Water and Sanitation in Indias Census-2012

Farhana Ahmed, March 26, 2012 The Census-2012 has given a very dismal picture water and sanitation facilities in India. Improper planning and casual implementation of schemes coupled with rampant corruption and irregularities in the concerned departments as well as lack of awareness among the public particularly in the rural areas have made India to be left behind in this most basic and important aspect of public health. The statistics on drinking water and sanitation of Assam also indicate a very disturbing picture. The Census-2011 report on water and sanitation says that out of 246,692,667 (191,963,935 in 2001) surveyed households 43.5% (36.7% in 2001) in India have tape water, 11% (18.2% in 2001) has wells, 42% (41.2% in 2001) hand pump/tube well and 3.5% (3.9% in 2001) has other sources of drinking water. The Census-2011 added two new queries on treated and untreated drinking water and on covered or uncovered source of drinking water. Here the report says only 32% of Indians use treated drinking water while 11.6% do not use treated drinking water. Similarly only 1.6% households use drinking water from covered sources while 9.4% do not have that. In Assam out of 6,367,295 households only 10.5% (9.2% in 2001) has tape water, 18.9% (26.7% in 2001) has wells and majority 59.4% (46.9% in 2001) use tube wells for drinking water followed by 11.3 % (14.6%) having drinking water from other sources. This is almost ten percentage drop of use of wells and more than 10 percent increase of the use of tube wells for drinking water in Assam. Likewise the only three percent fall of the use of drinking water from other sources like ponds and rivers is also a matter of concern and indicates the failure of concerned departments in policy making and implementation. In the rural sector the statistics of drinking water condition of the Census-2011 both the national and state figures are of mixed results. While 30.8% (24.3% in 2001) household in rural India has tape water sources for drinking water Assam has only 6.8% (5.4% in 2001). The national figure of wells for drinking water in the rural sector is 13.3% (22.2% in 2001) Assam has 19% (29% in 2001). 51.9% (48.9% in 2001) of rural household in India have drinking water from tube wells while the percentage in Assam is 61.5% (51.4%). On other sources of drinking water in rural India the findings are 4% (4.5% in 2001) and in rural Assam is 12.6% (16.2% in 2001). On treated drinking water the percentage in rural India is 17.9% and that of rural Assam is 5.8%. On untreated water the national figure in the rural sector is 13% and in Assam it is only 1%. Only 1.5% rural households in India collect drinking water from covered sources while in Assam the percentage is dismal 1.1%. Similarly on uncovered sources of drinking water the national figure of rural India is 11.8% and in Assam it is 18%. In the urban sector the all India Census-2011 findings of drinking water are like this:-70.6% (68.7% in 2001) using tape water, only 6.2% (7.7% in 2001) using wells, 20.8% (11.8% in 2001) using hand pumps/ tube wells and 2.55 (2.3% in 2001) using other sources. In Assam statistics are very unimpressive:-30.2% (31.4% in 2001) using tape water which is 1.02% less than the last census, 17.8% (24.6% in 2001) using wells, 48% (35.9% in 2001) using tube wells and 4% (5.1% in 2001) using from other sources. Similarly on the use of treated water in the urban sector Assams figure (29.4%) is far less than the national figure (62%). 4.5% of urban households in Assam have drinking water from covered sources while 13.1% do not have such. The distance of availability of water from the households is one important matter of concern. The 2011 Census reveals encouraging picture of Assam from the national level. While 46.6% (39% in 2001) Indian households have availability of drinking water inside their premises in Assam the figure is well above 54.8% (37.9% in 2001). The availability of drinking water near

