Global Access to Clean Drinking Water and Sanitation: U.S. and International Programs
Congressional research reportSep 10, 2012
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Global Access to Clean Drinking Water and
Sanitation: U.S. and International Programs
/name redacted/
Specialist in Global Health
September 10, 2012
Congressional Research Service
7-....
www.crs.gov
R42717
CRS Report for Congress
Prepared for Members and Committees of Congress
Global Access to Clean Drinking Water and Sanitation: U.S. and International Programs
Summary
According to a 2012 report released by the World Health Organization (WHO) and the United
Nations Children’s Fund (UNICEF), roughly 780 million people around the world lack access to
clean drinking water and an estimated 2.5 billion people (roughly 40% of the world’s population)
are without access to safe sanitation facilities. The United States has long supported efforts to
improve global access to clean water, sanitation, and hygiene (WASH). In 2000, for example, the
United States signed on to the Millennium Development Goals, one of which includes a target to
halve the proportion of people without access to safe drinking water and basic sanitation by 2015.
In 2002, the United States also participated in the 2002 World Summit on Sustainable
Development, which emphasized the need to address limited access to clean water and sanitation
among the world’s poor. The 109th Congress enacted legislation to advance these global goals
through the Senator Paul Simon Water for the Poor Act of 2005 (P.L. 109-121 [Water for the Poor
Act]). In March 2012, the U.S. Agency for International Development (USAID) announced that it
had joined the Sanitation and Water for All partnership—a coalition of governments, donors, civil
society and development groups committed to advancing sustainable access to clean drinking
water and sanitation.
Congressional support for the act was motivated, in part, by calls to augment funding for WASH
programs and improve the integration of WASH activities into broader U.S. foreign aid objectives
and programs, as well as global health efforts. The act called for USAID to bolster support for
WASH programs, further synthesize WASH activities into global health programs, and contribute
to global goals to halve the proportion of people without access to clean water and sanitation by
2015. In the 111th Congress, the Senator Paul Simon Water for the World Act of 2010 was
introduced, but not enacted. That bill would have amended the Water for the Poor Act and
addressed several concerns observers raised regarding the Water for the Poor Act, particularly by
creating senior leadership within USAID to address water and sanitation issues, assessing U.S.
water and sanitation programs, and strengthening reporting requirements. A new bill, introduced
in the 112th Congress as the proposed Water for the World Act (S. 641), awaits action by the
Senate Committee on Foreign Relations.
Several agencies contribute to U.S. efforts to improve global access to clean drinking water and
sanitation, of which programs implemented by the Millennium Challenge Corporation (MCC)
and USAID make up roughly 90%. In FY2010, for example, the United States invested $953
million on water and sanitation programs worldwide, including $898 million provided by USAID
and MCC. Appropriations for water projects are provided to USAID annually, while MCC
receives multi-year funding for its country compacts that include support for water projects. As
such, spending by MCC on water projects may vary significantly from year to year and may not
be requested annually.
The President requested $302 million for USAID’s water activities for FY2012 and Congress
appropriated not less than $315 million for international water and sanitation programs through
the FY2012 Consolidated Appropriations. The FY2013 request for USAID’s water and sanitation
efforts was slightly lower at $299.1 million. This report addresses congressional efforts to address
limited access to clean drinking water and sanitation, outlines related programs implemented by
USAID and MCC, and analyzes issues related to U.S. and international drinking water and
sanitation programs that the 112th Congress might consider.
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Global Access to Clean Drinking Water and Sanitation: U.S. and International Programs
Contents
Introduction...................................................................................................................................... 1
Background...................................................................................................................................... 2
Global Access Rates to Clean Water and Sanitation........................................................................ 6
Clean Water ............................................................................................................................... 8
Sanitation................................................................................................................................. 10
International Spending on Water and Sanitation............................................................................ 12
Water and Sanitation Funding Needs ...................................................................................... 13
Congressional Actions ................................................................................................................... 13
U.S. Foreign Assistance for Water and Sanitation ......................................................................... 14
U.S. Progress in Meeting Clean Drinking Water Targets ........................................................ 15
Water for the Poor Act, Implementing Agencies ..................................................................... 16
U.S. Department of State................................................................................................... 17
U.S. Agency for International Development ..................................................................... 17
Distribution of USAID WASH Resources, FY2006-FY2010........................................... 19
Millennium Challenge Corporation .................................................................................. 20
U.S. Global Water and Sanitation Efforts: Issues .......................................................................... 21
Clarifying Roles and Responsibilities and Authorizing Funding ............................................ 21
Balancing Funding Between WASH and Other Water Areas .................................................. 22
Balancing Regional Investments ............................................................................................. 22
Ensuring Accuracy of Data...................................................................................................... 24
Sustainability/Prioritizing Operations and Management......................................................... 24
Summary of Key Issues ................................................................................................................. 25
Figures
Figure 1. WASH Terminology ......................................................................................................... 4
Figure 2. The Water, Sanitation, and Poverty Cycle ........................................................................ 6
Figure 3. Progress Toward MDG Water and Sanitation Targets, 1990-2015................................... 7
Figure 4. Global Access to Clean Water, 2010 ................................................................................ 9
Figure 5. Global Access to Sanitation, 2010.................................................................................. 11
Figure 6. ODA Commitments and Disbursements, 2005-2010 ..................................................... 12
Figure 7. Number of People Who Gained Improved Access to Drinking Water and
Sanitation Through U.S. Programs, 2010 ................................................................................... 16
Figure 8. USAID Obligations on WASH Activities, FY2006-FY2010 ......................................... 19
Figure 9. USAID Water & Sanitation Obligations by Country, FY2010....................................... 20
Figure A-1. Water and Sanitation Access in Sub-Saharan Africa, 2004-2009............................... 28
Figure F-1. Access to Drinking Water & Sanitation, High Priority Countries, FY2009 ............... 36
Figure G-1. Number of People Who Gained Access to Water and Sanitation by Region,
1990-2010................................................................................................................................... 39
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Global Access to Clean Drinking Water and Sanitation: U.S. and International Programs
Tables
Table 1. Top Five Donor Countries for Water and Sanitation, 2005-2010 .................................... 13
Table 2. Number of People in Target Areas with First-Time Access to Improved Drinking
Water Supply as a Result of U.S. Assistance, FY2006-FY2012 ................................................ 15
Table 3. USAID Areas of Support for the Water Sector ................................................................ 18
Table 4. USAID Obligations for Water by Sector, FY2004-FY2012 ............................................ 18
Table B-1. Official Development Assistance Commitments for Water and Sanitation ................. 29
Table E-1. MCC Water and Sanitation Compacts, 2006-2008 ...................................................... 34
Table G-1. Explanation of Water Person Years.............................................................................. 38
Appendixes
Appendix A. Water and Sanitation Access in Sub-Saharan Africa, by Wealth and
Residence, 2004-2009 ................................................................................................................ 28
Appendix B. Official Development Assistance Commitments for Water and Sanitation,
2005-2010................................................................................................................................... 29
Appendix C. Summary of S. 641, The proposed Water for the World Act of 2011....................... 31
Appendix D. Description of USAID and State Department Accounts .......................................... 33
Appendix E. MCC Water and Sanitation Compacts by Country ................................................... 34
Appendix F. Access to Drinking Water & Sanitation, High Priority Countries, FY2009.............. 36
Appendix G. Measuring and Evaluating WASH Programs: Challenges........................................ 37
Contacts
Author Contact Information........................................................................................................... 40
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Global Access to Clean Drinking Water and Sanitation: U.S. and International Programs
Introduction
Tainted water and unsanitary practices are at the root of many health problems in the developing
world and are hindering U.S. and international global health efforts. Congressional interest in
combating this problem is strong, evidenced by the passage of P.L. 109-121, The Senator Paul
Simon Water for the Poor Act of 2005 (Water for the Poor Act). The law amended the Foreign
Assistance Act of 19611 to make the provision of “affordable and equitable access to safe water
and sanitation in developing countries” a U.S. foreign policy priority. The act also called for U.S.
agencies to work toward halving the 2009 level of people without access to clean drinking water
and sanitation by 2015. Key provisions of the law
•
direct the Secretary of State, in consultation with the U.S. Agency for
International Development (USAID) and other implementing agencies, to
develop and implement a strategy that boosts access to safe drinking water and
sanitation;
•
require the Department of State to report annually on U.S. efforts to expand
global access to clean drinking water and sanitation; and
•
urge USAID to raise resources for and attention on water and sanitation, and
better integrate water, sanitation, and hygiene (WASH) activities within global
health efforts.
Congressional support for the legislation was motivated, in part, by concerns that the United
States had not given WASH programs sufficient priority and that these efforts needed to be better
aligned with U.S. foreign aid programs, particularly global health efforts.2 Support for the act was
also tied to previously established commitments by the United States to support attainment of the
Millennium Development Goals.
The Obama Administration continues to demonstrate support for advancing access to clean water
and sanitation. On World Water Day in March 2010, Secretary of State Hillary Clinton pledged to
elevate water issues and later called on Under Secretary for Democracy and Global Affairs Maria
Otero and USAID Administrator Rajiv Shah to
•
spearhead U.S. efforts to address water issues;
•
develop a comprehensive approach to addressing water-related challenges;
•
identify areas of investment that can deliver sustainable, measurable results; and
•
maintain a long-term perspective on solving water-related issues.3
In March 2012, USAID announced that it had joined the Sanitation and Water for All (SWA)
partnership—a coalition of governments, donors, civil society, and development groups
committed to advancing sustainable access to clean drinking water and sanitation.4
1
22 U.S.C.A. §2151.
See H.Rept. 109-260.
3
Hillary Clinton, "Secretary of State," Remarks at National Geographic Society, Washington, DC, March 22, 2010.
4
USAID, "USAID Joins Global Water and Sanitation Partnership," press release, April 20, 2012,
(continued...)
2
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Global Access to Clean Drinking Water and Sanitation: U.S. and International Programs
Generally speaking, water-related efforts can be grouped into three areas: water supply,
sanitation, and hygiene (WASH), water resource management, and water productivity.5
•
WASH activities are aimed at addressing the health consequences of inadequate
access to clean drinking water and sanitation.
•
Water resource management programs promote policy and legal reforms, build
local capacity, and strengthen water resources planning, management, and
governance.
