Almost 900 million people worldwide live without access to clean water and more than two and a half billion people live without adequate sanitation – more than a third of the world's population. But, says the charity WaterAid in a report due out this week, aid given to solve this problem is not reaching the people who need it most.
Ninety per cent of people without access to sanitation facilities live in just 29 countries, with the highest absolute numbers in India and China. But new research by the charity shows that the top 10 recipients of water, sanitation and hygiene aid ("Wash") over the past decade have not been those in greatest need, but largely middle- or upper-middle-income countries.
Barbara Frost, chief executive of WaterAid, said: "Historical and strategic interests still influence where aid is going, rather than the countries and communities where poverty and need is highest. Over the past decade, least developed countries have received only 30 per cent of aid for water, sanitation and hygiene. With an increase of aid focused on the poorest countries in sub-Saharan Africa and South Asia, hundreds of thousands of lives could be saved every year, and a major step will have been taken towards ending the global water and sanitation crisis."
WaterAid's analysis of figures provided by the Organisation for Economic Co-operation and Development shows that, between 2000 to 2009, India and China, which have more than 800 million and 600 million people respectively without access to sanitation facilities, were top 10 recipients for Wash aid in nine and eight years respectively. Yet the poorest sub-Saharan African countries, where the proportion of those living in water and sanitation poverty is greatest, appeared only two or three times in the top 10 of aid recipients, in each of the past five years.
According to WaterAid's research, Malaysia, an upper-middle-income country, was the second biggest recipient of water aid in both 2000 and 2005, despite the fact that 97 per cent of the population already had access to sanitation and 92 per cent access to water. Morocco and Jordan, both middle-income countries, appear five and six times as top 10 aid recipients, despite the fact that 64 per cent and 98 per cent of their populations had access to sanitation and water respectively before aid was given.
By contrast, Niger, with only 9 per cent of its population with access to sanitation, has not appeared in the top 10 recipient list once. Iraq has been in the top 10 since 2004, attracting $3.7bn of aid in just six years. More than 70 per cent of its population have access to sanitation facilities, according to the latest official figures.
Despite United Nations evidence showing that investment in water and sanitation can be one of the most cost-effective forms of aid, WaterAid concludes that progress on sanitation has been "slow, uneven and unjust". The share of global aid going to sanitation and water projects has fallen to 5.5 per cent, down from more than 8 per cent in the 1990s.
Alastair Morrison, programme manager at the UNDP water governance facility at Stockholm International Water Institute, said low levels of sanitation access do not just
impact upon other global health indicators, but also on the world's wealth. "We need to be aware of how serious the issue of sanitation is. We are seeing a loss of 6 per cent a year to some countries' GDP due to poor sanitation; this is $50bn or so in India each year, on top of health and humanitarian impacts," he said.
While the United Nations target to halve the number of people without access to water by 2015 is globally on-track, in sub-Saharan Africa access to sanitation is now the least successful of its eight Millennium Development Goals, and will not be met for 200 years, WaterAid says. Rwanda has moved to improve household access to sanitation faster than any other country in the region, but there are still 328 million people living without access to water in sub-Saharan Africa, and the percentage of the population with access to sanitation facilities has gone up by only 2 per cent in the past decade, to 31 per cent.
The report draws particular attention to America's aid policy, pointing out that it spent more than eight times as much per person in countries where more than three-quarters of the population had adequate sanitation than in countries where access was lower.
A spokesman for USAID, the American government's humanitarian agency, said: "It is true that some of our largest programmes, on a per capita basis, are in countries with fairly high, though not universal, coverage levels," but he also stressed that USAID's programmes "target the marginalised and disadvantaged populations without service or with poor-quality service".
He added: "The US factors a number of foreign policy and development considerations into the allocation of resources to improve water supply, sanitation and hygiene. These include host-country engagement and capacity, the potential for systems strengthening to improve services, as well as low access to service."
Before the Water and Sanitation for All meeting in Washington DC in April next year, WaterAid has created a list of countries that they say are in most need of Wash aid. Ethiopia tops the table, followed by Burkina Faso, Afghanistan, Congo and Niger.
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