the households in India is 35.8% (44.3% in 2001). In Assam it is also less than national figure, from 39.7% in 2001 to 26.7% in 2011. However the state is ahead on the availability of drinking water away from the household. Here Assams figure is 18.5% (22.5% in 2001) and that of India is 17.6% (16.7% in 2001). On this same category Assam also has impressive figures in the rural sector than the all India figures with 50.4% (33.6% in 2001) of households having drinking water source available within the premises while the national figure is 35% (28.7% in 2001). There is a fall in households in rural Assam of availability of drinking water near the premises from 41.9% in 2001 to 29.3% this time. In India the figure is 42.9% (51.4% in 2001). The availability of drinking water away from the households in the rural sector is 22.1% (19.5% in 2001) at the national level while in Assam it is 20.4% (24.5% in 2001). Assam too has advanced in availability of drinking water sources within the households in the urban sector than the all India level with 78.8% (63.2% in 2001) while national figure is 71.2% (65.4% in 2001). Drinking water sources near urban households in India is 20.7% (25.2% in 2001) and in Assam is 12.8% (26.3% in 2001) while away from the households the national figure is 8.1% (9.4% in 2001) and the that of the state is 8.4% (10.5% in 2001). On 6th March, the WHO/UNICEFs Joint Monitoring Programme on sanitation for Millenium Development Goal released its report on India which indicated that 59% (626 million) Indians still does not have access to toilets and they use open defecation. The Census-2011 gives another disturbing account of India on sanitation which says 53.1% (63.6% in 2001) households in India does not have a toilet. In the rural sector the percentage is 69.3% (78.1% in 2001) and in the urban areas it is 18.6% (26.3% in 2001). In Assam overall 35.1% (35.4% in 2001) households have no toilet. That means in the last ten years the governmental schemes could reach only 0.3% of the households. In rural Assam the picture is as same as in 2001 with 40.4% households with no toilet in 2011 Census. In the urban areas the state has 6.3% (5.4% in 2001) households with no toilet. Assam also has over all only 28.5% (15.9% in 2001) households have toilets with water closet (all India figure is 36.4% as against 18% in 2001), 34.7% (43.9% in 2001) households have pit latrines (all India 9.4% as against 11.5%) and 1.8% (4.3% in 2001) households have other types of toilet (all India 1.1% as against 6.9% in 2001). In the rural sector Assam has 20.6% (8.6% in 2001) households having toilets with water closet (all India 19.4% as against 7.1% in 2001), 37.2% (46.9% in 2001) households have pit latrines (all India 10.5% as against 10.3% in 2001) and 1.8% (4% in 2001) households have other toilets (all India 0.8% as against 4.5% in 2001). Similarly in the urban sector the state has an impressive development with 71% (58.9% in 2001) households having toilet with water closet (all India 72.6% as against 46% in 2001). In the pit latrine category Assam has urban households 21.01% (26.4% in 2001) where the national figure is 7.1% (14.6% in 2001). The state has 1.7% (9.3%) urban households with other toilets (all India 1.7% as against 13% in 2001 Census). The increase of allocation of funds for rural drinking water in this years union budget from Rs 11,000 Crores to Rs 14,000 Crores and from Rs 1500 Crores to Rs 3500 Crores for the rural sanitation programme is the immediate step taken by the union government to address this problem. However policy making and implementation and public awareness holds the key to improve the water and sanitation standards of India. Source : http://www.scoop.co.nz/stories/HL1203/S00268/water-and-sanitation-in-indias-census2012.htm

India will achieve sanitation goals only by 2054 AARTI DHAR, The Hindu, 28 March, 2012 NEW DELHI : Going by the present pace of progress, India will achieve the millennium development goals (MDGs) on sanitation only by 2054. While some States had already achieved the target and some are close to it, other populous States such as Madhya Pradesh and Orissa will reach the target only in the next century, according to WHO and UNICEF's Joint Monitoring Programme for Water Supply and Sanitation (JMPWSS). According to the JMPWSS' report, which tracks the progress on drinking water and sanitation, 17 States, including Kerala, Haryana, Meghalaya, Himachal Pradesh, Punjab and most Union Territories, had already achieved the MDG target while Assam, Andhra Pradesh and Arunachal Pradesh will achieve it in the next 10 years. Karnataka, Maharashtra, Tamil Nadu and Chhattisgarh are some States that will meet the MDG target in the coming 25 years, while Madhya Pradesh is expected to achieve the goal in 2105 and Orissa in 2160 unless special strategies are adopted to speed up the progress, the report has said. The world has pledged to reduce by half the proportion of people without sustainable access to safe drinking water and basic sanitation by 2015 from 1990 figures. Though India has already achieved impressive results on water supply, with 85 per cent of its people having access to safe drinking water, 51 per cent or 626 million people in the country defecate in the open, accounting for 60 per cent of the world's total open defecations. India has seen an improvement in the sanitation figures from 1990, when 75 per cent people defecated in the open as against 51 per cent in 2010. But this improvement is seen only in the urban settings, where 28 per cent had no access to toilets in 1990 as against 14 per cent in 2010. In the rural areas, 91 per cent had no access to sanitation in 1990 as against 67 per cent in 2010, indicating that it was the rich who had more access to sanitation. Four out of every 10 people who have gained access to improved sanitation since 1990 live in China or India, and more than half of the 2.5 billion people without improved sanitation too live in these two countries. In India, 251 million people gained access to sanitation between 1990 and 2010 but the percentage continues to be low because of the annual increase in the population. Over 1.7 million (22% of the world total) children under five who died in 2010 were Indians, diarrhoea being one among the largest killer diseases and accounting for 13 per cent of the deaths. Worldwide, over 80 per cent of diarrhoeal deaths are due to unsafe water, inadequate sanitation and poor hygiene. Source : http://www.thehindu.com/todays-paper/tp-national/article3252400.ece

