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Water, Sanitation and Hygiene for a Healthy Asia and the Pacific

Article | 7 February 2014

Countries in Asia and the Pacific need to prioritize investments in water supply and sanitation services to support vibrant and livable cities.

Currently, around 1.7 billion people in Asia and the Pacific have no access to modern sanitation, a problem that is becoming increasingly acute in urban areas, with tens of millions of people moving every year into slums and other infrastructure-poor areas.

About 780 million people in the region still practice open defecation and 80% of wastewater is discharged with little or no treatment, resulting in pollution causing adult illness, long-term malnutrition, and exposure to diarrheal diseases, the second leading cause of infant and child deaths worldwide.

According to the Asian Water Development Outlook 2013, more than 75% of the countries in the region are experiencing serious water insecurity, with many facing imminent water crises unless immediate steps are taken to improve management of water resources, including household sanitation to protect water sources.

A recent publication, Health in the Post-2015 Development Agenda for Asia and the Pacific, states that rapid and unplanned urbanization causes problems of urban crowding, informal settlements, and lack of access to basic services. It highlights hygiene, access to safe drinking water, and sanitation as major issues for urban dwellers across the region, as more than 60% of households live without safe, piped water supply and improved sanitation.

For example, many urban dwellers in major population centers, including Manila, Jakarta, Dhaka, and New Delhi, lack access to modern sanitation, making them more vulnerable to waterborne diseases.

In September 2013, ADB partnered with the Bill & Melinda Gates Foundation to expand and speed up access to safe sanitation. Read how the Sanitation Financing Partnership Trust Fund will expand non-sewered sanitation and septage management solutions across the region.

Sanitation projects to improve health

ADB aims to optimize health impacts of infrastructure operations, specially in water and sanitation.

In Karnataka, India, an urban and sewerage system project is improving people's health and making cities more livable.

In Cambodia, an ADB Water Pilot and Demonstration project introduced the Kanchan Arsenic Filter in 2009 that became a suitable and affordable arsenic mitigation technology, improving groundwater safety throughout Cambodia's rural areas. The technology is now being used by about 15,000 rural households and promoted by the government, UNICEF, UN-Habitat, Red Cross, FINNIDA, a number of local NGOs, and a few private businesses across the country.

The ADB-supported Small Towns Water Supply and Sanitation Sector Project, has improved water supply and sanitation in 29 urban centers on Nepal's major highways. Supported by a concessionary Asian Development Fund (ADF) loan of $32.1 million, and running from 2001 to 2009, the project improved water and sanitation services for nearly 600,000 people. Installing public drinking-water taps and public toilets in various locations, including public schools, has reduced the risk of waterborne diseases and other health hazards.

Supporting maternal and child health

Piped clean water and sanitation facilities can improve maternal and child health in poor households, particularly in rural areas. In two of Uzbekistan's poorest provinces, Novoi and Kashkadarya, women and children traveled long distances to fetch water from contaminated sources or to buy bottled water in the market.

An ADB-supported project improved rural water supply and sanitation facilities, including chlorination and wastewater drainage systems. Health and hygiene awareness programs were also implemented as part of the project.

Another bane to child health is the rise of dengue cases in the region. Dengue is spread by a specific mosquito that breeds readily in still water, such as found in water storage containers, flower pots and discarded tires.

More than 70% of the approximately 2.5 billion people at risk of contracting dengue worldwide live in Asia and the Pacific. The threat of exposure to dengue-carrying mosquitoes is rising with uncontrolled urbanization and a surge in the use of non-biodegradable packaging, which can act as a water reservoir for dengue mosquito breeding.

To combat this, a trial study using guppy fish was introduced by the Governments of Cambodia and Lao People's Democratic Republic with the support of ADB and the World Health Organization (WHO).

The community-based project, conducted in two districts in Cambodia and the Lao PDR from 2009 to 2011, resulted in a sharp decline in mosquito larvae in water storage tanks after the tiny fish were introduced. Guppies eat larvae that grow into mosquitoes, which in turn bite humans and transmit dengue.