WORLD HEALTH ORGANIZATION
UGIONAL OfFICI POP. THE WESTE"N I'ACII'IC I~P.EAU RCGIONAL DU PACIFIQUE OCCIDENTAL
•
ORGANISATION MONDIALE DE LA SANTE
REGIONAL COMMITTEE
WPR/RC36/ 13
10 July 1985 ORIGINAL: ENGLISH
Thirty-sixth session Manila 16-20 September 1985 Provisional agenda item 18
INTERNATIONAL DRINKING WATER SUPPLY AND SANITATION DECADE- REVIEW OF PROGRESS
Report by the Regional Director
This document provides an overview of International Drinking Water Supply and Sanitation Decade activities in the Western Pacific Region of WHO during the first four years of the Decade. It describes accomplishments in the provision of water and sanitation services, identifies constraints which have impeded progress, and makes recommendations for future action, which the Regional Committee may wish to consider.
WPR/RC36/13 page 2
l.
INTRODUCTION
The International Drinking Water Supply and Sanitation Decade is now approaching the end of its fifth year. The concept was initiated at the United Nations Conference on Human Settlements (HABITAT) in 1976 and was subsequently supported by the United Nations Water Conference, held in Mar Del Plata, Argentina, in 1977. The United Nations General Assembly, by its resolution 35/18 in November 1980, proclaimed the period 1981-1990 as the International Drinking Water Supply and Sanitation Decade, 11during which Member States wiJJ assume a commitment to bring about a substantial improvement in the standards and levels of services in drinking water supply and sanitation by the year 1990. 11 In May 1981, the World Health Assembly, by its resolution WHA34.25, called upon Member States to accelerate substantially the pace of their drinking water supply and sanitation programmes, and also sought support from bilateral and multilateral agencies for national Decade plans. At its thirty-fourth session in 1983, the Regional Committee adopted resolution WPR/RC34.R4, urging Member States to promote the simultaneous implementation of their national water and sanitation programmes. The primary responsibility, however, rests develop the necessary policies and mobilize the national Decade targets. WHO's cooperative role support for the development of national plans information, the monitoring and evaluation of external resources. with the governments, which must resources necessary to achieve the consists principally in promotion and and programmes, the exchange of progress, and the mobilization of
The Decade is an essential element of primary health care, the activities of which will contribute to the attainment of the overall goal of health for all by the year 2000. Improvement of the quality, quantity and accessibility of water and sanitation services will undoubtedly reduce the incidence of disease in those populations that are currently underserved. Recognizing that existing programmes and policies have serious shortcomings, WHO has developed the following Decade guidelines for establishing national strategies and for planning and designing appropriate programmes: (1)
Ensure complementary sanitation and water supply development. Develop and implement strategies that stress coverage of the underserved populations, both rural and urban. Generate replicable, self-reliant and self-sustaining programmes. Use socially relevant appropriate technology that is affordable. Develop community participation at all stages of project development, implementation and operation. Ensure the linkage of water supply and sanitation with other health improvements. Encourage the close linkage of water supply and sanitation programmes and projects with other sectors, as a basis for community development.
(2) (3} (4) (5) (6) (7)
WPR/RC36/l3 page 3
2.
PRESENT SITUATION
The Region comprises thirty-two countries or areas of great diversity in terms of population, geographical area, socioeconomic development and per capita income. In view of these differences, a regional summary and a review become more meaningful if Member States with common features are grouped and analysed together. Six groups of countries or areas and one distinctly different Member State (China) are Hsted in Table 1 with their water supply and sanitation service levels established separately for the beginning of the Decade and for the end of 1984. TABLE 1 Water supply and sanitation service levels Western Pacific Regionl December 1980 - December I 984
1980 Population (x 1000) Group A B
Water supply Sanitation 1980 1984 1980 1984 Urban Rural Urban Rural Urban Rural Urban Rural (% of population served)
130 630 99 450 J 373 3 486 53 920 8 020 1 000 000
99 80 91 63
90 48 65
99 88 93 87 60 97
99 54 67
97 89 93 95 NA
92
99
99 61
c D E F
12
58 97 85
31
China Group A Group B Group C Group D GroupE Group F
50 30
13 31 50 NA
57 64 7 NA NA NA
89 90 95 NA
66 21 71
85 NA
85 NA
NA NA
85
Australia, Japan and New Zealand Malaysia, Philippines and the Republic of Korea South Pacific island communities (Polynesia/Micronesia) New Caledonia, Papua New Guinea, Solomon Islands, Vanuatu (Melanesia) Lao People's Democratic Republic, Viet Nam (no information on Democratic Kampuchea) Brunei Darussalam, Hong Kong, Macao and Singapore
1Data from Decade Baseline Reports ( 1981), country reports and field notes of
WHO staff.