High on hygiene, Himachal to get Nirmal Pradesh status soon

Vibha Sharma/TNS, The Tribune, 27 March, 2012 New Delhi: Having achieved full sanitation coverage, Himachal Pradesh is on the verge of acquiring the status of a Nirmal Pradesh- the second state after Sikkim to get the distinction.

However, the country will miss its 2017 target for achieving total sanitation coverage as the government today said that it would take at least 10 more years before all villages can boast of Nirmal Gram Panchayat status and completely eradicate the practice of open-air defecation. Drinking Water and Sanitation Minister Jairam Ramesh told the Rajya Sabha that it usually takes about a year to make a village a Nirmal Gram Panchayat. As per the Census data, only 28,000 of 2.60 lakh gram panchayats in the country have so far achieved complete sanitation, clearly indicating that states are not taking the task seriously. Incidentally, the data provided by states show 68 per cent sanitation coverage but according to the minister the latest Census pegs the figure at around 33 per cent for the entire country. I tend to believe Census numbers...We have to go a long way before we achieve total sanitation, Ramesh said. Total Sanitation Campaign was initiated in 1999 to ensure sanitation facilities in rural areas and eradicate the practice of open-air defecation by 2017. To give fillip to this endeavour, the government also launched Nirmal Gram Puraskar to recognise the efforts in terms of cash awards for fully covered panchayati raj institutions and those individuals who have contributed significantly in ensuring full sanitation coverage in their area of operation. Mission Clean * Himachal will be the second state after Sikkim to get the tag of Nirmal Pradesh as it has successfully eradicated the practice of open-air defecation. * The country will take another 10 years to achieve total sanitation; will miss its 2017 target. Only 28,000 of 2.60 lakh gram panchayats in India have so far achieved complete sanitation, clearly indicating that states are not taking the task seriously. Source : http://www.tribuneindia.com/2012/20120328/main6.htm

Water still a far-fetched dream for many

Times of India, 23 March, 2012 RANCHI: More than 31.9% households in the state have to trek for more than a kilometre to fetch drinking water everyday. To discuss this issue and to promote collaborative efforts of the civil society organizations and media for improving the status of drinking water, sanitation and hygiene in the state, a statelevel briefing-cum-consultation was organized by Gram Jyoti, an NGO, with the support of Water Aid India to observe World Water Day on Thursday. Godda's Megi panchayat mukhiya Babulal Marandi discussed the problems of his panchayat with the drinking water and sanitation department principal secretary Sudhir Prasad. Marandi said, "More than 500 houses under my panchayat falls in hilly areas and do not get drinking water as there is no electricity, hence pumps cannot be used." Prasad heard him out and said that the executive engineer of his department would be sent to his village in the first week of April to find a solution for the problem after discussing it with the local residents. Another problem that Marandi spoke about was no availability of guidelines to spend the funds given to them. "The government sends us funds but they never tell us how to

use it for the benefit of the villagers. The village representatives should be given training by the government to use the funds wisely," he said. Similarly, many representatives and NGO workers discussed their problems to which Prasad agreed to help them in all ways possible. Prasad also discussed about plans of the government for providing proper drinking and sanitation facilities and distributed books about them to the public representatives present in the conference. Neeraj, head of an NGO, Saathi, said, "The government plans fail because they are not discussed with the locals before being implemented. If the government passes and executes the plans made by NGOs working with the local people then drinking water problems will be solved automatically." Source: http://timesofindia.indiatimes.com/city/ranchi/Water-still-a-far-fetched-dream-formany/articleshow/12374711.cms

