Member countries of the WHO South-East Asia Region – including India – have made concerted efforts to provide water and sanitation infrastructure and services to all people everywhere. Infrastructure like safe water points and designated latrines. Services like sewage treatment and safe wastewater disposal.
Region-wide, that effort is paying off. In India, for example, inadequate water, sanitation and hygiene once had a dramatic effect on its disease burden. In 1990, at the start of the Millennium Development Goal era, poor sanitation was the second-largest cause of disease in the country. Thanks to a range of long-term initiatives that have since been intensified, water and sanitation is now the seventh-largest cause of disease, accounting for around 5% of the country’s disease burden. That is a substantial achievement – one that indicates the life-changing potential further progress holds-out.
The numbers are instructive. By 2015 88% of the country’s citizens had access to improved drinking water. 44% had access to improved sanitation. The ‘Swachh Bharat Abhiyan’ (or Clean India campaign), introduced in the same year, has since increased that proportion, and will continue to as the country-wide mission to end open defection and ensure every citizen has access to latrines by 2019 proceeds.
But as elsewhere in the Region, despite progress, insufficient water and sanitation-related infrastructure remains a significant cause of life-threatening diseases. Diseases responsible for severe and often fatal diarrhea. Diseases that impose malnutrition and stunting on millions of children and adolescents. Diseases that are both chronic and acute, and which can cause liver failure, urinary tract infection and blindness. Diseases like cholera and helminth infections, hepatitis, schistosomiasis and trachoma. Each one of these and more can be prevented by enhancing access to safe water and sanitation for all.
Making that happen means first and foremost focusing on equity – on ensuring resources are focused where the burden of water and sanitation-related disease is highest. To do that, health data must be utilized effectively to plan water and sanitation interventions. In India, that means ensuring the Ministry of Health and Ministry of Drinking Water and Sanitation work hand-in-hand to find targeted solutions. That is especially the case in the nine states where the burden of water and sanitation-related disease is most significant.
Notably, despite substantial Region-wide investment in constructing basic water and sanitation-related infrastructure, it is equally important that the water supplied is at all times safe, and that associated infrastructure is utilized and adequately maintained. That requires the enforcement of water quality regulations, ongoing behavioral change campaigns, as well as permanent vigilance to ensure facilities are safe and serviceable.
The safe disposal of sewage and wastewater is likewise crucial. Inadequate treatment of sewage and wastewater not only leads to the contamination of water sources by fecal matter and chemical contaminants, but also contributes to antimicrobial resistance – one of the 21st century’s greatest public health and health security threats.
To help mitigate that threat and accelerate access to safely managed water and sanitation for everyone everywhere – as per Sustainable Development Goal 6 – WHO guidelines for safe water and sanitation planning should be fully adopted and embraced. That includes conducting regular risk assessments and managing all risks effectively from catchment to consumer. It also means carrying out regular – and ongoing – water quality surveillance among other core monitoring activities.
Across the South-East Asia Region, WHO is committed to accelerating the significant progress already made in advancing access to safe water and sanitation and reducing associated disease burdens. India, too, is committed to that goal. To that end, WHO will continue to support India until all people everywhere have the water and sanitation needed to stay healthy, productive and disease-free.