Such concerns have helped push the international community to ensure that the targets of the 2000 Millennium Development Goals and the 2002 World Summit on Sustainable Development (WSSD) address improved access to safe drinking water and adequate sanitation.

The WSSD agreed target on water and sanitation is ‘To halve, by the year 2015, the proportion of people who are unable to reach or to afford safe drinking water and the proportion of people who do not have access to basic sanitation’.

A sustainable approach to sanitation includes wastewater collection, treatment and reuse

Increased problems
Population growth, rapid urbanization, and increasing water supply and sanitation provision to meet the 2015 targets will all generate increased problems from wastewater pollution. At present, only about a tenth of the domestic wastewater in developing countries is collected and only about a tenth of existing wastewater treatment plants operate reliably and efficiently. Ignoring wastewater pollution issues proves costly, in human, ecological and financial terms. Discharging it untreated to the natural environment directly affects the primary resource for drinking water supply, essential ecosystem functions and the sustainable use of water (see below). Increasing sanitation coverage, therefore, requires public sewage collection and treatment systems, so as to prevent raw sewage from entering groundwater, surface waters and coastal areas. Reusing wastewater should be considered as an important option, especially in water-scarce regions. A sustainable approach to sanitation includes wastewater collection, treatment and reuse.

Overall, the same number of people in both urban and rural areas (1.1 billion) will require improved sanitation by the target year of 2015. This means that 400,000 additional people will have to be supplied with services each day. The World Panel on Financing Water Infrastructure estimated in March 2003 that $72 billion was needed annually – four to five times more than currently spent – to achieve the target on sanitation, including household sanitation, hygiene and wastewater treatment: $56 billion of this is required for wastewater treatment alone.

One approach to bridging this enormous financial gap is to consider how the use of different technologies can affect costs. The figure above illustrates tentative cost estimates for different levels of sanitation service and technology as a ‘ladder of sanitation options’, starting at a basic level and moving up to higher levels of service. It illustrates that there is an important difference between the (mostly non-networked) rural sanitation component of the target and the (mostly networked) urban improved wastewater treatment component. Understanding these different options is important. Most sanitation discussions and financing calculations do not differentiate clearly between providing basic sanitary services or improved ones, including wastewater collection, treatment, reuse and reallocation to the environment. This can cause confusion and results in wide variations in cost estimates. Depending on the level of sanitation services, cost estimates vary widely – up to 32 times over.

Local low-cost solutions
Global estimates of financial needs therefore often do not consider local low-cost solutions. The funding gap between the current level of investment and what is required to reach the sanitation target agreed at WSSD can thus substantially be reduced if lower-cost technology is used in appropriate situations. This is particularly true in towns and cities, where the traditional assumption has been that full sewerage connection is the most appropriate level of service. Septic tank systems could also be suitable in densely populated areas, to give one example, and decentralized eco-technologies should also be considered as cost-effective alternatives. Some of the low-cost options, however, can have negative environmental consequences if not properly planned and managed: these include the effects of sewerage connection without adequate treatment, or of inadequate sludge disposal contaminating the environment.

Providing improved sanitation requires that a range of design attributes are considered – not just the technology but also, for example, institutional and management arrangements, or billing and tax collection procedures. Low-cost, appropriately designed sanitation schemes provide a possible option for poorer urban communities to match solutions to their limited cash resources.

A global consensus is emerging on how to address municipal wastewater collection and treatment sustainably. Guidelines on Municipal Wastewater Management and its Ten Keys for local and national action were considered by over 100 countries at the UNEP/GPA Intergovernmental Review meeting in 2001. Aimed at setting a new global standard in the field of sustainable municipal wastewater management, the Ten Keys cover policy issues, management approaches, technology selection and financing mechanisms. They have been developed jointly by UNEP, the World Health Organization, UN-HABITAT and the Water Supply and Sanitation Collaborative Council, and supported by UNICEF.

Some of the damage associated with inadequate
handling of wastewater

• Increased direct and indirect costs caused by increased illness and mortality.
  
  
• Higher costs for producing drinking and industrial water, resulting in higher tariffs.
  
  
• Loss of income from fisheries and aquaculture.
  
  
• Poor water quality deters tourists, immediately lowering income from tourism.
  
  
• Loss of valuable biodiversity.
  
  
• Loss in real estate values, when the quality of the surroundings deteriorates: especially important for slum dwellers where housing is the primary asset.

Some examples of the costs of inaction

• The global burden of human disease caused by sewage pollution of coastal waters is estimated at 4 million lost ‘person-years’ every year, which equals an economic loss of approximately $16 billion a year.
  
  
• GESAMP (Joint Group of Experts on the Scientific Aspects of Marine Environmental Protection) estimated the global impact of bathing in and eating shellfish from polluted seas at approximately $12-24 billion per year.
  
  
• Lost income and additional health costs from the 1992 cholera epidemic in Peru were estimated at ten times the annual national budget for water supply and sanitation.
  
  
• The aggregate annual benefits of improving the water quality of East Lake, a recreational area in Wuhan, China, affected by daily discharges of effluents from industries and households, ranged from $42 million to $112 million using contingent valuation.
  
  
• The cost of water pollution along 20 beaches of the Estoril Coast in Portugal, used by approximately a million people a year, was around $68 million annually.

1. Secure political commitment and domestic financial resources.

2. Create an enabling environment at national and local levels.

3. Water supply and sanitation is not restricted to taps and toilets.

4. Develop integrated urban water supply and sanitation management systems also addressing environmental impacts.

5. Adopt a long-term perspective, taking action step by step, starting now.

6. Use well-defined timelines, and time-bound targets and indicators.

7. Select appropriate technologies for efficient and cost-effective use of water resources and consider eco-technology alternatives.

8. Apply demand-driven approaches.

9. Involve all stakeholders from the beginning and ensure transparency in management and decision-making processes.

10. Ensure financial stability and sustainability.

10.1. Link the municipal wastewater sector to other economic sectors.

10.2. Introduce innovative financial mechanisms, including private sector involvement and public-public partnerships.

10.3. Consider social equity and solidarity to reach cost recovery.