WPR/R C36/ 1.3 page 4
Group A is composed of the highly developed countries of AustraHa, Japan and New Zealand, where water and sanitation services are provided to more than 90% of the population. Regional activities with these countries are directed to cooperation in their bilateral aid activities, since these Member States play a leading role as donors in the Region. In group B, the countries of Malaysia, the Philippines and the Republic of Korea represent the more advanced developing countries. AU three have attained high levels of water supply services in their urban centres while their rural water programmes are quite successful. The Republic of Korea has increased its rural water supply services by 9% to provide 61% coverage. Malaysia and the Philippines, with their integrated water and sanitation programmes, have realized .a n overall increase in coverage rates of 5% in both sectors since 1980. The Republic of Korea has active programmes for nightsoil treatment and basin environmental management planning while the Malaysia urban sewerage programmes are in an advanced planning stage. WHO is also collaborating with the Malaysian Government, under a UNDP-funded project, to upgrade engineers and technicians in the design, construction and operation of water supply systems. In the Philippines, the only major sewerage programme is under construction for central Manila, under a phased programme initially funded by the World Bank and the Asian Development Bank. These three countries have effective community participation programmes and maximum use is being made of these resources. It is expected that there wiU be considerable increases in water and sanitation coverage by the end of the Decade. The South Pacific island communities consist of two groups. Group C, which is made up of the smaller islands, has realized consistent progress in its water and sanitation programmes over the past two decades. For example, both Tonga and Cook Islands wiJl achieve I 00% coverage by 1990. Islands such as French Polynesia, Guam, New Caledonia and the Trust Territory of the Pacific Islands are also expected to achieve their targets of full coverage. While islands are improving their coverage, operation and maintenance remain a problem. Continuing efforts are being made to introduce appropriate technologies and to encourage communities to participate in their management. The remaining group of South Pacific island communities (group D) is composed of Papua New Guinea, Solomon Islands and Vanuatu. Papua New Guinea is implementing a project under an Asian Development Bank loan, which has a large rural water supply and sanitation component. The Government has also given more support from its national budget for the implementation of water and sanitation schemes, but concerted efforts wiJJ be required to obtain effective community participation. In Solomon Islands, good progress has been made on rural water supply systems through Australian bilateral aid and a UNDP/WHO project. The water supply of the only urban centre, Honiara, is being improved with support from an Asian Development Bank loan. Tile weaker pi;lrt of the Solomon Islands programme, however, is rural sanitation. An aggressive health education programme · is required to overcome local taboos. In Vanuatu, the national water supply and sanitation programme has received only limited WHO/United Nations support to date; a WHO sanitarian was recently assigned to that country. Lao People's Democratic Republic and Viet Nam in group E are similar in that their Decade programmes are just barely operational. Lao People's Democratic Republic has a WHO Decade project financed by UNDP, which is directed towards training a cadre of trainers and developing a national Decade programme. In Viet Nam, WHO has provided materials and technical guidance for the introduction of ferrocement technology and village water and sanitation schemes.