•
Water productivity projects seek to make water use more efficient for the
preservation of water reserves, and reduce pollution and other threats to water
quality for the protection of water supplies.
This report focuses on bilateral WASH schemes authorized by the Water for the Poor Act. These
programs are monitored and reported by the Department of State and implemented primarily by
USAID and the Millennium Challenge Corporation (MCC). In FY2009, USAID and MCC
accounted for roughly 90% of all U.S. spending on the issue.6 Broader water-related efforts
supported by other U.S. agencies and departments7 are not addressed, nor are water and sanitation
efforts implemented by a variety of international actors—including multilateral groups like the
World Bank, private businesses like Procter and Gamble, and foundations like the Bill & Melinda
Gates Foundation. This report identifies some issues that donors and U.S. agencies face while
carrying out global drinking water and sanitation projects.
Background
Roughly 780 million people lack access to clean drinking water and some 2.5 billion people are
without adequate sanitation facilities.8 The World Health Organization (WHO) estimates 6.3% of
all deaths are caused by limited access to
•
safe drinking water;
•
improved sanitation facilities and hygiene practices; and
•
water management practices that reduce the transmission of water-borne
diseases.9
According to the United Nations (U.N.), more than 14,000 people die daily from water-borne
illnesses.10 The bulk of these deaths are related to a number of infections, including
(...continued)
http://www.usaid.gov/news-information/press-releases/usaid-joins-global-water-and-sanitation-partnership. For more
information on SWA, see its website at http://www.sanitationandwaterforall.org.
5
For more information on each of these, see USAID’s webpage on water and sanitation at http://www.usaid.gov/whatwe-do/water-and-sanitation.
6
U.S. Department of State, Senator Paul Simon Water for the Poor Act: Report to Congress, June 2010, p. v,
http://www.state.gov/documents/organization/146141.pdf.
7
For more information on activities by other U.S. agencies in support of WASH activities, see U.S. Department of
State, Senator Paul Simon Water for the Poor Act: Report to Congress, June 2010, p. 71.
8
UNICEF and WHO, Progress on Sanitation and Drinking Water: 2012 Update, 2012, p.2.
9
WHO, Safer Water, Better Health, 2008, p. 10.
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Global Access to Clean Drinking Water and Sanitation: U.S. and International Programs
•
2 billion cases of intestinal worms;
•
5 million cases of lymphatic filariasis and trachoma, each;
•
1.4 million child diarrheal deaths; and
•
500,000 deaths from malaria.
Children are especially susceptible to unsafe water and poor sanitation. Related death and
disability rates are twice as high among children younger than 14. Some 5,000 children die daily
from preventable water- and sanitation-related diseases, 90% of whom die before age five.11
(...continued)
10
Information in this paragraph and the subsequent one was summarized from the United Nations 2005 World Summit
website at http://www.un.org/summit/water.html, accessed on July 31, 2012.
11
United Nations Development Program, Water Supply and Sanitation,
http://www.undp.org/water/priorityareas/supply.html.
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Global Access to Clean Drinking Water and Sanitation: U.S. and International Programs
Figure 1. WASH Terminology
Source: Reproduced by CRS from U.N. Children’s Fund (UNICEF) and WHO, Progress on Sanitation and
Drinking Water: 2010 Update, 2010, p. 34.
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Global Access to Clean Drinking Water and Sanitation: U.S. and International Programs
WHO believes the impact of unclean water and unsanitary practices is underestimated,
because of weak data collection and insufficient research on several WASH issues. WHO
also expects global phenomena, such as climate change, to exacerbate WASH-related
morbidity and mortality by creating hospitable environments for disease-carrying pests
and facilitating the spread of water-related diseases.
Water advocates link inadequate access to potable water and sanitation with poverty because it
affects many aspects of people’s lives. These areas include
• Health—Several diseases, including diarrhea and several neglected tropical
diseases, are contracted through contact with bacteria-infested water and soil and
cause millions of deaths and illnesses annually.12 At the same time, mosquitoes,
flies, and other vectors breed in water. Good sewerage and drainage systems can
eliminate breeding grounds and water can be treated to remove bacteria found in
tainted water.
• Agriculture and economic growth—Parasitic worms afflict more than 1 billion
people annually and cause a variety of ailments, including stunting, malnutrition,
and anemia. Worm eggs are deposited in the soil when humans carrying the worms
defecate on the ground. Humans can be infected should worms penetrate the skin;
they fail to adequately wash their hands before eating and after touching tainted
soil; or they eat crops grown in contaminated soil. While fleeing infested fields,
farmers may relocate to areas with lower quality soil and less water access and
may inadvertently carry the worm eggs with them.13 Expanded access to improved
farming technology (such as irrigation, fertilizers and mechanized farming tools)
and improved sanitation facilities can help interrupt the transmission of these
diseases.
• Education—Women and children are often tasked with collecting water. While
collecting water, children miss school. Following menses, girls without access to
sanitation facilities may drop out of school.14 Access to clean water can minimize
the amount of time children spend collecting water and allow more time for
education. At the same time, availability of sanitation facilities at schools can help
with school completion rates among girls.
•
Conflict—A growing number of conflicts are exacerbated by limited access to
water. Increasing demand and greater variability in rainfall can inflame tensions,
as seen in Kenya.15 Regional water management strategies can help deter conflict
and improve international relations.
12
Neglected tropical diseases are a group of diseases that impact more than 1 billion people worldwide who are mostly
poor and rural populations. For more information on neglected tropical diseases, see CRS Report R41607, Neglected
Tropical Diseases: Background, Responses, and Issues for Congress, by (name redacted).
13
See Peter Hotez et al., "Rescuing the Bottom Billion Through Control of Neglected Tropical Diseases," The Lancet,
vol. 373 (May 2, 2009), pp. 1570-1575.
14
Water Aid, Is menstrual hygiene and management an issue for adolescent girls?, March 2009, p. ii,
http://www.wateraid.org/documents/plugin_documents/wa_nep_mhm_rep_march2009.pdf.
15
U.N. Office for the Coordination of Humanitarian Affairs, "KENYA: Early drought prompts conflict," IRIN News,
July 26, 2012.
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Global Access to Clean Drinking Water and Sanitation: U.S. and International Programs
Figure 2. The Water, Sanitation, and Poverty Cycle
Source: WaterAid, Water for Life, November 8, 2009\\CRS
Global Access Rates to Clean Water and Sanitation
In September 2000, the United Nations (U.N.) adopted the Millennium Declaration, which
committed member states to support needy countries in reaching eight Millennium Development
Goals (MDG) by 2015.16 Progress toward the eight MDGs is measured through 21 targets and 60
indicators. Target 7C aims to halve, from 2000 levels, the share of people without access to safe
drinking water and basic sanitation by 2015. In March 2012, WHO announced the world had met
the MDG target for clean water (Figure 3).17
16
U.N. General Assembly, United Nations Millennium Declaration, September 18, 2000, http://www.un.org/
millennium/declaration/ares552e.pdf. The eight MDGs are eradicate poverty and hunger (MDG1), achieve universal
primary education (MDG2), promote gender equality and empower women (MDG3), reduce child mortality by twothirds (MDG4), reduce maternal mortality by two-thirds (MDG5), combat HIV/AIDS, malaria, and other diseases
(MDG6), ensure environmental sustainability, including halving the proportion of those without access to clean water
and sanitation (MDG7), and develop a global partnership for development (MDG8).
17
WHO, "Millennium Development Goal drinking water target met," press release, March 6, 2012,
http://www.who.int/mediacentre/news/releases/2012/drinking_water_20120306/en/index.html.
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Global Access to Clean Drinking Water and Sanitation: U.S. and International Programs
Figure 3. Progress Toward MDG Water and Sanitation Targets, 1990-2015
Source: Compiled by CRS from UNICEF and WHO, Progress on Sanitation and Drinking Water: 2012 Update,
2012, pp. 4 and 15.
More than 2 billion people have gained access to improved water sources from 1990 to 2010
(almost half of whom lived in China or India, Figure G-1).18 Despite this worldwide
achievement, some regions were not expected to reach the target, particularly much of subSaharan Africa and parts of Asia. At the same time, the world is not on track to reach the
sanitation targets.
18
See UNICEF and WHO, Progress on Sanitation and Drinking Water: 2012 Update, 2012, p.4.
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Clean Water
While worldwide access to clean drinking water has progressed enough to reach the MDG target,
780 million people remain without access to clean drinking water. Significant disparities exist
among and within countries (Figure 4). Roughly 90% or more of populations across Latin
America and the Caribbean, Northern Africa, and much of Asia have access to clean drinking
water, while an average of 61% of people in sub-Saharan Africa do. Certain segments of the
population in sub-Saharan Africa, however, enjoy broad access to clean drinking water. Across 35
countries in sub-Saharan Africa, over 90% of the richest quintile in urban areas use improved
water sources and over 60% have piped water on their premises (Appendix A). In the poorest
rural quintile, however, piped water is non-existent.
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Figure 4. Global Access to Clean Water, 2010
Source: WHO World Map Gallery at http://gamapserver.who.int/mapLibrary/Files/Maps/phe_Global_water_2010.png, accessed on August 2, 2012.
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Global Access to Clean Drinking Water and Sanitation: U.S. and International Programs
Sanitation
Use of improved sanitation facilities can help to prevent the spread of diseases that are
transmitted through human feces, including intestinal worms and other neglected tropical
diseases.19 Access to these facilities is widespread in most industrialized countries while less than
half of the people in much of sub-Saharan Africa and southeast Asia have access (Figure 5).
Global progress in achieving sanitation targets has been skewed. South Asia (led primarily by
India) made substantial progress, having halved the proportion of its population using unsafe
sanitary systems. In 2010, 69% of people in the region had access to improved sanitation services,
up from 46% in 1990. Sub-Saharan Africa made the least progress, having decreased the
proportion of its population engaged in unsanitary practices by roughly 15%. In 2010, about 30%
of people in the region had access to an improved sanitation facility, up from 26%.