Sunita Narain: Why excreta matters

Sunita Narain, Business Standard, 23 January 2012 Indians know little about the water they use and the waste they discharge Water is life, and sewage tells its life story. This is the subject of the Citizens Seventh Report on the State of Indias Environment, Excreta Matters: How urban India is soaking up water, polluting rivers and drowning in its own excreta. It has a seemingly simple plot: it only asks where Indian cities get their water from and where their waste goes. But this is not just a question or answer about water, pollution and waste. It is about the way Indian cities (and perhaps other parts of the world that are similarly placed) will develop. It is about the paradigm of growth thats sustainable and affordable. Urbanisation in India, relentless as it is, will only grow. How should the country manage its water needs, so that it does not drown in its own excreta? This is what the Centre for Science and Environment (CSE) has asked and tried to answer in the book. What has amazed us is the lack of data, research and understanding of this issue in the country. This is when water concerns all. People in cities get water in their houses; they discharge waste; and they see their rivers die. But they dont make the connection between flushing toilets and dying rivers. It is as if they do not want to know. But they should. Is this a reflection of the caste system of Indian society, where removing waste is somebody elses business? Or is it a reflection of current governance systems, where water and waste are governments business, and within that the business of a lowly water and sanitation bureaucracy? Or is it simply a reflection of Indian societys extreme arrogance it believes it can fix it all as and when it gets rich; that water scarcity and waste are only temporary problems; that once it gets rich, infrastructure will be built, water will flow and the embarrassing stink of excreta in cities will just disappear. It is clear that Indians know little about the water they use and the waste they discharge. CSE researchers had to collect data the hard way city by city, ferreting out the material from government offices, which are rarely visited by researchers. The second volume 71 cities: water-excreta survey of the seventh citizens report puts together individual city profiles. Each city is mapped to know more about its past, current and future water footprint. Each city is

mapped to know more about where the waste generated from such use of water goes. It is a geography lesson thats essential to learn. It was way back in the late 1990s that environmentalist Anil Agarwal, who conceived and crafted the State of Indias Environment reports, had said one needs to understand the political economy of defecation, where the rich are subsidised to excrete in convenience. Now when we researched for this report, which explains the political economy of defecation, we were struck by one fact that should make us all angry, really angry. We found countless instances when a citys drain, called a nullah today, was actually a river. Delhi residents are familiar with the Najafgarh drain, which discharges the citys waste into the Yamuna. But most of them do not know that this drain has its source in the lake Sahibi. Now the Sahibi is gone, and what has replaced it in living memory is a drain carrying only filth, not water. Worse, New Gurgaon is now dumping its sewage into the same Najafgarh jheel (lake). Buddha Nullah in Ludhiana is referred to as a drain because it is that full of stench and filth. But not so long ago, the Buddha was called darya (river). It was a clean freshwater stream. One generation has changed its form and name. The Mithi is the Maximum Citys shame. When floods drowned Mumbai in 2005, the city learnt it had a clogged drain called the Mithi, marred by encroachments. It did not realise that the Mithi had not shamed the city; the city had shamed the Mithi. This drain, which originates near the city, is really a river. It was recognised as a river. It flowed like one. But today even the official environmental status report calls this living river a storm water drain. One more city has lost its river. These lost rivers are our collective shame. But should Indians be surprised? Today they take water from their rivers for irrigation, drinking and hydroelectric plants and give back waste. Water no longer flows in Indias rivers, just loads of excreta and industrial effluent. Indians should be angry over the loss of rivers. More worryingly, if they do not change their ways, they will lose the remaining rivers, lakes and other water bodies. This generation will then not just be pitied for losing rivers, but accused of committing deliberate hydrocide. The coming generations will forget that the Yamuna, Cauvery and the Damodar were rivers. They will know them as drains, only drains. Source : http://business-standard.com/india/news/sunita-narainexcreta-matters/462540/

