequate sanitation, unsafe water or poor hygiene.

It is clear to me that one of the most important ways in which we can help the poorest people in the world is by providing support in the areas of water, sanitation and hygiene, collectively referred to as WASH. Many of the other targets of our aid provision—education, agriculture, business development and health—need, as a starting point, people to have access to decent water, sanitation and hygiene.

I have seen at first hand the impact that help with those facilities can make. I have seen, for example, a health clinic in the bush in Ethiopia that was almost deserted because of the improvements in the health of local people following the installation of water pumps in local villages. In many other places I have seen the impact of the excellent work done by the UK-based charity WaterAid. I have even done a bit of well building for it in Zambia.

I thank the hon. Gentleman for introducing a debate on this important subject, on which I support him. I have to declare an interest: my father spent his entire professional career as a water engineer, building and maintaining water and sanitation projects both in the UK and in many countries abroad. Does the hon. Gentleman agree that if we are to ensure the sustainability of projects in the developing world such as those provided by WaterAid, it is essential that community groups and church groups on the ground are trained to maintain the projects commenced by voluntary organisations and ensure their continuity?

The hon. Lady is absolutely right. Like me, she has probably seen examples of totally unsustainable aid development. In Zambia I once saw a brand-new fire engine that had been donated to Lusaka urban district council by another country. Within 24 hours nobody could use the fire engine, because its engine was designed to use a fuel that was not available in Zambia. I have seen video recorders provided by other countries with videotapes in a language that was not understood by the population. She is right: there is no point in installing a water pump without involving the villagers in learning how to maintain it and ensuring that they will be able to get parts for it. They can possibly even go further by making a small charge for the water from the pump, so that there can be paid attendants to ensure that it is well looked after and serviced, and the project is sustainable. I agree that involving local people is critical.

As I said, I have seen some excellent work by WaterAid, but many other charities such as Tearfund and Pump Aid work in the field and deserve our praise. Given the importance of that aspect of the UK’s aid work, I was pleased by the Government’s promise in the coalition agreement, which stated:

“A key aim of our aid is to make sure everyone gets access to the basics: clean water, sanitation, healthcare and education.”

Those words are encouraging, but delivering that aim will not be easy.

One of the United Nations millennium development goals is to halve, by 2015, the proportion of the world’s population without sustainable access to safe drinking water and basic sanitation. Sadly, that goal is not going to be met. According to a UN report this year, the number missing out on proper sanitation will actually grow to 2.7 billion by 2015, if current trends continue. Although the safe water target is on track globally, there are parts of the world where it will be missed by miles, not least in sub-Saharan Africa, where it is predicted that 350 million people will remain without access to safe water.

The UN report says:

“the safety of water supplies remains a challenge and urgently needs to be addressed.”

That warning becomes even more pressing in the context of climate change. The problem is not just hotter weather, causing more frequent droughts that in turn limit access to water. Climate change also disrupts weather patterns, resulting in more frequent and powerful floods. Flooding leads to overflowing latrines, contaminated drinking water, waterborne diseases such as cholera and all kinds of other sanitation problems. The problem is extremes of water shortage and water excess, and that problem will intensify as climate change continues to progress. That is part of the reason why we need to do even more.

Rather than discuss the work of my right hon. Friend the Secretary of State for Energy and Climate Change and his Department, however, I wish to concentrate on what I believe the Department for International Development can do. In recent years water and sanitation have not been given the priority that I would wish them to have. As a proportion of the UK’s aid budget, spending on water and sanitation has dwindled to just 2.2%, yet if I am right, and if water and sanitation are a vital plank in delivering all our aid goals, increasing the proportion of aid money dedicated to them would be money well spent. WaterAid made that argument powerfully in its recent submission to the Department—

Motion lapsed (Standing Order No. 9(3)).

Motion made, and Question proposed, That this House do now adjourn.—(Miss Chloe Smith.)

The argument was well made by WaterAid, and I hope the Minister has had a chance to read its submission. It considers each of the millennium development goals in turn in the context of WASH.

The first goal is to eradicate poverty. The World Health Organisation estimates that for every £1 invested in WASH, £8 is generated. That is because people save time on water collection, so they can be more productive, and WASH provision limits the number of days lost to illness.

The second goal is universal primary education, but children who are busy fetching water do not have time to go to school. The education of young girls ends up suffering the most, as that task more often than not falls to them. Sanitation also has a role to play in education. Dedicated girls’ toilets and menstrual hygiene facilities are important in making schools accessible for older girls.

DFID already knows that. It published a girls’ education strategy in January 2005, which prioritised

“non-education programmes such as clean water supply and sanitation facilities”.