Nonetheless, open defecation rates were the highest across southern Asia. Roughly 41% of the
people in the region practiced open defecation in 2010, down from 67% in 1990. Nonetheless, the
region made greater strides than sub-Saharan Africa, which had lower rates (25%), but made the
least progress in curbing the practice. Open defecation rates were particularly high among the
poor who had the least access to sanitation services and were most likely to practice unsanitary
practices, including open defecation (Appendix A).
19
For more information, see CRS Report R41607, Neglected Tropical Diseases: Background, Responses, and Issues
for Congress, by (name redacted).
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Figure 5. Global Access to Sanitation, 2010
Source: WHO World Map Gallery at http://gamapserver.who.int/mapLibrary/Files/Maps/phe_Global_sanitation_2010.png, accessed on August 2, 2012.
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Global Access to Clean Drinking Water and Sanitation: U.S. and International Programs
International Spending on Water and Sanitation
According to the Organization for Economic Cooperation and Development (OECD), global
funding for water and sanitation efforts has steadily increased since 1971.20 Pledges in 2010,
however, dropped from 2009 levels (Figure 6). In 2010, members of the OECD and multilateral
agencies committed $7.8 billion for improving global access to clean drinking water and
sanitation, down from $8.7 billion in 2009 (Appendix B). Roughly 65% of these funds have been
disbursed. In 2010, the five largest donors were Japan, Germany, France, the United States, and
Spain. The extent to which donors funded these pledges varied. Between 55% and 108% of
pledges were funded (Table 1).
Figure 6. ODA Commitments and Disbursements, 2005-2010
(constant 2010, U.S. $ millions)
10000
9000
8000
U.S. $ millions
7000
6000
5000
4000
3000
2000
1000
0
2005
2006
2007
ODA Commitments
2008
2009
2010
ODA Disbursements
Source: Created by CRS from OECD, Aid Activity Database, http://stats.oecd.org/Index.aspx, accessed on July 31,
2012.
20
OECD, Financing Water and Sanitation in Developing Countries: The Contribution of External Aid, June 2010,
http://www.oecd.org/dataoecd/34/2/45902160.pdf.
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Table 1. Top Five Donor Countries for Water and Sanitation, 2005-2010
(constant 2010, U.S. $ millions)
Donor Commitments
% of Commitments Disbursed
2005
2006
2007
2008
2009
2010
2005
2006
2007
2008
2009
2010
2,533.3
1,594.8
2,498.4
1,916.6
2,899.3
1,933.3
28%
59%
37%
81%
52%
85%
Germany
447.8
546.8
589.4
847.1
785.0
750.8
95%
69%
70%
64%
70%
79%
France
131.7
285.6
385.4
335.3
747.0
500.9
148%
84%
42%
53%
35%
55%
1,139.0
879.2
451.5
865.6
467.2
431.3
111%
102%
127%
27%
61%
92%
84.0
62.1
109.4
573.6
549.4
308.5
82%
123%
98%
93%
91%
108%
Japan
United States
Spain
Source: OECD, Aid Activity Database, http://stats.oecd.org/Index.aspx, accessed on July 31, 2012.
Water and Sanitation Funding Needs
The World Health Organization estimates that between 2005 and 2015, it would cost $72 billion
annually to implement and maintain enough water and sanitation schemes to meet the water and
sanitation targets. Each year, $18 billion of those funds would be spent on building new systems
and $54 billion on maintaining them.21
Commitments by donors (multilateral organizations and donor countries) on water and sanitation
are enough to fund roughly half the amount WHO recommends be spent on building new water
and sanitation networks in developing countries. Should the expense of operations and
management be considered, however, these funds only meet about 12% of the financial needs.
Inadequate investments in operations and management can weaken the impact of water and
sanitation projects and shorten the lifespan of water and sanitation projects (see
“Sustainability/Prioritizing Operations and Management”).
Congressional Actions
Congressional support for improving access to clean water and sanitation has grown, particularly
since FY2003 when Congress directed USAID to make available $100 million for WASH efforts
through its Development Assistance account (see Consolidated Appropriations Resolution, 2003,
P.L. 108-7). In FY2006, Congress raised that amount to $220 million. In FY2008, Congress
boosted funding for WASH projects again, appropriating not less than $300 million for safe
drinking water and sanitation supply projects and directing that not less than $125 million of
those funds be spent in sub-Saharan Africa. In each of FY2010-FY2012, Congress appropriated
not less than $315 million for water and sanitation programs. Obligations for water and sanitation
activities typically exceed appropriated levels (see “U.S. Agency for International
Development”). In FY2011, for example, USAID obligated $597 million to the water sector,
including $343.7 million for water and sanitation efforts; down from $642 million in FY2010,
when some $520.4 million was obligated to WASH programs.
21
Guy Hutton and Jamie Bartram, Regional and Global Costs of Attaining the Water Supply and Sanitation Target
(Target 10) of the Millennium Development Goals, WHO, 2008, p. iv, http://www.who.int/water_sanitation_health/
economic/mdg_global_costing.pdf.
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Budgetary increases for water and sanitation efforts followed enactment of The Senator Paul
Simon Water for the Poor Act of 2005 (P.L. 109-121), which made the provision of “affordable
and equitable access to safe water and sanitation in developing countries” a U.S. foreign policy
priority. The act amended the Foreign Assistance Act of 1961 and the Agricultural Trade
Development and Assistance Act of 1954, and called for U.S. agencies to seek to halve the
proportion of people without access to clean water and sanitation by 2015 (from 2009 levels). The
act also called for
•
•
the Secretary of State, in consultation with USAID and other implementing
agencies, to develop and implement a strategy to increase affordable and
equitable access to safe drinking water and sanitation. The strategy is to include
•
specific and measurable goals, benchmarks, and timetables for improving
access to clean water and sanitation;
•
an evaluation of ongoing activities;
•
an assessment of the funding and types of assistance needed to achieve the
goals, benchmarks, and timetables related to the strategy;
•
methods to coordinate and integrate U.S. water and sanitation programs with
other U.S. development programs, and with other related donor programs;
•
a list of high-priority countries with the greatest need for access to safe water
and sanitation and where assistance can make the greatest impact; and
•
an appraisal of recipient government commitments to policies or reforms that
support affordable and equitable access to safe water and sanitation.
the Secretary of State to submit annual reports to Congress on the
implementation of the strategy, including the amount the United States obligates
for water and sanitation activities in each country; progress made in improving
access to clean water and sanitation; and any changes to the strategy.
In the first session of the 112th Congress, on March 2011, Senator Richard Durbin introduced the
proposed Water for the World Act of 2011 (S. 641). The act calls for the United States to provide,
within six years, safe water and sanitation to 100 million people, among other things. For a
detailed synopsis of the bill, see Appendix C.
U.S. Foreign Assistance for Water and Sanitation
In FY2010, the United States spent some $953 million on water and sanitation programs
worldwide, of which $898 million was obligated by USAID and MCC.22 This report focuses on
the programs supported by these two agencies, though other agencies also take part in the U.S.
response.23 Other sources of U.S. support include contributions to international organizations and
22
U.S. Department of State, Senator Paul Simon Water for the Poor Act: Report to Congress, June 21, 2011, p. 1.
These include: the Centers for Disease Control and Prevention, Department of Defense, Department of State,
Environmental Protection Agency, U.S. Geological Survey, National Aeronautics and Space Administration, National
Oceanographic and Atmospheric Administration, Overseas Private Investment Corporation, Peace Corps, and U.S.
Army Corps of Engineers. See U.S. Department of State, Senator Paul Simon Water for the Poor Act: Report to
Congress, June 2010, p. 10.
23
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participation in several development banks. In FY2010, for example, the United States
contributed approximately $40 million to nine U.N. organizations in support of international
water, sanitation, and emergency relief efforts.24
It is important to note that information on U.S. global WASH activities is not always
disaggregated from broader water efforts. In this report, efforts related to drinking water,
sanitation, and hygiene will be specifically referred to as WASH. Otherwise, references to water
programs refer to U.S. efforts to improve access to clean water through any number of efforts
including WASH, water resource management, and water productivity.
U.S. Progress in Meeting Clean Drinking Water Targets
In the FY2012 Congressional Budget Justification (CBJ) for Foreign Operations, the State
Department published a set of targets for expanding access to clean drinking water. According to
the report, the United States sought to extend clean drinking water to more than 5 million in 2010,
but only reached 3 million people (Table 2).25 More than 90% of those assisted resided in Africa
or Asia (Figure 7). The department attributed the bulk of the shortfall to delays in projects
throughout Pakistan, West Bank and Gaza, and the Africa Regional office.
Table 2. Number of People in Target Areas with First-Time Access to Improved
Drinking Water Supply as a Result of U.S. Assistance, FY2006-FY2012
FY2006
Results
FY2007
Results
FY2008
Results
FY2009
Results
FY2010
Target
FY2010
Results
FY2010
Rating
FY2011
Target
FY2012
Target
1,918,205
4,988,616
4,633,566
7,751,265
5,616,991
2,844,484
Below
Target
5,369,572
2,988,050
Source: Department of State, Foreign Operations Congressional Budget Justification, Volume 2, April 8, 2011, p. 393.
24
U.S. Department of State, Senator Paul Simon Water for the Poor Act: Report to Congress, June 21, 2011, p. 2.
Information in this section was summarized by CRS from Department of State, Foreign Operations Congressional
Budget Justification, Volume 2, FY2012, p. 393 http://www.state.gov/documents/organization/158267.pdf.
25
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Figure 7. Number of People Who Gained Improved Access to Drinking Water and
Sanitation Through U.S. Programs, 2010
Source: Created by CRS from Department of State, Senator Paul Simon Water for the Poor Act, Report to
Congress, June 2011, pp. 3-4.
In Pakistan and West Bank and Gaza, delays were caused by shifts in the focus of the programs.
The Africa Regional program encountered delays launching a Global Water Development
Alliance between Coca-Cola and USAID to support water-related programs in 19 countries. On
the other hand, the State Department noted advancements in other areas, particularly in Kenya,
where a water treatment project exceeded its target by 252%. The State Department also noted the
Coca-Cola partnership “has leveraged $15 million in private funds to provide improved access to
clean water for 500,00 people.”26
Water for the Poor Act, Implementing Agencies
The State Department, USAID, and MCC each play a unique role in reaching the goals indicated
in the Water for the Poor Act. The State Department plays a convening and oversight role, USAID
works with host governments to expand access to potable water and sanitation and funds related
activities, and MCC supports broader national development plans that include WASH activities.