70% houses in Kerala lack access to safe drinking water

T. NANDAKUMAR, The Hindu, 15 March, 2012 Having a kitchen in the house is a priority for an overwhelming majority of Malayalis, but safe drinking water remains a dream for more than 70 per cent of the households in the State while 3.8 per cent still defecate in the open. The latest Census figures reveal that Kerala pales in comparison with most other States in access to piped drinking water. Only 29.3 per cent of the houses in the State are serviced by the water supply network and just 23.4 per cent get treated water. While Union Territories of Chandigarh (96.7) and Puducherry (95.3) top the list, 19 States have ensured that more than 50 per cent of their population has access to tap water. Sixty-two per cent of the households in Kerala depend on wells for drinking water, 1.4 per cent of houses rely on springs, 0.2 per cent on rivers and canals and 0.7 per cent on tanks, ponds and lakes, exposing themselves to bacterial and chemical contamination. While 0.7 per cent use hand pumps to draw water, 3.7 per cent are serviced by tubewells. The figures show that 77.7 per cent of households have drinking water sources within their premises, 14.1 per cent near the premises and 8.2 per cent away. As many as 2,93,222 households in Kerala, representing 3.8 per cent of the total, use open grounds for defecation. Though the figure is relatively very low compared to most other States and Union Territories, the fact that it exists is embarrassing for Kerala, a State that claims to be very high on hygiene and sanitation. While more than 70 per cent of households in Jharkhand, Odisha, Bihar, Chhattisgarh and Madhya Pradesh still resort to open defecation, Chandigarh (3.2), Delhi (3.3) and Lakshadweep (1.8) have a lower percentage than Kerala. Only 12 per cent of the houses in Kerala are connected to the piped sewer system, while 50.3 per cent depend on septic tanks and 4.4 per cent on other systems. 0.2 per cent of the households discharge toilet waste into open drains. As many as 3,70,385 households, representing 4.8 per cent of the total, do not have a latrine within their premises and 1.1 per cent use public latrines. While 14.2 per cent of houses do not have a bathroom, 4.6 per cent of the population bathe in enclosures without a roof. As many as 53.6 per cent of households has no drainage system for bathrooms and 21.2 per cent have open drainage. The data reveals that 96.7 per cent of households in the State have a kitchen, with just 1.5 per cent having to cook in the open. Source : http://www.thehindu.com/todays-paper/tp-national/article2996919.ece

UN-led initiative harnesses partnerships to tackle water and sanitation challenges

UN News Centre, 16 March, 2012

A young boy drinks fresh water from a well in a village in Northern Laos. Photo: UNDP/A. Rogers 16 March 2012 The United Nations Development Programme (UNDP) has facilitated the formation of a global platform to unite local actors to solve water and sanitation challenges, including encouraging water authorities in developed countries to support the improvement of services in poorer regions through donations. The Global Water Solidarity Platform was launched on Wednesday at the World Water Forum in Marseille, France, where 20,000 participants from the private, public and non-profit sectors gathered this week to address global water challenges. UNDP led a group of 25 institutions, including local, regional and national authorities, international and multilateral organizations, water operators, non-governmental and private organizations, as well as prominent figures to assess, design and constitute the new international tool to promote decentralized cooperation in water and sanitation. This UNDP initiative is important because 11 per cent of the planets population still lacks access to potable water, and 2.5 billion people do not have adequate sanitation services, said UNDP Deputy Director for External Relations and Advocacy Romesh Muttukumaru. Through the Platform, which is supported by the Governments of France and Switzerland, municipal water authorities in developed countries can, for example, take direct action to support the improvement of water and sanitation services in developing nations by contributing one per cent of their revenue or budgets.