WPR/RC36f13 page 5
The last group consists of Brunei Darussalam, Hong Kong, Macao and Singapore (group F). Although high levels of water and sewerage services are already provided to their dense urban populations, all are experiencing serjous constraints with regard to available water resources. Singapore has problems in dealing with animal or poultry waste in a constrained island environment while both Macao and Hong Kong have major water pollution control problems. Brunei Darussalam has good water services but its rural sanitation services need to be improved. With sound planning and efforts, these countries or areas have good prospects of meeting their Decade goals. China is listed separately from other countries because of its extremely large population of over J billion. A National Action Committee has been designated (Office of the National Patriotic Health Campaign Committee) and the Government is giving strong support to Decade activities. An imbalance exists between the urban and the rural sectors with respect to water supply activities. While approximately 85% of the urban population is served, only 30% of the rural areas have reasonable access. What is needed is large financial support for a major construction programme in both the urban and rural areas. However, a recent World Bank loan of $80 million should make a substantial contribution to the rural water supply programme in that country. Data on sewerage and excreta disposal service levels are not available in China, but it is known that sewerage systems serve many large cities and that nightsoil collection and disposal facilities exist in most urban peripheral areas, municipalities and villages. However, the handling of nightsoil and its application to farmlands as a fertilizer does constitute a health risk not only to nightsoil coJJectors but also to consumers of crops. There appears to be a need to improve the coHection and disposal practices of existing nightsoi! systems in China in the interests of public health. The overall rates of coverage given in Table I show the progress achieved during the first four years of the Decade. It is evident that sanitation services in some countries have still not kept pace with water development. While water supply has improved in urban areas, the coverage for ruraJ communities has not . greatly exceeded the increases in population. The relatively small increase in water supply may, however, be attributed to the fact that the early years of the Decade were in part a preparatory phase and that major efforts are onJy now gathering momentum.
3.
PROGRAMME ACCOMPLISHMENTS AND CONSTRAINTS
3.1
Administrative framework
During the first stages of the Decade, progress has been slower than desired in developing an effective administrative framework for programme development and implementation in many countries or areas. However, comprehensive national plans have been developed in the Philippines, Samoa and Solomon Islands. In American Samoa, Guam and the Trust Territory of the Pacific Islands, effective plans have been developed through United States federal grants in compliance with drinking water and water quality management legislation and regulations. Unfortunately, however, in most of the other countries or areas, national plans consist merely of Hne items in the national budgets for construction of facilities. Long-term approaches to sector needs are not being identified. While coordination of country activities has been fostered by designated Decade action committees in China, Lao People's Democratic Republic, Papua New Guinea, the Philippines, Samoa and Viet Nam, most of the remaining countries or ar~as depend on existing inter-agency coordination mechanisms. In many
WPR/RC36/13 page 6
of the sma!J island c~mmunities of .the South Pacific, these approaches have proved to be rea~onably effe_ct1ve, but they have not been particularly successful in the larger countnes. What IS really needed at the country leveJ is the establishment of a committee wHh authority to coordinate, monitor and control the development and implementation of Decade plans and programmes. 3.2 Human resources development
Human resources development is considered to be one of the most important activities in the Decade. Lack of adequately trained manpower is one of the main programme constraints and a WHO strategy document has provided useful guidelines in this area.l WHO field staff have been cooperating in Lao People's Democratic Republic, the Philippines, Samoa, and Solomon Islands in national training programmes. UN DP has provided support to the intercountry training project for water supply and sanitation personnel in the South Pacific communities, to develop a core group of trainers skilled in related tasks. Decade management workshops have also been conducted by WHO staff at Madang, Papua New Guinea, in 1981, Suva in 1982 and DaHan, China, and Hanoi in J 983. A regional workshop on pre-investment planning for water and sewerage facilities was held at Kuala Lumpur in 1981. At country level, WHO field staff have participated in a number of local training activities, usuaJly in coordination with primary health care activities. WHO fellowships and study tours have provided further support for human resources development in the sector. Shortage of staff is, however, a major constraint. It can be said that, in general, insufficient personnel are being employed by countries to ensure that the installed facilities are designed and adequately managed. 3.3 Financing
Serious difficulties are being experienced with programme financing for the development of rural water supply schemes, whether for rainwater catchments in small islands in the South Pacific or to meet the immense needs of the many villages in China. In the South Pacific island communities, bilateral aid from Australia, France, New ZeaJand, the United Kingdom and the United States has provided substantial support. In the remaining parts of the Region, the more advanced developing countries (Malaysia, the PhiJippines and the Republic of Korea) have received, mainly as a result of their own efforts, substantial financial support from the World Bank, the Asian Development Bank and bilateral sources. Despite all these activities, additional financial commitments from national budgetary allocations and from international and bilateral arrangements (loans/grants) will be needed to sustain and further advance national Decade programmes. 3.4 Maintenance
Maintenance of systems is also quite inadequate throughout the Region. This is a major constraint. In general, a review of the operational reliabiJity of water installations indicates a high failure rate caused by the lack of systematic maintenance
1Basic strategy document on human resources development. Recommendations of the Task Force on Human Resources Development of the IDWSSD Steering Committee for Cooperative Action (WHO document EHE/82.3.5), 1982.