As specified by the Water for the Poor Act, the U.S. strategy for expanding access to potable
water and sanitation is being jointly developed by the State Department and USAID while
USAID and MCC serve as the primary implementers of designated efforts.
26
U.S. Department of State, Foreign Operations Congressional Budget Justification, Volume 2, FY2013, p. 267.
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U.S. Department of State
Each year, the State Department reports to Congress progress made by the federal government in
implementing the Water for the Poor Act. Though the report is intended to report on governmentwide water and sanitation activities, comprehensive information is only available for USAIDsupported efforts with a summary table of water projects supported by MCC. The most recent
report, released in June 2011, documents activities supported from FY2006 to FY2010.27
In addition to its oversight role, the Department of State plays an important role in expanding
access to water and sanitation through diplomatic channels. U.S. officials emphasized the
importance of addressing water issues early in the Obama Administration. On World Water Day
in March 2010, for example, Secretary of State Hillary Clinton called for a five-pronged water
strategy that focused on
•
building capacity at the local, national, and regional levels;
•
bolstering water diplomacy;
•
mobilizing financial support at the local, national, and regional levels;
•
researching and developing improved technologies to address water-related
issues; and
•
broadening partnerships.
Secretary Clinton also pledged to elevate water issues within the Global Partnerships Initiative—
an effort to convene actors from various regions and sectors to work on issues of common
interest.28 While making a speech during World Water Day on March 22, 2011, Secretary Clinton
underscored the importance of leveraging partnerships to resolve water issues and signed a
memorandum of understanding (MOU) with the World Bank to enhance collaboration between
the United States and the World Bank on water efforts.29
U.S. Agency for International Development
USAID is the lead implementer of U.S. international clean drinking water and sanitation
programs. These efforts are one component of broader efforts to address water issues, including
water scarcity, water degradation, and inadequate water network systems. USAID groups its
water programs into three sectors: water supply and sanitation, water resource management, and
water productivity. Table 3 describes activities that are typically supported in each of these
sectors. Roughly 70% of USAID’s budget is spent on water supply and sanitation, which support
improvements in water purification, public taps, small-scale piped water, tube wells, small sewer
systems, septic tanks, and hygienic latrines. USAID also invests in education programs and public
awareness campaigns that promote good sanitation and hygiene.
27
See Department of State, Senator Paul Simon Water for the Poor Act, Report to Congress, June 2011,
http://www.state.gov/documents/organization/166895.pdf
28
For more information on the partnership, see http://www.state.gov/s/partnerships/.
29
See Department of State, "Secretary of State Remarks on World Water Day," press release, March 22, 2011,
http://www.state.gov/secretary/rm/2011/03/158833.htm. See the MOU at http://www.state.gov/g/oes/158770.htm.
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Table 3. USAID Areas of Support for the Water Sector
Water Supply and Sanitation
Water Resource Management
Water Productivity
Strengthening the capacity and sustainability of
small-scale service providers in rural and periurban areas;
Addressing related policy, regulatory, and
institutional frameworks at the appropriate
scale and across all relevant sectors
Applying techniques to foster
the efficient use of water in
agriculture
Improving the capacity and financial
sustainability of utilities that serve cities and
towns undergoing population booms
Optimizing water supply and assessing
surface and groundwater supplies, water
balance, wastewater reuse, and
environmental impacts
Helping countries to manage
hydrologic variability and adapt
to climate change
Mobilizing capital from domestic markets for
infrastructure development on a permanent
and sustainable basis
Addressing water demand, cost-recovery
policies, water technologies, and
decentralized water resource management
authorities
Reducing water pollution by
industry
Improving household- and community-level
hygiene and sanitation
Facilitating equitable access to water through
participatory and transparent governance
Conserving water use in rural
areas
Source: Summarized by CRS from USAID, Addressing Water Challenges in the Developing World: A Framework
for Action, March 2009.
Every year, USAID reports to Congress how it spent funds on global water activities, which are
funded through several accounts.30 For a description of these accounts, see Appendix D. Annual
requests for water-related programs, however, do not specify the type of support that will be
funded and tend to be less than half the obligated amounts after funding from all sources is
considered, including supplemental appropriations. In FY2011, for example, the President
requested $260.4 million for water programs. By the end of the fiscal year, however, USAID had
obligated $596.7 million for water activities, including $343.8 million for WASH (Table 4).
Congress appropriated not less than $315 million for global water and sanitation programs in
FY2012, slightly more than requested levels ($302 million).
Table 4. USAID Obligations for Water by Sector, FY2004-FY2012
(current, U.S. $ millions)
FY2004
Actual
FY2005
Actual
FY2006
Actual
FY2007
Actual
FY2008
Actual
FY2009
Actual
FY2010
Actual
FY2011 FY2011 FY2012 FY2013
Request Estimate Approp Request
WASH
239.8
216.9
265.0
213.2
389.9
493.0
520.4
n/a
343.8
n/s
n/s
WRM
82.5
60.7
56.0
27.4
58.6
41.2
47.2
n/a
124.4
n/s
n/s
WP
68.4
45.4
22.5
17.4
38.9
45.3
53.1
n/a
98.5
n/s
n/s
DRR
10.0
6.8
5.8
5.7
2.2
50.6
21.5
n/a
30.0
n/s
n/s
TOTAL 400.7
329.8
349.3
263.7
489.6
630.1
642.2
260.4
596.7
315.0
299.1
Sources: USAID Budget Office, March 10, 2011, correspondence with the Water Team, September 13, 2011,
and the FY2012 Consolidated Appropriations.
Acronyms: Appropriation (Approp), not available (n/a),Water Supply, Sanitation, and Hygiene (WASH), Water
Resources Management (WRM), Water Productivity (WP), and Disaster Risk Reduction (DRR).
30
These accounts include: Assistance for Europe, Eurasia, and Central Asia (AEECA), Development Assistance (DA),
Economic Support Fund (ESF), Global Health and Child Survival (GHCS), International Disaster Assistance (IDA),
and P.L. 480 (food aid).
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Notes: Includes supplemental funding and spending through several accounts, including Assistance for Europe,
Eurasia, and Central Asia (AEECA), Development Assistance (DA), Economic Support Fund (ESF), Global Health
and Child Survival (GHCS), International Disaster Assistance (IDA), and P.L. 480 (food aid).
Distribution of USAID WASH Resources, FY2006-FY2010
In September 2010, the U.S. Government Accountability Office (GAO) released a report that
analyzed U.S. global water and sanitation efforts from FY2004 through FY2009. This section
summarizes these findings and adds details from the State Department June 2011 report to offer a
review of USAID global water and sanitation programs from FY2004 through FY2010.
Figure 8. USAID Obligations on WASH Activities, FY2006-FY2010
(current, U.S. $, millions)
Source: Created by CRS from GAO, U.S. Water and Sanitation Aid: Millions of Beneficiaries Reported in Developing
Countries, but Department of State Needs to Strengthen Strategic Approach, September 2010, p. 18 and Department
of State, Senator Paul Simon Water for the Poor Act, Report to Congress, June 2011, pp. 4-5.
Acronyms: Middle East and North Africa (ME&NA), sub-Saharan Africa (SSA), Asia and Pacific (A&P), Europe
and Eurasia (E&EA), and Latin America and Caribbean (LA&C).
From FY2006 to FY2009, USAID made the highest investments related to water and sanitation in
the regions of the Middle East and North Africa (ME&NA) and sub-Saharan Africa (Figure 8).31
The State Department report of June 2011, however, noted delayed WASH projects in the
ME&NA led to lower obligation levels in the region in FY2010. At the same time in that fiscal
year, investments in Asia & Pacific (A&P) rose precipitously from FY2009. In 2010, more than
half of all funds for water and sanitation programs were obligated in 10 countries (Figure 9).
31
GAO, U.S. Water and Sanitation Aid: Millions of Beneficiaries Reported in Developing Countries, but Department
of State Needs to Strengthen Strategic Approach, GAO-10-967, September 2010, p. 18,
http://www.gao.gov/new.items/d10957.pdf.
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Figure 9. USAID Water & Sanitation Obligations by Country, FY2010
(share of all spending, U.S. $ current millions)
Source: Created by CRS from Department of State, Senator Paul Simon Water for the Poor Act, Report to
Congress, June 2011, pp. 4-5.
Millennium Challenge Corporation
The Millennium Challenge Corporation (MCC) was established in 2004 as an alternative
approach to traditional foreign aid.32 Whereas USAID seeks to create an enabling environment
that facilitates development, MCC awards aid to those countries that are demonstrating good
governance, encouraging economic freedom, and investing in their people. The development
programs supported by MCC are conceived and implemented by the host countries, whereas
development programs supported by USAID are usually developed and implemented by nongovernmental organizations and other partners. Through multi-year funding, MCC has
considerable flexibility in determining how to allocate its resources, whereas USAID relies on
annual appropriations to fund its development programs, which are often shaped by congressional
directives. Since MCC-funded compacts are country-driven, MCC does not designate priority
areas, such as health, food, or water.
Since its inception, MCC has approved multi-year grant agreements, known as compacts and
threshold agreements, in several countries worth more than $8 billion. These agreements support
country-driven development projects across several sectors including
•
agriculture and irrigation,
•
transportation (roads, bridges, ports),
•
water supply and sanitation,
•
access to health,
32
For more information on this process, see CRS Report RL32427, Millennium Challenge Corporation, by (name
redacted).
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•
finance and enterprise development,
•
anticorruption initiatives,
•
land rights and access, and
•
access to education.
Roughly $803 million of those funds are aimed at water and sanitation projects in seven
countries: El Salvador, Georgia, Ghana, Lesotho, Jordan, Mozambique, and Tanzania.33 The water
and sanitation projects support activities that range from improving complex water networks and
wastewater systems (Jordan) to implementing more rudimentary approaches like drilling wells
and boreholes (Ghana). Appendix E summarizes progress made in MCC-supported water
projects, based on information made available on their website on July 7, 2011.