There were two updates on implementing this strategy—the first in December 2006 and the second in July 2009—but when I asked the Library for further reports, I came away empty-handed. I therefore hope that the Minister can tell us what progress has been made in the year and a half since the second report was published, and that he confirms that the education of girls still an important part of his Department’s programme—which brings me neatly to MDG 3, which is to promote gender equality and empowerment.

Seventy-two per cent. of water fetching is done by women and girls. The task takes up an average of 14 hours a week—I have seen it take very much longer—and distracts girls and women from education and other potentially productive activity, such as building their economic independence. That is a significant barrier to gender equality.

The fourth goal is to reduce child mortality rates. As I have already said, diarrhoea is the biggest child killer in Africa, and 90% of cases are caused by inadequate sanitation, unsafe water and poor hygiene. Poor water quality will always undermine our investment in health. We would be horrified if our own local clinics had only dirty water coming out of the taps, or if the only water available for swallowing medication was contaminated.

Clean water is a fundamental part of health, including maternal health, which is the subject of MDG 5. WASH poverty causes the most significant health risks for women. A hygienic environment for childbirth and post-natal care will increase the survival chances of mothers and newborns.

Finally, MDG 6 is to combat HIV/AIDS and other diseases. HIV/AIDS patients require more water—up to five times as much as normal water consumers—because the most common diseases caused by AIDS are diarrhoeal and skin-related. My point is not that MDG 7 and the water and sanitation goals that I mentioned earlier should be prioritised at the expense of all the others. Rather, I believe that prioritising WASH will increase our chances of delivering on both the UK’s aid pledges and the MDGs. Until we fund WASH better, our investment in health and education will be less effective: the money will only ever achieve a part of what it could otherwise achieve.

Some progress has been made. Spending on WASH has gone up slightly in recent times, and we recently became part of the Sanitation and Water for All international global partnership. I look forward to a progress report. However, that will not be enough without more UK investment, so I am calling for two things. First, by reordering or rebalancing priorities, the Department should increase the sum spent on water, sanitation and hygiene to £600 million per annum. That would lift 100 million people out of water, sanitation and hygiene poverty.

When Governments are looking to make a real difference, they invest in huge infrastructure projects. One of the challenges that they face in doing that—as opposed to what happens when charities invest smaller amounts in, say, village wells—is to ensure that the governance of those involved in partnering in those projects is sound. I would be interested in hearing the Minister’s response to that point, but does the hon. Gentleman agree?

I entirely agree. Indeed, with the work that I have seen, particularly in Africa, I have been incredibly impressed by the way in which the various charities involved work with local communities, empowering and involving them, before ultimately moving away and leaving those local community organisations to run by themselves what has been put in place. That is important.

The hon. Lady talks about large sums, and that is the crucial point that I am trying to make. We welcome the increase in the aid budget—I will mention that briefly in my summation—but I am talking about reprioritising that money. For example, we have just increased the amount of money used to tackle malaria by £500 million. That may seem like an enormous sum going to do something important, but we know that diarrhoea causes more deaths than malaria, HIV/AIDS and tuberculosis combined, and as I said earlier, 90% of cases are caused by poor water, sanitation and hygiene. Therefore, the £600 million that I am arguing for to lift 100 million people out of that situation would be money well spent.

Secondly, water, sanitation and hygiene issues need to be mainstreamed into our wider development, public health and poverty reduction efforts. Again, that will require a big shift in thinking. We are still trying to break down the divide between sanitation and water, which is hard enough. For instance, DFID’s business plan promises that regular reports will be published on the number of sanitary facilities built or upgraded with DFID funding. Those extra data will no doubt be useful, but that promise indicates something of a silo mentality. We should not be thinking in terms of either water or sanitation. That is why I am asking for enough money to bring those things together.

However, I also think that we should go further. Such issues should become an important part of our strategies for dealing with infant mortality, maternal health and other global issues. Departmental advisers working on water and sanitation should be properly linked to colleagues working on health or poverty reduction. We should be breaking down the sectoral divides that still exist in the aid world. In all, we need a truly integrated approach—for instance, by ensuring that new schools are always built with suitable hygiene and sanitation facilities; or, as the hon. Member for Congleton (Fiona Bruce) suggested, by recognising the importance of transparency and accountability when a Government make decisions about major capital projects and services, such as their water systems. All that depends on facilitating and encouraging better co-operation between those in different sectors.

All of us in this House should be proud of the way in which our country contributes directly, and through international organisations, to help alleviate poverty and ill health in some of the poorest countries in the world. We should be proud of our commitment to increase further the money spent on aid. However, we need to ensure that we get the best possible value for that money. We need to ensure that the way in which it is spent provides the best possible route towards the reduction of poverty and ill health. That can best be done by rebalancing our aid budget in favour of water, sanitation and hygiene. A modest change in that area would reap huge rewards. I hope that my right hon. Friend the Minister agrees.