Together with an active coalition of stakeholders and concrete cooperation mechanisms, local leaders from across the globe are working in solidarity so everyone can access safe water and sanitation services, said Mr. Muttukumaru. Source : http://www.un.org/apps/news/story.asp?NewsID=41565&Cr=Water&Cr1=Sanitation

Water access must reach rural and marginalized areas in Europe UN report
UN News Centre, 13 March, 2012

A United Nations report launched today spotlights the need to address unequal water access in Europe, stressing that certain populations such as rural communities and marginalized groups are still not getting this vital resource. The report, which was produced by the UN Economic Commission for Europe (UNECE), provides guidance on how to address water access disparities, and showcases successful policies that have been implemented by governments, water operators and civil society. No one left behind: Good practices to ensure equitable access to water and sanitation notes that access to improved water and sanitation solutions in rural areas in the pan-European region is 10 per cent lower than for urban areas, and suggests putting investment programmes in place to help reduce this gap. In addition, the report underscores that social inclusion policies are needed to be able to provide water access to marginalized and vulnerable groups such as the homeless, disabled, sick, or those living in unsanitary housing, who are often unable to get access to safe drinking water. Increasing water prices are also singled out as a key factor for unequal water access in European Union countries, with the report highlighting how tariffs and social protection measures can help consumers cover the costs.

UNECE Deputy Executive Secretary Andrey Vasilyev, who presented the report at the World Water Forum in Marseille, underlined that political will and strong water governance are needed to tackle these disparities. Last week, the UN announced that the goal of reducing by half the number of people without access to safe drinking water was achieved, ahead of the 2015 deadline for reaching the Millennium Development Goals (MDGs), the globally agreed development targets aimed at ridding the world of extreme poverty, hunger and preventable diseases. However, the target for sanitation has not been met, and nearly one billion people still lack access to safe drinking water. Source : http://www.un.org/apps/news/story.asp?NewsID=41532&Cr=water&Cr1=sanitation

Investing in water, sanitation as important as in defence: Jairam

K. BALCHAND, The Hindu, 22 February, 2012 Proposes inter-ministry contribution for prioritising the issues Union Minister of Rural Development Jairam Ramesh has presented a plan to various Central ministries to contribute to the cause of drinking water and sanitation, saying that investment for a healthy population was as important as investing for defence. Mr. Ramesh, who also holds the Drinking Water and Sanitation portfolio, on Tuesday had his proposals ratified at the National Drinking Water and Sanitation Council which comprises representatives of various ministries like agriculture, water resources, environment and forest, science and technology, human resources development and health and family welfare. You can invest in missiles, tanks and aircraft, but if we don't have clean drinking water and proper sanitation, the population is not going to be healthy. Highest priority Intending to write to the Ministers holding these portfolios, Mr. Ramesh correlated how quality drinking water and sanitation were critical for a healthy nation. He said that now is the time to accord highest priority to these sectors and project them as the agenda of the country. Utilise ASHAs Wondering why the two issues did not receive any attention under the National Rural Health Mission (NRHM), he underlined the need to utilise the services of Accredited Social Health Activists (ASHA) appointed by the Ministry of Health as motivators to sensitise people to hygiene and sanitation. The proposal is to provide incentives to the 8-lakh-strong ASHAs across the country to spread the awareness as ultimately there was no distinction between hygiene and sanitation.

He added: We are becoming a wealthy people not a healthy one, pressing for a change in attitude towards these two programmes for which he was expecting a 40 to 60 per cent budgetary hike in 2012-13. Pointing out that water-borne diseases and contamination posed a host of risks like cholera, diarrhoea and even cancer, Mr. Ramesh said it was a mistake to segregate the Ministries of Health and Drinking Water and Sanitation. Cleaner the water, safer the sanitation, healthier the population, he asserted. Testing water quality The National Drinking Water and Sanitation Council proposed sharing of water quality testing laboratories for testing drinking water quality. The Central Ground Water Board (CGWB) has been requested to conduct heavy metals and pesticides testing in drinking water and share information with the States. Mr. Ramesh also intends to write to the Environment and Forest Minister to consider increasing the rate of cess imposed on industries so as to act as a deterrent and to cover the treatment costs of polluted water. The note pointed out that the cess collected for toxic and non-biodegradable wastes is only 30 paise per KL while treatment of this water (through RO) for drinking purposes will cost Rs. 50 to Rs. 60 per KL which is about 20,000 time costly. Proposal to incentivise 8-lakh-strong ASHAs to spread awareness on hygiene, sanitation Minister requested to increase cess on industries to cover treatment costs of polluted water Source : http://www.thehindu.com/todays-paper/tp-national/article2918388.ece

Millennium Development Goals: progress towards the health-related Millennium Development Goals May 2011
Key facts

Fewer children are dying. Annual global deaths of children under five years of age fell to 8.1 million in 2009 from 12.4 million in 1990. Fewer children are underweight. The percentage of underweight children under five years old is estimated to have dropped from 25% in 1990 to 16% in 2010. More women get skilled help during childbirth. The proportion of births attended by a skilled health worker has increased globally, however, in the WHO Africa and South-East Asia regions fewer than 50% of all births were attended. Fewer people are contracting HIV. New HIV infections have declined by 17% globally from 20012009. Tuberculosis treatment is more successful. Existing cases of TB are declining, along with deaths among HIV-negative TB cases.