U.S. Global Water and Sanitation Efforts: Issues
The Water for the Poor Act reflected congressional support for the Millennium Development
Goals by calling for U.S. programs to halve the 2009 level of people without access to clean
water and sanitation by 2015. The act provided general guidance on how this should be done, but
allowed flexibility on what steps implementing agencies should take to reach the goal. While the
legislation did not specify how water funding should be spent, it called for increasing investments
in water and sanitation activities, particularly in sub-Saharan African countries. Several groups
have debated how to improve U.S. implementation of the Water for the Poor Act. This section
discusses key issues raised by observers, which focus on
•
clarifying roles and responsibilities of implementing agencies;
•
balancing funding between WASH and other water areas;
•
balancing regional investments; and
•
verifying program data.
Clarifying Roles and Responsibilities and Authorizing Funding
The Water for the Poor Act directs the Secretary of State to develop a water strategy in
conjunction with USAID and other implementing partners and to annually submit a report to
Congress delineating U.S. progress in expanding access to clean water and sanitation. At the same
time, the act calls on USAID to allocate greater resources to water and sanitation programs. The
act does not specify, however, who has authority over funding and implementation.
Under the President’s Plan for Emergency AIDS Relief (PEPFAR), for example, Congress
appropriates the bulk of global HIV/AIDS funds to the Department of State. The Global AIDS
Coordinator at the Department of State distributes most of these resources out to several U.S.
agencies that implement the international HIV/AIDS programs while the State Department
oversees and reports on U.S. progress in tackling HIV/AIDS worldwide.
33
Also see the MCC webpage on Water and Sanitation at http://www.mcc.gov/pages/activities/activity-two/water-andsanitation.
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The Water for the Poor Act and the proposed Water for the World Act call on the State
Department to develop targets for improving global access to water and sanitation. Each act also
designates the State Department as the agency responsible for enforcing implementation, but
neither provides budgetary authority. Without a mandate, the State Department can not dictate
how agencies spend water resources or coordinate program implementation across agencies.
At the same time, some observers point out Congress has not appropriated funds specifically for
implementing the act. A number of supporters are concerned USAID might reduce the budgets of
other non-WASH activities to meet statutory requirements.
Balancing Funding Between WASH and Other Water Areas
Following the enactment of the Water for the Poor Act, spending by USAID on water
management and productivity declined while funding for WASH activities increased. USAID
reports that it has increasingly concentrated its water and sanitation resources on WASH efforts to
comply with appropriations language that emphasizes WASH.34 Today, roughly 70% of these
investments are aimed at improving water supply and sanitation. WASH funds may be used to
build new water and sanitation systems, but funds provided for water resource management and
productivity are used to maintain these systems and identify where water scarcity exists. Whether
this apportionment for water-related projects is appropriate is a key subject of debate. Some
groups advocate for increasing support for water management while others believe investing in
water management distracts from efforts to achieve public health goals.
Congressional language does not bar investments in operations and management. In fact,
language in the Water for the Poor Act specifies that related U.S. assistance shall
•
support the design, construction, maintenance, upkeep, repair, and operation of
water delivery and sanitation systems;
•
improve the safety and reliability of water supplies, including environmental
management; and
•
improve the capacity of recipient governments and local communities, including
capacity-building programs for improved water resource management.
Congress might consider clarifying how water funds are to be used through an amended Water for
the Poor Act, annual appropriations legislation, or through the proposed Water for the World Act.
On the other hand, some observers maintain that removing legislative directives might enable
USAID to better balance water funding across water sectors. At the same time, fewer
congressional mandates might also allow USAID to apply funds, as needed, to meet other
development priorities that affect successful implementation of WASH efforts.
Balancing Regional Investments
In FY2009, USAID obligated $482 million for water and sanitation with about half of those
investments provided in five countries or territories (Figure 9): West Bank & Gaza ($102.2
million), Jordan ($53.5 million), Pakistan ($48.0 million), Sudan ($38.9 million), and Afghanistan
34
U.S. Department of State, Senator Paul Simon Water for the Poor Act: Report to Congress, June 2008, p. v.
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($22.6 million).35 USAID and the Department of State designated 31 countries as “high priority”
in FY2009. GAO raised questions, however, about how the priority countries were selected and
noted that 4 of the 10 countries that the United Nations concluded had the greatest need for access
to improved water sources were not among the high priority countries, and 7 of the 10 countries
that U.N. data show with greatest need for access to improved sanitation were also not counted
among the high priority countries.36
At the same time, GAO noted that several of the “high priority countries” were not among those
that the United Nations considered with the greatest need for water or sanitation. In 6 of the 31
high priority countries—Lebanon, Georgia, Armenia, Jordan, and the West Bank and Gaza—at
least 76% of the population had access to improved sanitation facilities (Appendix F). At the
same time, two of these territories—Jordan and West Bank & Gaza—were among the top 10
recipients of WASH resources and received 32% of USAID WASH funds in 2010. Similarly, in
12 of the 31 high priority countries, at least 79% of the population had access to improved water.
Five of these territories were among the top 10 recipients of WASH resources and accounted for
nearly half of all USAID WASH spending.
The Water for the Poor Act specifies that water and sanitation assistance is to be focused toward
“the countries, locales, and people with the greatest need.” Some observers assert that the
concentration of U.S. WASH resources in Middle Eastern countries with high water and
sanitation access is motivated more by strategic geopolitical reasons than by need.37 Several
groups call on USAID to adhere to the legislative language, adjust the disbursement of its
resources, and allot greater proportions to those countries most in need, particularly in subSaharan Africa. Other experts maintain congressional directives limit the ability of USAID to
adjust WASH resources. At the same time, another group points out the United States considers a
number of factors when determining the level and type of investment, including opportunities to
leverage U.S. resources and capacity to sustain the programs. At the root of this debate are
questions about whether need should outweigh other mitigating factors like political will and
other factors that contribute to program success like long-term capacity of recipient countries to
assume ownership of water and sanitation programs.
Water and sanitation projects are considered by USAID to be a “cross-cutting issue” and are
funded through several accounts that are jointly managed by USAID and the Department of State,
including Assistance for Eastern Europe and Central Asia (AEECA), Development Assistance
(DA), Economic Support Fund (ESF), Food for Peace (FFP), and Global Health and Child
Survival (GHCS). This means that USAID and the State Department attempt to address the multifaceted impacts of limited access to clean water and sanitation through a variety of programs,
bureaus, and budgetary sources. The bulk of spending on water and sanitation-related activities is
funded primarily through the DA and ESF accounts. Each account is funded at different levels
and has distinct objectives; see Appendix D. As such, water activities are implemented as part of
the goals and objectives of the overarching account. Some believe a government-wide water and
35
U.S. Department of State, Senator Paul Simon Water for the Poor Act: Report to Congress, June 2010.
GAO, U.S. Water and Sanitation Aid: Millions of Beneficiaries Reported in Developing Countries, but Department
of State Needs to Strengthen Strategic Approach, GAO-10-967, September 2010, p. 32.
37
See, for example, a report released by several non-governmental groups, including Care, Catholic Relief Services,
and WaterAid, U.S. Implementation of the Senator Paul Simon Water for the Poor Act: Small Steps for a Crisis that
Calls for Great Srides, November 2010, p. 10.
36
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sanitation strategy might help to make U.S. international water and sanitation responses more
cohesive, effective, and balanced.
Ensuring Accuracy of Data
U.N. agencies responsible for monitoring progress in attaining the MDGs expressed some
skepticism about water and sanitation data (see Appendix G). Furthermore, WHO discourages
attempts to compare data released in each annual report, because efforts to improve data
collection are ongoing and each report incorporates new information.38 Uncertainty about these
data raises several questions regarding water and sanitation programs in general and U.S. WASH
programs in particular, including:
•
How will the United States know when project goals are met?
•
How will implementing U.S. agencies determine whether projects are reaching
those most in need?
•
How will the United States confirm the projects are designed to meet the needs of
the target population?
The GAO recognized this challenge in its 2010 report on the Water for the Poor Act.39
Specifically, the report indicated that the Department of State had not yet “developed specific and
measurable goals, benchmarks, and timetables to assess its progress.” Observers urge
governments and donors to strengthen data collection and information systems and bolster
operational research efforts. Regarding data collection and evaluation, Congress might consider
providing sufficient resources for USAID and other implementing agencies to conduct rigorous
field surveys. WHO and UNICEF found that such efforts are useful, but expensive. To drive
down the expense, WHO calls for developing innovative, field-ready tools that could be used to
rapidly and reliably measure water quality at a low cost.40
Sustainability/Prioritizing Operations and Management
Ensuring adequate funding for operation and maintenance is an important, but often overlooked,
part of sustaining access to clean drinking water and sanitation. While investments in water and
sanitation have been escalating since the launch of the Millennium Development Goals, several
experts point out that much of this spending is aimed at developing new water and sanitation
systems and little is budgeted for operation and maintenance (O&M).41 As a result, these facilities
often fail before their expected lifetimes and quality of service is compromised by deteriorated
pipes and machinery that were not sufficiently cared for due to short supply of maintenance
equipment, vehicles, and spare parts.
38
UNICEF and WHO, Progress on Sanitation and Drinking Water: 2010 Update, 2010, p. 35.
See GAO, U.S. Water and Sanitation Aid: Millions of Beneficiaries Reported in Developing Countries, but
Department of State Needs to Strengthen Strategic Approach, September 2010, p. 25.
40
UNICEF and WHO, Progress on Sanitation and Drinking Water: 2010 Update, 2010, p. 31.
41
See Lucrezia Koestler et al., "Improving Sustainability Using Incentives for Operation and Maintenance: The
Concept of Water-Person-Years," Waterlines, vol. 29, no. 2 (April 2010), p.149, http://www.fontes.no/a/uploaded/file/
Waterlines%20April2010%20-%20Waterpersonyears-Koestler.pdf. Edward Breslin, Rethinking Hydrophilanthropy:
Smart Money for Transformative Impact, Water for the People, January 29, 2020, p. 1,
http://www.waterforpeople.org/assets/pdfs/rethinking-hydrophilantropy.pdf.
39
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Underfunding operations and management of water supply creates a cyclical effect. As countries
attempt to expand water and sanitation services (often through new investments by donors),
governments must seek ways to cover the costs of operation and maintenance, as well as capital
costs. There is often little support within national budget ministries and among the general public
to increase service charges, particularly when quality of service is poor. At the same time, donors
expect governments to cover O&M expenses. Poorly defined agreements among donors and
recipient countries regarding roles and responsibilities for operating and maintaining water and
sanitation systems are a key contributor to poorly functioning systems and complicate efforts to
sustain advancements made in broadening use of clean water and safe sanitation systems.