I am grateful to my hon. Friend the Member for Bath (Mr Foster) for raising this topic. Achieving the millennium development goals, including the two vital targets on clean water and improved sanitation, is at the very heart of the coalition’s agenda on international development. I recognise and respect his interest in water and sanitation, and in particular his high regard for WaterAid, which we, too, consider a valued partner in our work.

Speaking personally, I am also convinced of the importance of water, sanitation and hygiene. In Hoa Binh province in Vietnam, I have seen how these simple interventions can make a remarkable difference to people’s health and opportunities. One local woman showed me the new latrine in her garden that had vastly improved her life, and told me that she had pinned up a hygiene advice sheet in her house to educate her whole family. I have also inspected at close quarters some latrines—of variable quality, I have to say—in rural Bangladesh. Indeed, I am proud to say that I am fast becoming something of a ministerial latrine expert. I commend to the House the UNICEF booklet entitled “Low-cost latrine options”, which contains an encyclopaedic list of various designs, including the Blair pit latrine. Known as a VIP latrine, it is a ventilated, improved pit, designed and used, as it happens, in Zimbabwe.

Furthermore, I am proud that the United Kingdom is the first country in the G20 to set out how we will meet our promise to spend 0.7% of our gross national income on aid from 2013. This also places a serious responsibility on us to use the money well, and water, sanitation and hygiene fit squarely within that agenda. Each pound of taxpayers’ money in this area can bring direct, tangible benefits for poor people. As many will know, we are currently reviewing all our bilateral and multilateral aid. I cannot therefore make any detailed announcements on numbers today, but we have a high level of ambition in this area and my right hon. Friend the Secretary of State has already stated in the House that we know we will support tens of millions of people in gaining access to sanitation over the next four years.

Today I can outline seven principles of how we, the British Government, will respond to this global crisis. First, we will ensure excellence in our Department for International Development country office programming. A vital part of our efforts will be through our bilateral programmes. Our current programmes in Bangladesh will affect up to 30 million people by 2011. Our current programmes in Ethiopia, Sierra Leone, the Democratic Republic of the Congo and Nigeria will provide up to 17 million people with access. We will also be making new commitments under the bilateral aid review. We will of course ensure that there are sufficient and qualified staff in DFID country offices to deliver our programmes. There will be close co-ordination with our climate change work, including work on water management, and we will continue to ensure an excellent humanitarian response, dealing with issues of water storage, water supply, health care in emergencies and cholera pandemics.

Secondly, we will link our work on water, sanitation and hygiene especially closely with our work on health. We cannot achieve other key millennium development goal targets in the absence of action on something as fundamental as basic water supply, sanitation and hygiene promotion. Recent articles in the Public Library of Science medical journal, launched last month by the Under-Secretary of State for International Development, my hon. Friend the Member for Eddisbury (Mr O’Brien), conclude that 2.4 million deaths each year could be prevented if people had adequate access to hygiene, sanitation and drinking water. They emphasised, as has my hon. Friend the Member for Bath, that diarrhoea is the biggest killer of children in Africa, with about 4,000 under-5s dying every single day. Yet simply washing hands with soap can reduce the risk of diarrhoeal diseases by 42% to 47%.

This issue was once much closer to home. It was John Snow who, in London in 1854, first traced a cholera outbreak to a contaminated water source in Broad street in Soho. This very institution of Parliament was brought to a standstill in 1858 by the “great stink” of inadequate sanitation. In 1862, Florence Nightingale, through her meticulous statistical analysis, showed that high death rates in the British Army in India were actually due to poor water, sanitation and hygiene. Today, globally, we must follow in the great British tradition of investing strongly in water, sanitation and hygiene to deliver the health gains that we need. Clearly, as diarrhoea is today the main killer of children in Africa, we cannot achieve the MDG on child mortality without that, and the evidence shows it will also play a major role in improved nutritional status, as well as reductions in pneumonia, maternal and neonatal infections and preventable blindness. So we will complement and co-ordinate our direct actions on health, and our sizeable new commitments on malaria, reproductive and maternal health, with substantial and closely linked actions on water, sanitation and hygiene.

Thirdly, we will increase our focus on gender and disability. Currently in the developing world, too much time is wasted, day in and day out, collecting water. That time could be spent in other productive, caring or educational activities. Women lose out most, as they are twice as likely to fetch water and they also face indignity, and often the risk of violence, because of a lack of sanitation facilities. Clean toilets in schools can contribute to keeping girls in school, and that alone is a reason to take action. Standard designs for water and sanitation may be inaccessible for people with disabilities, but simple modifications can solve that. They can reduce stigma and the burden of care, and increase dignity and social integration. So we will support innovation and scaling up of what works, to benefit women, girls and people with disabilities.