More people have safe drinking-water, but not enough have toilets. The world is on track to achieve the MDG target on access to safe drinking-water but more needs to be done to achieve the sanitation target. In September 2000, 189 heads of state adopted the UN Millennium Declaration and endorsed a framework for development. The plan was for countries and development partners to work together to reduce poverty and hunger, tackle ill-health, gender inequality, lack of education, lack of access to clean water and environmental degradation. They established eight Millennium Development Goals (MDGs), with targets set for 2015, and identified a number of indicators to monitor progress, several of which relate directly to health. All the goals and their targets are measured in terms of progress since 1990. Reporting on progress towards the MDGs has underscored the importance of producing more reliable and timely data. Progress report on the health-related MDGs While some countries have made impressive gains in achieving health-related targets, others are falling behind. Often the countries making the least progress are those affected by high levels of HIV/AIDS, economic hardship or conflict. Detailed updates on the progress Please note that the following statistics are estimates. Halve, between 1990 and 2015, the proportion of people who suffer from hunger (MDG 1, target 1.C) Children's nutrition has improved. The percentage of underweight children is estimated to have declined from 25% in 1990 to 16% in 2010. But 104 million children are still undernourished. Stunting in children under five years old has decreased globally from 40% to 27% over the same period. However, in the UN Africa Region, the number of stunted children is estimated to have increased from 45 million in 1990 to 60 million in 2010. Reduce child mortality (MDG 4) Annual deaths of children under five years of age in 2009 fell to 8.1 million, down by 35% from 1990. The rate of decline has doubled to 2.7% per year since 2000, compared to the previous decade (1.3%). The deaths of nearly 3 million children under five each year worldwide can be attributed to diarrhoea and pneumonia. An estimated 40% of deaths in children under five occur in the first month of life, so improving newborn care is essential for further progress. The coverage of infants immunized against measles increased from 73% to 82% from 1990 to 2009. Improve maternal health (MDG 5) The number of women dying as a result of complications during pregnancy and childbirth has decreased by 34% from 546 000 in 1990 to 358 000 in 2008. Although the progress is notable, the annual rate of decline of 2.3% is less than half of the 5.5% needed to achieve the target. Almost all maternal deaths (99%) in 2008 occurred in developing countries. From 2000 to 2010 just over half of all pregnant women made the WHO-recommended minimum of four antenatal visits. While the global proportion of births attended by a skilled health worker has increased, in the WHO regions of Africa and South-East Asia fewer than half of all births had skilled assistance. Globally, contraceptive use has been on the rise, annually increasing 0.2% since 2000. From 2000 to 2008 there were 48 births per 1000 adolescent girls aged 1519 globally.