WPRfRC36/ 13
page 7
programmes. In one country, for example, approximately 66% of the handpump installations had faHed because preventive maintenance programmes had not been developed at the vHlage level and the water agencies had failed to provide the necessary technical support. Resources are thus being wasted because of lack of attention to these details but, what is more important, people's health is being jeopardized since communities are forced to use traditional and unsatisfactory water sources when system breakdowns occur. To ensure safe drinking water, there is also a need to monitor the quality of drinking water and the adequacy of sanitation disposal systems. While many countries do have monitoring programmes, financial a!Jocations for laboratory equipment and supplies services and for training of surveillance staff are insufficient. WHO has provided training for laboratory personnel through national workshops and on t he occasion of the supply of laboratory equipment but additional efforts will be needed in future to ensure that the drinking water provided is suitable for human consumption. 3.5 Community involvement
Community involvement is an essential part of the Decade approach. In some countries such as China, Lao People's Democratic RepubUc, the Republic of Korea and Viet Nam, effective community participation programmes have been integrated into water and sanitation activities. In WHO collaborative programmes, Decade activities have also been linked with primary health care in New Ireland, Papua New Guinea and leyte, Philippines. In many countries, however, the community is only involved during the construction phase. Insufficient national efforts are being applied to the development of community resources in administering, financing, operating and maintaining the installations. · 3.6 I
Appropriate technology
Efforts have been made by WHO through national and regional workshops to introduce appropriate technology which is relevant to the needs of the community and which can be operated and maintained by the people at an affordable cost. Varjous designs for long-lasting ferrocement tanks have been successfully used in the South Pacific and in Viet Nam. In addition, an easier and less costly method for monitoring water quality is being developed. As the initial costs of solar-powered pumping systems are declining, these installations are becoming more appropriate because their operating and maintenance costs are minimal. In the selection of technology, however, choices are made on the basis of the standards of the agency concerned and not of the social and cultural needs of the people. In addition, aU too frequently, systems are being installed which the communities cannot afford to operate or maintain. 3.7 Information systems
Accurate and up-to-date information systems are required to monitor Decade progress. Such management tools are also necessary for controlling and influencing resource aHocation. While a number of countries in the Region participated in the Decade baseline report in 1980 and in the 1983 updating, it is evident that the information systems in use are not as accurate as they might be. Further efforts are required to ensure that the records are regularly updated to reflect field conditions.
WPRjRC36/l 3 page 8
4.
FUTURE PLANS
Future Decade activities of the regional programmes wiJl be directed towards collaborating . . with Member States in accordance with their specific needs. However ' smce requJrements vary from one country to another, attention wiH be directed to those problem areas which are common to countries, such as development of human resources, promotion of full community participation, and selection of technologies that are appropriate for operation and maintenance at the viHage level. WHO wiJJ continue to collaborate with Member States in the further development of plans which wHJ provide full coverage in water and sanitation over a time period which is appropriate to the country resources. A sufficient number of personnel is essential to ensure that the required facilities are designed and adequately managed. WHO will, therefore, collaborate with governments in the development of long-term staffing criteria to meet the administrative, financial and maintenance needs of existing and planned systems. Training efforts will, of course, be continued to support these related activities. Maintenance of systems is a neglected area which deserves more attention. WHO wiH therefore accelerate its cooperative efforts with countries in developing and strengthening preventive maintenance programmes. Community resources also are generally not being utilized effectively. People are being used only in the construction of facilities or in the provision of local materials. In most countries, they are generally not being trained or motivated to be active participants in the planning, administration, and operation and maintenance of installed systems. WHO will cooperate with countries in strengthening the community participation elements of programme development. Finally, technologies imposed on communities are not genera!ly relevant to the social and cultural habits. Concerted efforts will, therefore, be directed towards encouraging countries to select technologies which are appropriate to the needs of specific communities.