If you want to see the true difference between polio eradication and water supply look no further than the recent announcement that the Millennium Development Goal (MDG) for water has been achieved.
With polio, a rigorous monitoring program and an unrelenting focus on actual polio eradication has led to tremendous and real success. Polio is now a distant memory in most parts of the world. Results can be demonstrated and have been verified -- and the fact that India recently announced that no new cases of polio were reported for more than a year is but one example of the rigor and programmatic success that is now the hallmark of those who worked so hard to rid the world of polio.
Contrast that with water supply. Mr. Sanjay Wijesekera, chief of water and sanitation at UNICEF, announced that the MDG for water has been reached. The announcement makes the case that over 2 billion people have received access to improved water supplies across the global landscape since 1990 and is cause for celebration.
The response from water supply advocates has been muted at best. A few international NGO CEOs and advocacy groups have praised this result and quickly tried to shift the focus to the yawning MDG gap in sanitation, but in general the response from organizations working on this issue has been, "What?"
Cynics would say that this response is simply because MDG success undermines the need for further funding of water supply. But that is not what is happening here.
One must take a step back to look at this MDG success in detail and with a bit of rigor.
UNICEF and the World Health Organization (WHO) manage and report on water and sanitation trends annually through the Joint Monitoring Program (JMP). The JMP is the global data set that is used to track progress in water supply and sanitation.
Without getting into too much detail, the JMP uses a wide range of data, including census data and data from national health surveys, to make a determination on water and sanitation access in each country. The JMP was an enormous step forward because at least data was finally being tracked. That must be applauded. But the key word is access. Sadly the JMP picked the wrong indicator.
There is a fierce debate over the accuracy of the data set that is frankly somewhat exhausting. The core issue that is real is that there is a big difference between simplistic views of access and substantive views of functionality.
Access means that there is a tap nearby that people could use. Functionality means that water actually flows from that tap. To revert to our polio example, access in that scenario would be that polio medication was available. Polio succeeded because they did not focus on access but rather made sure everyone received the polio vaccine -- a focus on the functionality of the system, not the availability of the medicine.
Let's use a story to illustrate this even better. I speak of a great teenage girl, Fanta, quite often. She is a girl with big dreams and was named after the popular Coca-Cola product that her mother loves so much. Fanta orange of course. I met Fanta in Zimbabwe when she was lugging water from an unprotected water source. She had missed another day of school fetching water, and we talked next to a broken handpump that she passed each day on the way back and forth from the unprotected puddle she used now for her household supply. She has "access" to an improved water point per JMP numbers via Zimbabwe census data but she does not access water from that source because it does not function. That is the difference in plain sight between JMP numbers and reality.
The JMP is right that 2 billion people have gained access to a tap or a handpump. Critics of this view correctly point out that far too often the tap does not produce water, so it is not functional and therefore is not effective at what the MDG is really trying to do -- eradicate water poverty.
Hence the muted response.
Evidence that explains this difference is abundant. A few examples should suffice.
Let's start with my personal experience. I worked for seven years as the country representative of WaterAid in Mozambique. In 2004, we saw the potential of GPS and mapping as a means to verify the actual water supply situation in the places where we worked and to visualize these results in a new way. Handpumps are abundant in rural Mozambique but nobody could really quantify the actual scope of handpump functionality. We decided to map each water point and determine whether that water point was actually working to gain some clarity on this issue.
We started in the district of Sanga in the far north of the country. WaterAid, government staff from the provincial and district water department, a consultant and local NGOs went to every single water point, geocoded the water point and made a simple determination if the water point was actually producing water.
When we started, the conventional view of "access" was that 72.9 percent of the residents of Sanga district had access to an improved water supply. JMP numbers, positive, actually quite significant coverage.
When we went to every water point in every village in the district, we verified the existence of the water points (access) but we found that the actual functionality -- the percentage of those water points that actually produced water for families and met even some semblance of Mozambique's water regulations -- was only a fraction of what conventional views of access were. Only 21.91 percent of the district had access to improved water supplies. The full report is here.
The reasons for this discrepancy were simple -- access figures are impressive but do not tell a very compelling story when so many water points that provide access do not actually provide water or are not actually used.
Let's build a bit further on this. UNICEF and the WHO have recently started putting together country studies that explain their JMP results. These reports are extremely helpful. So let's look at Liberia.
Liberia has done wonders since emerging from war and is led by a government that wants to end its dependence on outside assistance within 10 years. Bravo! The JMP estimates, updated in March 2012, suggest that a hair shy of 60 percent of the people who live in rural Liberia have access to improved water supplies, while urban is close to 90 percent
This contrasts sharply with the exceptional work done by the Water and Sanitation Program (WSP) with support from UNICEF. Every single rural water point in Liberia -- approximately 7,500 in total - was geocoded, photographed and evaluated for functionality. The full WSP report is here. The main finding -- only 38.4 percent of all these water points -- the ones that made up Liberia's 60 percent rural MDG access figures used by the JMP -- are functioning.
Finally, those claiming water supply MDGs have been reached hold up Malawi as an example of success. Malawi is certainly trying and has made great strides in areas of sustainability/functionality, but the JMP results are intriguing on at least two fronts.
In terms of urban water supply, the JMP data published here suggests that 95 percent of the people living in urban centers in Malawi have access to improved drinking water while 77 percent of rural Malawians have access.
Yet once again, actual data on functionality from Blantyre (the second largest city in Malawi) suggests that only 35.6 percent of the low income areas (where 70 percent of urban Malawians live) have reliable water services, with a further 32.1 percent have "ok" service -- water flows but problems with the service are evident. That is only 67.7 percent, a far step away from the JMP figures. Note -- some may suggest that the JMP numbers are for other parts of the city, not low-income areas, but this misses the point. Blantyre as a city has enormous water challenges that the Blantyre Water Board is making great strides to address, but their challenge is masked by JMP numbers that confuse access with functionality.
Rural Malawi is one of the most mapped water countries in the world -- initially led by WaterAid and now managed by the WSSCC with financial support from UNICEF. The data clearly shows that the percentage of water points that are actually functioning is variable across the country but low, meaning people are walking past broken handpumps back to polluted rivers, streams and puddles. Nobody in the country believes that 77 percent of rural Malawians are collecting water from an improved source.
Let's be clear -- water point functionality is a real global challenge. Data on functionality, like presented in this nice blog post and reports from cities like Mumbai, highlight the need to get water flowing from the investments made in increased access to water facilities. The MDG numbers push has, to date, masked the critical gap between access and functionality. This is precisely what a group of people are working on now - reshaping the post 2015 JMP focus from access to functionality -- this is to be welcomed and supported.
But given the reality of the gaps between access and functionality, the "MDG success" is not a cause for celebration just yet. The failure of the investments in improved access to flowing water is a cause for alarm. The muted response by the water sector to the news of MDG success is therefore welcome. We have too much to do to clap just yet.
To learn more about how Water For People's Everyone Forever initiative, visit: http://www.waterforpeople.org/everyone/
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