Combat HIV/AIDS, malaria, and other diseases (MDG 6) HIV/AIDS From 2001 to 2009 new HIV infections worldwide declined by 17%. In 2009, 2.6 million people contracted the virus and there were 1.8 million HIV/AIDS-related deaths. In 2009, around 53% of the 1.4 million HIV-positive, pregnant women in low- and middle-income countries received antiretroviral therapy (ART) to prevent the transmission of HIV to their babies. More than 5 million people in low- and middle-income countries were receiving ART by the end of 2009 but that left more than 9 million untreated HIV-positive people in these countries. Tuberculosis Despite a rise in the number of new tuberculosis (TB) cases worldwide due to an increase in population more people are being successfully treated. TB mortality among HIV-negative people has dropped from 30 deaths per 100 000 people in 1990 to 20 deaths per 100 000 in 2009. However, HIV-associated TB and multidrug-resistant TB are harder to diagnose and cure. Malaria Indications are that 42 countries are on course to meet the MDG target for reducing malaria; in 2009 an estimated 225 million cases of malaria caused 781 000 deaths, mostly of children under five. The supply of insecticide-treated nets increased but need outweighed availability almost everywhere. Access to antimalarial medicines (especially artemisinin-based combination therapy) increased but it was inadequate in all countries surveyed in 2007 and 2008. Other diseases An estimated 1 billion people suffer from neglected tropical diseases. This includes lymphatic filariasis which in 2009 was endemic in 81 countries. There were over 220 000 cases of cholera reported in 2009, an increase over the previous year. In 2009, 244 617 cases of leprosy were reported, down from 5.2 million in 1985. In 2009, only 3190 cases of dracunculiasis were reported while in the 1989 the estimated number of cases was almost 900 000. Halve, by 2015, the proportion of people without sustainable access to safe drinking water and basic sanitation (MDG 7, target 7.C) Globally, the percentage of the worlds population with access to safe drinking-water increased from 77% to 87%, which is sufficient to reach the MDG target if the rate of improvement is maintained. In low-income countries, however, the annual rate of increase needs to double in order to reach the target and a gap persists between urban and rural areas in many countries. In 2008, 2.6 billion people had no access to a hygienic toilet or latrine and 1.1 billion were defecating in the open. The slowest improvement has been in the WHO African Region, where the percentage of the population using toilets or latrines increased from 30% in 1990 to 34% in 2008. Inadequate sewerage spreads infections such as schistosomiasis, trachoma, viral hepatitis and cholera. In cooperation with pharmaceutical companies, provide access to affordable essential medicines in developing countries (MDG 8, target 8.E) Although nearly all countries publish an essential medicines list, the availability of medicines at public-health facilities is often poor. Surveys conducted in over 40 low-income countries show that 44% of public sector and 65% of private sector outlets had the listed generic medicines in stock. Lack of medicines in the public sector forces patients to go without or purchase medicines from private sector outlets where generic medicines cost on average 610% more than their international reference price. Source: http://www.who.int/mediacentre/factsheets/fs290/en/index.html

Water and Sanitation Related Diseases and the Environment: Challenges, Interventions and Preventive Measures
once we can secure access to clean water and to adequate sanitation facilities for all people, irrespective of the difference in their living conditions, a huge battle against all kinds of diseases will be won. Dr Lee Jong-wook, Former Director-General, World Health Organization Written by authorities from the fields of public health, medicine, epidemiology, environmental health, climate change, environmental engineering, and population research, this book presents an interdisciplinary picture of the conditions responsible for water and sanitationrelated diseases. It examines the pathogens and their biology, morbidity and mortality resulting from lack of safe water and sanitation, distribution of these diseases, and the conditions that must be met to reduce or eradicate them. The publication covers access to and the maintenance of clean water, and includes guidelines for the safe use of wastewater, excreta and greywater along with examples of solutions; this is presented with an emphasis on what is actually achievable in the real world, considering that, currently 2.6 billion individuals have no toilet and 1.2 billion people are exposed to water-related illness from their drinking water. Meeting water and sanitation needs, coupled with protection of the environment and prevention of pollutants, is essential to every effort to improve the health and living conditions of billions of people. Meeting these needs is fundamental, not only to effectively diminish incidence of diseases that afflict a third or more of the people of the world, but also to improve education and economic well-being and elevate billions of individuals out of vicious cycles of poverty. The preventive measures and solutions presented in this book provide guidance for possible action on the local, national and international levels. Source: http://www.wsscc.org/resources/resource-advocacy-materials/water-andsanitation-related-diseases-and-environment

Towards drinking water security in India: Lessons from the field A report by Water and Sanitation Program
Source:http://www.indiawaterportal.org/sites/indiawaterportal.org/files/Towards_drinking _water_security_in_India_Lessons_from_the_field_WSP_2011.pdf

Progress on Drinking Water and Sanitation: JMP Report 2012

Source: http://www.wssinfo.org/fileadmin/user_upload/resources/JMP-report-2012-en.pdf

Drinking Water: Equity, Safety and sustainability: 2011

Source: http://www.wssinfo.org/fileadmin/user_upload/resources/report_wash_low.pdf