Summary of Key Issues
If enacted, the proposed Water for the World Act might address several of the concerns raised by
observers regarding the implementation of the Water for the Poor Act, but several issues remain.
•
Water and sanitation goals. The Water for the Poor Act provides a broad goal for
improving access to clean water and sanitation but does not specify how the United States
might measure progress in attaining the goal. An option Congress might consider would
be to specify what outcomes should emerge from U.S. water and sanitation efforts,
particularly those that measure
•
impacts on the local community (e.g., Do unsanitary practices or use of unclean
water abate following project implementation?);
•
how long the tools (handpumps, wells, etc.) remain operational; and
•
the connection between WASH outcomes and health improvements, for example,
reductions in diarrhea cases.
•
Balanced water sector funding. Annual reports to Congress on U.S. water and
sanitation efforts seem to reflect a perception that congressional support for water and
sanitation eclipses support for other efforts, particularly water management and
productivity. Language in the Water for the Poor Act, however, indicates support for
improving the safe and efficient use of water and sanitation systems. The proposed Water
for the World Act appears to address this ambiguity and emphasizes capacity building and
water resource management. Congress might consider amending the Water for the Poor
Act to clarify how water and sanitation resources should be spent in light of diminished
investments in water resource management. At the same time, some advocates call for a
removal of all statutory language that directs how funds should be spent.
•
Connect authorizing and appropriating language. Both the Water for the Poor Act and
the proposed Water for the World Act, as introduced, outline a number of goals and
actions for the Administration in relationship to improving global access to clean water
and sanitation. Neither act, however, authorizes funds to support these efforts. Some fear
USAID might siphon funds from other development programs to meet the goals of the
act. Congress might consider authorizing and appropriating additional funds to facilitate
attainment of the goals outlined in the Water for the Poor Act and taking the same action
if Congress passes the proposed Water for the World Act. Congress might also consider
authorizing and appropriating gradual funding increases to extend time for planning and
absorbing resources.
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•
Multi-year funding authority. Goals and targets are established by considering a
number of long-term action plans. It is difficult for USAID to develop multi-year plans,
however, while receiving annual appropriations. Without funding security, agencies are
uncertain about what steps can be taken to reach program goals. Congress might consider
authorizing multi-year funding to facilitate achievement of goals established in the Water
for the Poor Act.
•
Reporting requirements. As discussed in “Water for the Poor Act, Implementing
Agencies,” reporting by the State Department on U.S. progress on improving access to
clean water and sanitation worldwide focuses almost exclusively on USAID with limited
discussion about MCC activities. Congress might consider directing the State Department
to include additional details about other U.S. government (USG) water and sanitation
efforts, particularly those conducted by agencies like the Army Corps of Engineers that
provide significant resources. In FY2009, for example, the agency obligated an estimated
$54 million on water and sanitation efforts.42 The proposed Water for the World Act
specifies that the report should include information on all implementing agencies.
Congress might also consider how to address incomplete compliance with
reporting requirements. GAO reports, for example, that the State Department has
neither developed a budget for attaining goals outlined in the Water for the Poor
Act nor outlined specific and measurable goals, benchmarks, and timetables to
assess WASH programs.43 Further, GAO indicates none of the annual reports to
Congress include performance measures. The Congressional Budget Office
(CBO) estimated that the Paul Simon Water for the World Act (S. 624), which
was introduced in the 111th Congress, reintroduced in the 112th Congress as S.
641, and would modify the goals outlined in the Water for Poor Act, would cost
roughly $1.3 billion annually.44
•
Political will and program sustainability. The detrimental effects of inadequate access
to clean drinking water and sanitation have been well-documented. Some observers
maintain, however, that limited access to these necessities should not be the main factor
for allocating aid. Instead, some analysts urge the U.S. government to invest more
heavily in countries that have demonstrated commitment to improving access to clean
drinking water and sanitation, capacity to sustain and leverage U.S. investments in these
areas, and interest in building public-private partnerships that could advance such efforts.
Supporters of these ideas maintain U.S. resources would be better spent on creating an
enabling environment (such as encouraging policy reforms) and monitoring and
evaluating ongoing efforts. U.S. participation in the SWA partnership may help to
advance these goals. The SWA emphasizes country ownership and commitment to
addressing water and sanitation issues.
•
Collection of baseline data. As discussed in “Ensuring Accuracy of Data,” experts have
expressed some uncertainty about water and sanitation data. Inaccurate data on water
needs and use of water resources raises questions about how the United States can (1)
42
Department of State, U.S. Engagement on Water Issues, Fact Sheet, October 1, 2010,
http://www.state.gov/g/oes/rls/fs/2010/148545.htm.
43
GAO, U.S. Water and Sanitation Aid: Millions of Beneficiaries Reported in Developing Countries, but Department
of State Needs to Strengthen Strategic Approach, GAO-10-967, September 2010, p. 25.
44
See CBO, S. 624 Senator Paul Simon Water for the World Act of 2009, May 4, 2010, http://www.cbo.gov/ftpdocs/
114xx/doc11484/s624.pdf.
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accurately measure progress in reaching the needy, (2) ensure WASH projects meet the
needs of the community, and (3) make certain U.S. resources are efficiently and properly
used. The Water for the Poor Act does not address questions about data accuracy. While
the proposed Water for the World Act acknowledges the need to collect baseline data, it
does not specify how the United States will collect the data, if at all. Congress might
consider providing a separate budget allocation for monitoring and evaluation that would
ensure funding is reserved for collecting data across implementing agencies and specify
common indicators to reduce costs and harmonize efforts.
•
U.S. and donor coordination. Each agency has a unique role to play in improving water
and sanitation conditions. Each annual report to Congress asserts U.S. agencies are
coordinating their efforts on water and sanitation but provides no supporting details.
Congress might consider providing further guidance on U.S. coordination, which could
include
•
discussing the role of Ambassadors in ensuring implementing agencies cooperate
with each other, to the extent possible, at all stages of implementation (planning,
execution, and monitoring and evaluation);
•
developing joint indicators and coordinated reporting, auditing, and procurement
processes, to the extent possible; and
•
illustrating how investments in WASH activities by one agency advance related
efforts by another agency (e.g., how MCC investments in wastewater treatment
facilities and water distribution networks amplify USAID efforts to decrease waterborne morbidity and mortality).
The proposed Water for the World Act calls for the creation of two high-level positions at the
Department of State to coordinate U.S. water and sanitation efforts and for USAID Mission
Directors to report on the coordination of water and sanitation efforts in high priority countries.
Neither of these positions have been granted budgetary oversight authority. Congress might
consider what oversight and budgetary duties each official should play.
Congress might also consider the importance of U.S. government coordination with other donors.
In many developing countries, water and sanitation efforts are primarily funded by foreign donors
and the private sector. In Ghana, for example, one estimate indicates between 80% and 90% of
spending on water and sanitation is funded by donors, including the private sector.45 Experts
assert that disjointed management of water and sanitation resources contributes to weak oversight
of associated activities and resources. The Water for the Poor Act calls for 25% of all spending on
water and sanitation activities to be provided by non-federal actors, but does not specify how this
is to be accomplished or whether these efforts are to be integrated with U.S. efforts.
45
Frankie Freeman, "Ghana: The Waste Land," World Policy Journal, vol. 27, no. 2 (Summer 2010), p. 34, p. 52.
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Appendix A. Water and Sanitation Access in SubSaharan Africa, by Wealth and Residence, 2004-2009
Figure A-1. Water and Sanitation Access in Sub-Saharan Africa, 2004-2009
Source: Compiled by CRS from UNICEF and WHO, Progress on Sanitation and Drinking Water: 2012 Update,
2012, p. 29.
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Appendix B. Official Development Assistance
Commitments for Water and Sanitation, 2005-2010
Table B-1. Official Development Assistance Commitments for Water and Sanitation
(current U.S. $ millions)
Donors
2005
2006
2007
2008
2009
2010
Australia
3.9
35.1
2.9
37.5
75.9
217.8
Austria
19.4
23.0
24.4
34.5
22.4
18.0
Belgium
67.1
77.2
91.1
97.4
58.7
48.9
Canada
54.6
24.8
26.1
49.4
84.2
16.3
Denmark
115.7
168.6
33.0
18.1
161.9
140.8
Finland
49.9
50.1
31.3
48.0
51.9
99.4
France
131.7
285.6
385.4
335.3
747.0
500.9
Germany
447.8
546.8
589.4
847.1
785.0
750.8
Greece
0.6
1.2
3.0
0.7
2.9
0.2
Ireland
17.2
16.5
18.2
21.6
15.8
9.9
Italy
85.9
58.4
57.8
154.0
53.4
65.0
Japan
2,533.3
1,594.8
2,498.4
1,916.6
2,899.3
1,933.3
Korea
0.0
75.0
66.4
278.7
81.1
283.1
Luxembourg
16.9
12.4
13.8
18.3
22.8
21.1
Netherlands
235.6
504.0
362.5
345.7
189.3
123.1
New Zealand
5.8
4.0
2.8
0.7
2.2
6.1
Norway
63.5
30.5
42.7
49.3
55.2
47.5
Portugal
2.9
0.7
1.6
0.3
0.4
1.0
Spain
84.0
62.1
109.4
573.6
549.4
308.5
Sweden
135.1
82.7
45.1
83.7
21.6
55.0
Switzerland
83.8
43.6
51.6
36.6
52.4
49.6
United Kingdom
85.4
122.8
145.9
228.4
256.2
67.8
United States
1,139.0
879.2
451.5
865.6
467.2
431.3
DAC Countries Total
5,379.2
4,699.1
5,054.4
6,041.2
6,656.1
5,195.5
AfDF
85.3
502.5
241.0
289.9
287.5
204.7
Arab Fund
0.0
0.0
0.0
121.4
79.0
105.1
AsDB
154.4
286.1
273.5
2.6
405.7
194.4
E.U. Institutions
818.4
812.2
491.3
158.8
505.8
678.1
Inter-American Bank
0.0
50.1
52.1
12.1
46.1
57.7
IFAD
3.6
10.3
2.8
2.8
0.0
6.6
U.N. Children’s Fund
20.1
29.1
44.5
41.1
46.7
48.8
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Donors
2005
2006
2007
2008
2009
2010
UNDP
2.1
2.2
0.9
2.1
6.4
3.2
UNECE
0.0
0.0
0.0
0.7
1.4
2.0
570.8
813.0
1013.3
889.2
468.7
1034.9
Multilateral Total
1,654.8
2,505.5
2,119.5
1,520.7
1,847.3
2,335.4
All Donors
7,034.0
7,204.6
7,173.9
7,561.9
8,697.5
7,781.5
World Bank
Source: Summarized by CRS from OECD, Aid Activity Database, http://stats.oecd.org/Index.aspx, accessed on July
31, 2012.