I have already alluded to the fourth principle: ensuring cost-effectiveness and value for money. Water, sanitation and hygiene are among the most cost-effective health interventions, according to the World Bank and the World Health Organisation. Hygiene promotion comes out as just $5 per disability-adjusted life year, known as DALY, averted—a measure of the impact of the intervention on reducing sickness and death. Sanitation promotion is also within the top 10 interventions, at $10 per DALY. We will work to ensure that whether we are working through multilateral, non-government or Government partners, we further improve the value for money we are achieving with UK taxpayers’ money.

Fifthly, we will directly empower communities and help them to hold their Governments to account. The community-led sanitation programmes which the UK and others have supported, first in Bangladesh and now spreading rapidly in Asia and Africa, have shown the powerful influence of shared action. Once communities start to work together on ensuring latrines and hand-washing for all, not just the few, experience shows that they go on to work together in addressing other problems. Natural community leaders emerge and they gain confidence to do more.

We have also been supporting citizens to hold their own Governments to account. We fund a global network of southern civil society organisations, the Freshwater Action Network, in south Asia and Africa. Local groups, for example, are carrying out citizen audits to investigate whether there are latrines in schools and presenting the findings to their local Governments. Lessons on what works are being shared via the global network. The network is also taking part in regional intergovernmental conferences, bringing the views of poor people who are demanding water and sanitation directly to the decision makers, and we will continue to support and develop such innovative and empowering approaches.

The sixth principle is that we will build further evidence and test innovative approaches. We will keep building evidence regarding both the cost-effectiveness of our interventions and what really works at scale. The British Government are funding the largest research programme in the world on sanitation and hygiene in the developing countries—the SHARE consortium—bringing together leading researchers and practitioners. We are supporting a major trial in Zimbabwe, examining the link between sanitation and nutrition. Not having latrines and not washing hands can cause intestinal infections and long-term malabsorption of nutrients, and so damage the long-term growth and development of children. This research is potentially vital to achieving global targets on nutrition. We will also investigate how we can use the entrepreneurship of the local private sector for providing and maintaining water supplies. The results from these will not just inform our programming but that of other donors too and, most importantly, the investments and policies of developing countries themselves.

Finally, we will work with others in the sector to ensure a collective response to this global crisis. We know it is possible to achieve results at scale: 1.3 billion people have gained access to sanitation since 1990, but particularly in Africa our collective efforts and resources have still not been enough.

The sanitation MDG target is likely to be missed by 1 billion people, and Africa is off-track for both water and sanitation. The UK is already the largest donor to basic water and sanitation systems in low-income countries. These simple systems reach people in rural and peri-urban areas where there are the lowest levels of coverage, and so are targeted well to the poorest people. Globally however, aid to basic systems has declined from 27% to just 16% of aid in the sector over the last five years, and only 42% of the sector’s aid goes to low-income countries. I am pleased that DFID supports an annual report, known as the GLAAS report and produced by UN-Water and the World Health Organisation, giving a global picture of how aid to water and sanitation is allocated. That will help us to hold each other to account, and assist better targeting in the future.

We must be realistic. We alone cannot solve all the problems. We also need others to play their part in focusing aid resources on the people who need them most, and this is not just about aid. Developing country Governments have the leading role to play in ensuring action on water and sanitation, backing it with their own policies, programmes and resources. In this way, donors can support countries to achieve their own targets in the way that they want.

Sometimes, however, there is not the political will or capacity to develop credible investment plans. We will therefore work closely with all our partners in the sector to solve this global crisis together, including through the UK leadership role in the sanitation and water for all initiative, where we are at the forefront of helping to address some of these wider issues. This global partnership of 31 developing countries, six donor countries, nine multilaterals and development banks and countless southern and northern civil society networks has come together with the common goal of ensuring both results on the ground and accountability in respect of them. The sanitation and water for all initiative has already achieved changes that should lead to improved results in Ghana, Burkina Faso, Senegal and other countries.

We will find new ways to work jointly with other donors. Specifically, we are looking for ways to enable fragile states, and those that are most off-track on the targets, to develop the capacity and plans to ensure access to water, sanitation and hygiene. It is imperative that we find ways for these countries to attract and use the finance for achieving results at scale.

The British Government know how important this agenda is, and we have a clear picture of the needs. We are ready to play our role in a global effort, complementing our leading role on health. In the coming weeks, we will finalise our commitments across the board and our policy support to this vital area. I can already confirm, however, that the Government have great ambition in water, sanitation and hygiene, and that that will continue to be an important part of DFID’s business.

Question put and agreed to.

House adjourned.