To meet human needs / by Gro Harlem Brundtland

To meet human needs by Her Excellency Gro Harlem Brundtland, Prime Minister of Norway and Chairman of the World Commission on Environment and Development he International Drinking Water Supply and Sanitation Decade is of great social, developmental and environmental significance. Hu- man needs are largely identical with health needs, and meeting the human needs of their people is an important and an urgent development priority in all countries whether developed or developing. However, given the uneven in- creases in global incomes , the demand for resources and the increased popu- lations projected for the future, hu- man needs have not only to be met but ' they have to be met in a socially, economically and environmentally sustainable manner. The designation of the Decade has provided a suitable 2 occasion for governments to get in- volved in many-faceted human needs programmes , while simultaneously providing a format for a broader rela- tionship with the social, economic and environmental determinants of development. After five years , the achievements of the Decade-though modest-have been encouraging. Considerable ef- forts have been made in improving potable water supply and sanitation. More importantly, the Decade has contributed significantly towards rais- ing awareness, both at national and international level, of the importance of safe water and sanitation for health , well-being and socio-economic devel- opment. All this has been achieved against the background of unfavour- able international trends, which have affected the capacity of many govern- ments to invest more resources in public works and social programmes. The provision of good quality water in adequate amounts , when and where it is needed, is not just a question of disease prevention. Nor are · arrange- ments for waste and sewage disposal a separate question of sanitary signifi- cance only. The two are complemen- tary, and both are required to achieve the wider objectives of good health and general well-being. If the health benefits of water supply are to be maximised , the chain of disease trans- mission has to be broken and this calls for increased emphasis on sanitation. W ORLD HEALTH, December 1986 c 0 -~ LJ c ::J 0 lL LJ 0 lL 0 I s 0 0 £ ()_ Recognition of this complementarity is of fundamental importance to the planning of community water supply programmes. At the local level, community water supply needs to be integrated with other initiatives and investments in rural development. The early involve- ment of local people alongside health workers and technicians will ensure that the water supply has the max- imum impact on the general well- being of the population. Moreover, emphasis ·on other benefits of safe water and sanitation will promote local funding and better community participation , particularly for opera- tion and maintenance. Indirectly , such participation will help to reduce the current imbalances that favour water supply to the detriment of sanitation. The broader approach to health pol- icy through an emphasis on " primary health care" is the cornerstone of the WHO strategy of Health for All by the Year 2000. National health agencies should consider support for communi- ty water supply and sanitation as part of primary health care and therefore of the Health for All strategy. Health care workers in turn will need to strengthen community involvement and train community workers to stress the health and developmental signifi- cance of safe water and sanitation. During the remainder of the De- cade-given the constraints on finan- cial resources-greater emphasis will have to be placed on rehabilitating existing systems and making better use of them. This calls for appropriate training, and for technologies to be employed that are consistent with the resources available. Experience shows that, when maintenance is entrusted to women , the results are more satisfac- tory! In order to improve mainte- nance , the community and especially women must fully participate . It.is clear that the dimensions of safe water and sanitation are multisectoral. While adequate attention has to be paid to technical and health aspects, the underlying social forces have cre- ated a need for the social, economic, environmental and political variables to be considered in the design, con- struction, operation and maintenance of safe water and sanitation systems . Thus, as governments focus on safe W oRLD HEALTH, December 1986 water and sanitation, they will have to tackle a whole series of issues that are interrelated . And in planning and car- rying out community water pro- grammes, decisions about increasing the supply have to be tempered by considering just who makes what type of demand, where and when. In other words, "Water is not just pipes , it is people. " The priority for the next five years must be the achievement of the De- cade targets , in a context of overall social and development relevance. Safe water and sanitation must be seen as a health issue as well as a develop- ment issue; certainly it is no longer necessary to justify the expenditure Her Excellency Gro Harlem Brundtland, Prime Minister of Norway, and Chairman of the World Commission on Environment and Development (The "Brundtland Com- mission "). Photo S Farkas © involved. By the same token, the cost- effectiveness of the sector should not rely on health indicators alone. Com- munity water supply programmes have to be drawn up and put into effect as integral parts of the sectoral policies on agriculture, health, education, nut- ntwn, housing and environment. Bringing this about will be one of the greatest challenges of the future in the field of safe water and sanitation. • Cover: Safe water and sanitation: an essentia l precondition for social and economic development Photo WHO/T. Fa(kas IX ISSN 0043-8502 World Health is the official illustrated magazine of the World Health Organization. Editor: John Bland Deputy Editor and this month's Theme Editor: Christiane Viedma Art Editor: Peter Davies News Page Editor: Peter Ozorio World Health appears ten times a year in English·. French. German, Portuguese. Russian and Spanish. and four times a year in Arabic and Farsi . Articles and photographs not copyrighted may be repro· duced provided credit is given to the World Health Organization. Signed articles do not necessarily reflect WHO's views. World Health, WHO, Av. Appia, 1211 Geneva 27. Switzerland. Contents To meet human needs by Mrs Gro Harlem Brundtland Millions in need . . . . . . . . . .. Health-giving rain by Branko Cvjetanovic ..... . . Quality of life for all by Dr Emil Salim ..... . . A plan to quench Haiti's thirst 2 4 5 7 by Serge Gaspard . . . . . . . . . . . . . . . . 10 Uphill work by Juliusz Kozinski ....... , . . . . . . . . 13 Water is development... . . . . . . . 16-17 Water development funding by Louis Laugeri . . . . . . . . . . . . . . . . . 18 Water for a million by Timo Vuori . . .... . . . 22 Quality groundwater for tomorrow by Janne Fors lund . . . . 25 The Decade at half-time by Gregor Watte rs. . . . . . . . . . . . . . . . 27 • Departments: Primary Health Care Common action by Pablo R. Imperio . . . . . . . . . . . ... . . . 9 Appropriate Technology Basic X-ray units in Kenya . . . . . . . . . . 20 X-ray Manual: Picture-Perfect Success.............. 21 News Page . . . . . . . . . . . . . . . . . . 30-31 3