Water as priority

In 2015, the UN replaced the Millennium Development Goals (MDGs) with the Sustainable Development Goals (SDGs), which are more elaborate, specific and comprehensive. Known as the 2030 Agenda, the 17 goals identify 169 targets that are to be achieved in a span of 15 years. Goal 6 of the SDGs relates to water and sanitation. It lays down the task of "ensuring [the] availability and sustainable management of water and sanitation for all". If you go by the SDGs, you will conclude that there is a dynamic, two-way interdependence between Goal 6 and every other goal. It is, therefore, vital that linkages are understood to achieve social, economic and environmental dimensions of the 2030 Agenda.

If we introduce policies that are instrumental in ensuring the availability and sustainable management of water and sanitation, we will be implementing the other goals and their targets, such as decreasing water-borne diseases and malnutrition, supporting education and productive workforce, addressing poverty and achieving gender equality.

Thus the goal of "leaving no one behind", as far as availability and access to water and sanitation is concerned, is not just our national duty but is part of the global commitment to which Pakistan is a signatory. Improving access to clean drinking water and safe sanitation is one of the least expensive and most effective means of improving public health and saving human lives.

Millions suffer from preventable diseases and die every year because water and sanitation services are still severely lacking in many developing countries. Global figures that describe the lack of water and sanitation are alarming. More than 1.1 billion people do not have access to improved drinking water supplies and an estimated 2.6 billion individuals live without improved services.

There is a pressing need to develop partnerships with local communities to implement water and sanitation solutions that account for environmental, cultural, and economic conditions. The obstacles in improving water and sanitation services must be overcome. This will require greater collaboration among the water, health, and education sectors in conducting community-based research, formulating evidence-based policies that facilitate effective investments and focusing on developing solutions that can be locally managed. The adverse health impacts attributable to the lack of water are significant. Nearly 60 percent of infant mortality is linked to infectious diseases. Most of them are related to water sanitation and hygiene. Globally, diarrhoea, a water-borne disease, is the third largest cause of morbidity and the sixth largest cause of mortality.

For interventions to be effective, they must consider the environmental, cultural and economic conditions of a particular community. An example of such an intervention is community-led sanitation, which began in Bangladesh. It focuses on sustainability by supporting communities in prioritising their needs and developing sanitation interventions that incorporate local materials and marketing strategies. The overall result has been an explosion of new, innovative community-developed and managed technologies, significant health gains and overall improvements in well-being.

Lending institutions and national governments have traditionally focused on the implementation of large, centralised treatments systems. Such systems do not serve rural areas. Given the shortfall of the centralised systems, it is apparent that a variety of options are needed - especially in developing countries - where conditions are challenging. A decentralised approach that relies on household water use and sanitation technologies may present a viable alternative.

In many developing countries, a lack of financial resources and the low priority given to water and sanitation constrain both the maintenance and expansion of services. Corruption, the lack of accountability and the inefficient management have plagued efforts to improve water and sanitation services. The problem is compounded by the difficulty in enforcing standards.

Even countries where such standards exist, there is a lack of monitoring equipment, personnel and political will to ensure that health guidelines are enforced. Increasing funding alone is not the solution. An emphasis should be placed on implementing demand-based rather than supplybased drinking water systems whereby communities commit to join hands in developing locally-based systems.

Overcoming the obstacles to providing water and sanitation require policies and investments that address the interrelated nature of water, sanitation and health. There is a need for integrated endeavours with a focus on disease prevention. Such integrated approaches are especially important for developing countries where resources are scarce and competing needs are immense.

Interventions must reflect the needs and capacity of local communities to carry out operation and maintenance. Low-cost household water and sanitation technologies provide a viable alternative to centralised systems.

This initiative deserves to be supported and emulated by other provinces. However, the pace of implementation will have to be quickened to complete the project before elections. Public health is inextricably linked to the provision of safe drinking water. The provision of communitybased water supply solutions to the marginalised segments of society is an act of empowering them.