Acronyms: African Development Fund (AfDF); Asian Development Bank (AsDB); European Union (E.U.);
International Fund for Agricultural Development (IFAD); United Nations Development Program (UNDP), United
Nations Economic Commission for Europe (UNECE)
Notes: Commitments made for less than three years were excluded. The total for all donors includes
commitments made in 2009 by the Organization of the Petroleum Exporting Countries (OPEC) Fund for
International Development (OFID, $47.1 million) and the United Arab Emirates (UAE, $147.0 million); and in
2010 by the Islamic Development Bank ($60.2 million); Nordic Development Fund ($9.3 million); OFID ($70.2
million); Kuwait ($72.0 million); UAE ($31.7 million); and Global Environment Facility (GEF, $7.3 million).
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Appendix C. Summary of S. 641, The proposed
Water for the World Act of 2011
In the first session of the 112th Congress, on March 2011, Senator Richard Durbin introduced the
proposed Water for the World Act of 2011 (S. 641). The act addresses several of the issues
observers raised regarding implementation of the Water for the Poor Act. The act calls for the
United States to provide, within six years, safe water and sanitation to 100 million people, on a
sustainable basis, who had yet to receive such services.
The act would also amend the Foreign Assistance Act of 1961 by
•
•
creating a Senior Advisor for Water at USAID who shall
•
report to the USAID Administrator, replace current Water Coordinator (the
initial Senior Advisor shall be the Water Coordinator who is serving at the
time of enactment), and be responsible for developing and overseeing U.S.
water and sanitation efforts in high priority countries;
•
prioritize water, sanitation, and hygiene activities that build capacity,
strengthen institutions, encourage regulatory reform, seek partner
collaboration, and are consistent with sound water resource management
principles;
•
integrate water strategies with country-specific or regional food security
strategies; and
•
ensure that at least 25% of the overall funding necessary to meet the
millennium development targets for water and sanitation is provided by nonfederal sources, including foreign governments, international institutions, and
through partnerships with universities, civil society, and the private sector.
creating a Special Coordinator for International Water at the Department of State
who shall
•
report to the Under Secretary for Democracy and Global Affairs and replace
the current Special Coordinator for Water Resources (the initial Senior
Advisor shall be the Special Coordinator for Water Resources who is serving
at the time of enactment), and be responsible for overseeing and coordinating
the diplomatic policy of the United States with respect to global freshwater
issues; and
•
ensure international freshwater issues are represented within the United
States government and in key diplomatic, development, and scientific efforts
with other nations and multilateral organizations.
In addition, the proposed Water for the World Act would amend Section 6 of the Water for the
Poor Act, which outlines the development of a U.S. strategy to meet the goals outlined in the
Water for the Poor Act. The amended language would mandate the Special Coordinator for
International Water to
•
integrate the U.S. water and sanitation strategy into any strategy for global
development, global health, or global food security that sets forth or establishes
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•
a U.S. mission for global development,
•
guidelines for U.S. assistance, or
•
how development policy will be coordinated with policies governing trade,
immigration, and other relevant international issues;
•
assess all U.S. foreign assistance allocated to water and sanitation over three
fiscal years preceding enactment, across all United States government agencies
and programs, including an assessment of the extent to which U.S. efforts are
reaching and supporting the goal of enabling first-time access to safe water and
sanitation on a sustainable basis for 100 million people in high priority countries;
•
recommend what the United States Government would need to do to reach 100
million people; and
•
identify best practices for mobilizing and leveraging the financial and technical
capacity of business, governments, nongovernmental organizations, and civil
society in forming public-private partnerships that measurably increase access to
safe, affordable, drinking water and sanitation.
The act would also add reporting requirements that call for
•
•
the USAID Mission Director for each high priority country and for each region
containing a country receiving such designation to report annually to Congress
on the status of
•
designating safe drinking water and sanitation as a strategic objective;
•
integrating the water strategy into a food security strategy;
•
assigning a USAID employee as in-country water and sanitation manager to
coordinate in-country implementation with host country officials, the
Department of State, and other relevant United States government agencies;
•
conducting formative and operational research and monitoring and
evaluating the effectiveness of programs that provide safe drinking water and
sanitation in collaboration with the Centers for Disease Control and
Prevention, the Department of Agriculture, the Environmental Protection
Agency, the National Oceanic and Atmospheric Administration, and other
agencies, as appropriate; and
•
integrating efforts to promote safe drinking water, sanitation, and hygiene
with existing foreign assistance programs, as appropriate, including activities
focused on food security, HIV/AIDS, malaria, tuberculosis, maternal and
child health, food security, and nutritional support.
the U.S. Comptroller General to submit to the Committee on Foreign Affairs of
the House of Representatives and the Committee on Foreign Relations of the
Senate a report on the effectiveness and efficiency of United States efforts to
provide safe water and sanitation for developing countries.
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Appendix D. Description of USAID and State
Department Accounts
USAID manages a range of budget accounts that are organized largely along functional and
regional lines. In addition, USAID co-manages several accounts with the State Department and
administers a growing amount of funding transferred from other agencies, such as MCC. Below is
a summary of how USAID describes the accounts through which it funds water and sanitation
efforts.
•
Assistance for Eastern Europe and the Baltic States (AEEB), jointly managed
by USAID and the State Department, promotes local and regional stability and
supports the region’s transition into the European and transatlantic mainstream.
AEEB also supports post-conflict, health, and environment programs, as well as
activities to reduce the threat of organized crime and HIV/AIDS. This account is
also known as Support for East European Democracy (SEED).
•
Development Assistance (DA), managed by USAID, provides sustained support
to help countries acquire the knowledge and resources that enable development
and nurture indispensable economic, political, and social institutions.
•
Global Health and Child Survival (GHCS), jointly managed by USAID and
the State Department, expands basic health services and strengthens national
health systems to significantly improve people’s health, especially that of
women, children, and other vulnerable populations.
•
Economic Support Fund (ESF), jointly managed by USAID and the State
Department, promotes U.S. economic and political foreign policy interests by
financing economic stabilization programs, supporting peace negotiations, and
assisting allies and countries that are in transition to democracy. USAID
implements most ESF-funded programs, with overall foreign policy guidance
from the State Department.
•
P.L. 480 Title II (Food for Peace), managed by USAID, uses abundant U.S.
farm resources and food processing capabilities to enhance food security in the
developing world by providing nutritious agricultural commodities. P.L. 480 Title
II funds are appropriated to the Department of Agriculture and administered by
USAID.
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Appendix E. MCC Water and Sanitation Compacts
by Country
Table E-1. MCC Water and Sanitation Compacts, 2006-2008
Compact Entry Into
Value
Force
Compact Progress
Country
Compact Summary
Compact Goal
El Salvador
Construct improved sanitation
systems (flush and compositing
toilets and pit latrines); and conduct
trainings on hygiene and sanitary
practices
Provide potable water
to 18,000 households
systems; improve
access to sanitation
services; and reduce
incidence of waterborne diseases
$23
million
September
2007
As of December 31,
2010, MCC awarded
$3.2 million for
feasibility, design, and
environmental studies
and $2.5 million for
water and sanitation
construction activities
Georgia
Increase water quality and improve
water supply systems in five cities;
and help targeted regions deliver
safe, reliable, affordable, and
accessible public and utility services
Strengthen regional
and municipal water
and sanitation
infrastructure to
228,000 people
$58
million
April 2006
As of September 30,
2010, an estimated
42,000 people had
access to improved
potable water supply
Ghana
Provide safe water and sanitation
facilities to 129,840 people;
construct or rehabilitate 350 water
systems (e.g., boreholes and wells);
construct and rehabilitate 25 small
town water systems; partner with
the Carter Center to help eradicate
guinea worm disease; and extend
existing water urban system to
infected farming areas in the
Northern region
Expand access to
potable water
$13
million
February
2007
As of December 31,
2010, MCC reported no
water and sanitationrelated activity
Lesotho
Extend and rehabilitate urban and
peri-urban water networks serving
the capital and other major cities;
improve sanitation services for an
estimated 25,000 households
through construction of ventilated
improved pit latrines and water
systems; restore degraded wetlands
at three areas in highland areas; and
prepare a strategic environmental
assessment to support the
development of a national
watershed management and
wetlands conservation plan
Improve the water
supply for industrial
and domestic use
$164
million
September
2008
As of September 2010,
MCC provided $4.5
million to conduct
feasibility studies,
estimated to cost $11.6
million to extend clean
water to 30,000 people
and improve latrines to
16% of the population
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Country
Compact Entry Into
Value
Force
Compact Progress
Compact Summary
Compact Goal
Jordan
Expand the As-Samra Wastewater
Treatment Plant’s treatment
capacity by 97,800 cubic meters per
day, an increase of more than onethird; replace or rehabilitate up to
29 kilometers of undersized trunk
lines and expand sewers by up to
140 kilometers in East Zarqa and
West Zarqa; reduce water loss by
constructing and repairing
reservoirs, pump stations, and up to
67 kilometers of primary, 927
kilometers of secondary, and 256
kilometers of tertiary pipes; and
replace household connections and
meters in the two poorest, most
heavily populated water service
areas of Zarqa Governorate
Improve the water
supply for industrial
and domestic use; and
help improve the
efficiency of water
delivery; and
collection and
treatment of
wastewater
$275
million
The
compact
was signed
in
October
2010 and
has not
yet
entered
into force.
As of December 2010,
activities had not yet
begun on this project
Mozambique
Supply water and sanitation services
to six cities; extend water supply in
two mid-sized towns; rehabilitate a
critical water supply dam and rural
water supply services covering 600
water points in two provinces;
improve the capacity of local
institutions; increase water supply
productivity; reduce water-borne
diseases; and support policy reforms
Provide access to safe
and reliable water
supply and sanitation
services; and train
7,200 people on
hygiene and sanitary
practices
$204
million
September
2008
As of December 2010,
MCC had provided
$31.4 million to conduct
feasibility studies in five
cities. The studies
estimated it would cost
$154 million to improve
access to clean water
and sanitation facilities
in those areas
Tanzania
Improve water supply infrastructure
in two major cities (Dar es Salaam
and Morogoro); enhance the system
efficiencies of the Dar es Salaam
Water and Sewerage Authority; and
reduce the prevalence of waterrelated diseases
Increase the quantity
and reliability of
potable water for
domestic and
commercial use
$66
million
September
2008
As of September 2010,
no construction had
begun on the water
infrastructure projects
Sources: MCC, MCC's Commitment to Clean Water, Sanitation and Improved Water Infrastructure, Fact Sheet,
March 16, 2010, http://www.mcc.gov/documents/press/factsheet-2010002010802-water.pdf; and MCC’s webpage
on compacts at http://www.mcc.gov/pages/activities, accessed on June 7, 2011.
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Appendix F. Access to Drinking Water & Sanitation,
High Priority Countries, FY2009
Figure F-1. Access to Drinking Water & Sanitation, High Priority Countries, FY2009
Source: Adapted by CRS from GAO, U.S. Water and Sanitation Aid: Millions of Beneficiaries Reported in Developing
Countries, but Department of State Needs to Strengthen Strategic Approach, GAO-10-967, September 2010, p. 35.
Note: Top 10 WASH Recipients are bolded.
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Appendix G. Measuring and Evaluating WASH
Programs: Challenges
Clean water and sanitation efforts are implemented by a variety of actors, including donors,
governmental groups (at several levels), non-governmental groups, private businesses, and
foundations. At present, there is no coordinating body responsible for overseeing international
water and sanitation efforts. The Sanitation and Water for All partnership is an attempt to develop
a coordinated approach to water and sanitation. Nonetheless, one authoritative body has yet to be
formed. As such, a number of challenges remain, including how to ensure the accuracy of WASH
data, measure the impact of related programs, and ensure proper use of the resources. Although
this section discusses some of the challenges related to WASH programs in general, many of the
observations may apply to U.S. bilateral WASH efforts.
Measuring Access to Clean Water and Sanitation
The implementation, oversight, and maintenance of water and sanitation services can be provided
by a number of actors. In some countries, there is no central authority responsible for these
services, and municipal or district assemblies—who are primarily responsible for providing
services—often subcontract the work with private operators. Because such duties can be
fragmented, data can be disjointed and inconsistent. While national statistics offices (NSOs) are
typically responsible for maintaining nationwide data on water and sanitation,46 municipal
governments often maintain their own data that may not align with NSOs. Whereas NSOs largely
rely on household surveys and census data, municipal governments usually monitor actual use of
water and sanitation systems or the number of service connections.
Donors and other actors commonly use national data to design WASH projects, although they
may not align with municipal records. In Mozambique, for example, government records
indicated 72% of the population in Sanga district had access to clean water. Subsequent studies
concluded, however, that clean water coverage in the area was 22%.47 Similarly, official
documents indicated 78% of water systems in the Kanungu district were functional, yet
monitoring and evaluation studies found 46% of them were capable of extracting water.48
Measuring the Impact of WASH Programs
Debate is intensifying around revising indicators for measuring access to clean water and
sanitation. Donors most frequently use the number of beneficiaries as a proxy for measuring the
impact of water and sanitation activities. The number of people reached in a program, however,
may not adequately reflect impact. Some observers urge donors to monitor the number of people
46
Frankie Freeman, "Ghana: The Waste Land," World Policy Journal, vol. 27, no. 2 (Summer 2010), p. 34.
Edward Breslin, Rethinking Hydrophilanthropy: Smart Money for Transformative Impact, Water for the People,
January 29, 2020, p. 1, http://www.waterforpeople.org/assets/pdfs/rethinking-hydrophilantropy.pdf.
48
Lucrezia Koestler et al., "Improving Sustainability Using Incentives for Operation and Maintenance: The Concept of
Water-Person-Years," Waterlines, vol. 29, no. 2 (April 2010), p.149, http://www.fontes.no/a/uploaded/file/
Waterlines%20April2010%20-%20Waterpersonyears-Koestler.pdf.
47
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with sustained access to clean water and sanitation rather than only those who gained access in a
given year.
Counting the proportion of people with access in a given year does not take into account other
factors, like population growth. As a result, countries experiencing rapid population growth might
improve coverage rates while the count of people with improved access declines. In sub-Saharan
Africa, for example, open defecation declined by 11% since 2010. Nonetheless, due to population
growth, the number of people practicing open defecation increased by 33 million.49
Some experts advocate a metric called “water person years” (WPY).50 This statistic measures the
cost and the utility of the initial investment (Table G-1). Other examples include metrics that
count the amount of latrines that are functional and continue to be used and the number of hands
that are consistently washed. In an effort to take population changes into account the UNICEF
and WHO 2012 Water and Sanitation Report began to report “the increase since 1995 in the
number of people with access as a proportion of the current (2010) population” rather than
counting only the number of people who gained access in a given year.51
Table G-1. Explanation of Water Person Years
Organization A
Organization A seeks to boost access to clean water. It constructs three water systems at 100 units each for a total
cost of 300 units. The new water systems are placed in three villages that each have 1,000 residents. The organization
offers no funding for operation and maintenance and the community does not have sufficient resources to maintain
the systems. The water systems installed by Organization A become dysfunctional in about three years. Using the
WPY formula, Organization A reports 9,000 WPY for its investment.
3 villages × 1,000 people × 3 years = 9,000 WPY
Organization B
Organization B invests in one village and constructs one water system at the cost of 100 units. It sets aside 10% of the
water budget (10 units) for operation and maintenance. With consistent maintenance, the water system lasts 20
years. Using the WPY formula, Organization B reports 20,000 WPY for its investment.
1 village × 1,000 people × 20 years = 20,000 WPY
Source: Created by CRS from New incentives: economic projections with the water-person-years concept, IRC
International Water and Sanitation Center, Presentation at IRC Symposium 2010, November 16-18, 2010,
Inadequate investment in clean water and sanitation impacts sustained access. One report
contends donors overemphasize expanding coverage while largely ignoring operation and
maintenance.52 Several papers discuss the frequent sighting of idle handpumps—abandoned due
to disrepair—littering the landscape of rural areas throughout the developing world. Widely cited
estimates indicate that handpump failure rates across sub-Saharan Africa range between 15% and
49
UNICEF and WHO, Progress on Sanitation and Drinking Water: 2012 Update, 2012, p. 18.
Lucrezia Koestler, Marius A. Koestler, and Christoph Gisler, New incentives: economic projections with the waterperson-years concept, IRC International Water and Sanitation Center, Presentation at IRC Symposium 2010,
November 16-18, 2010, http://docs.watsan.net/Downloaded_Files/PDF/Koestler-2010-New.pdf.
51
UNICEF and WHO, Progress on Sanitation and Drinking Water: 2012 Update, 2012, p. 11.
52
Lucrezia Koestler et al., "Improving Sustainability Using Incentives for Operation and Maintenance: The Concept of
Water-Person-Years," Waterlines, vol. 29, no. 2 (April 2010), p. 147.
50
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50%.53 Research on water pump sustainability is scant, however, and reasons for pump failure
vary. Some causes include
•
poorly constructed wells or boreholes;
•
disagreement on who is responsible for operations costs;
•
inability of local caretakers to maintain operations; and
•
poorly constructed water taps requiring frequent repair and replacement of parts.
Debates about whether donors should expect countries to maintain water and sanitation systems
that they establish can be seen in other foreign aid programs. It is not uncommon to see other
goods donated by foreign governments and other entities fall into disrepair. This tension is part of
a larger debate about the utility of foreign aid.
Ensuring Accuracy of Water and Sanitation Data
WHO established microbiological and
chemical standards to measure the safety of
drinking water. WHO relies on countries to
comply with these standards when reporting
on clean water usage. After conducting pilot
surveys in eight countries, WHO and
UNICEF found that countries complied with
WHO guidelines 90% of the time when
reporting on access to clean water from piped
water sources. Compliance rates were lower,
however, for other water sources (between
40% and 70% for wells, boreholes, and rain
collection).
Similar challenges exist with sanitation data.
WHO and UNICEF had difficulty, for
example, confirming use of improved
sanitation systems in China. The Chinese
government reported that from 1991 to 2008,
rural use of “sanitary latrines” had increased
and that the percentage of the population
using other types of sanitation facilities like
dry latrines and shallow pits had fallen from
84% to 68%.54 Not enough information was
shared, however, to determine whether the
facilities met the standards of improved
sanitation. As such, there is some uncertainty
Figure G-1. Number of People Who
Gained Access to Water and Sanitation by
Region, 1990-2010
Source: Recreated by CRS from UNICEF and WHO,
Progress on Sanitation and Drinking Water: 2010 Update,
2010, pp. 7 and 17.
53
Rural Water Supply Network (RWSN), Sustainable Handpumps, RWSN Strategy Paper, February 25, 2005, p. 1,
http://www.watersanitationhygiene.org/References/EH_KEY_REFERENCES/WATER/Handpumps/Handpump%20Ge
neral/Sustainable%20Handpumps%20(RWSN).pdf.
54
UNICEF and WHO, Progress on Sanitation and Drinking Water: 2010 Update, 2010, p. 24.
Congressional Research Service
39
Global Access to Clean Drinking Water and Sanitation: U.S. and International Programs
about the actual number of people with access to improved sanitation in the country. Ambiguity
about water and sanitation data in China is important, as the country accounts for a large
proportion of those who gained access (Figure G-1).
Author Contact Information
(name redacted)
Specialist in Global Health
[redacted]@crs.loc.gov, 7-....
Congressional Research Service
40
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