Universal access to safe drinking water, sanitation and hygiene, a human right enshrined in the 2030 Global Goals, can only be reached if countries monitor and address affordability, according to a new report from WHO and UNICEF.
The report comes at a time when the economic shocks of the COVID-19 pandemic reverberate through household and national budgets just as awareness of the importance of hygiene in infection prevention and control soars.
But an estimated 3 billion people worldwide still do not have a handwashing facility with water and soap at home and an estimated 2.2 billion people do not have access to safe drinking water. Little progress has been made in integrating affordability into national and global monitoring of WASH services.
One problem is that there is no universally agreed definition of affordability; no commonly agreed approaches to assessing and monitoring it. Affordability goes beyond the monetary. For example, when people struggle to access WASH services that meet the national minimum standard, close to home, they also incur health, time and social costs, much of it borne by women and children.
"Affordability is a missing piece in national and global monitoring, with far-reaching implications for a healthy and sustainable recovery. This report shines a light on the pressing need for governments to review, study and reflect upon what needs to be done to achieve affordable WASH services for all," said Dr Maria Neira, WHO Director, Department of Environment, Climate Change and Health.
"The economic shocks from the Covid-19 pandemic underscore that safe and affordable WASH services are needed now more the ever, especially for the most vulnerable families and communities. The practical tools in this report will help governments better measure and monitor the cost of WASH services, helping to identify precisely which population groups and households face financial barriers to WASH services and how to best address them," said Kelly Ann Naylor, UNICEF Associate Director, Water, Sanitation and Hygiene (WASH) Section, Programme Division.
It also provides insights into WASH affordability in case study countries, including the percentage of income spent on WASH, spending preferences, poverty status and existing measures to ensure access to WASH.
Finally, the report spells out several recommendations for future national and global monitoring of WASH affordability, including reaching a broad consensus on what households need to spend on different items to meet their essential needs, from which a proposed maximum ratio could be defined for an affordable WASH service; and conducting further in-depth country case studies that can contribute to enhanced national policies to make WASH services affordable for all.
It also recommends strengthening datasets and data analyses of income and expenditure surveys, to provide initial affordability assessments in over 50 countries; building and strengthening national and global databases of WASH tariffs and costs; and strengthening the use of the UN-Water GLAAS survey to collect and analyse policy indicators relevant for affordability assessment.
"Those of us engaged in the collective challenge of setting up the foundations and processes to monitor WASH affordability can take heart from the fact that this is hardly a new concept — cost of living, inflation and affordability are already being monitored and compared through a recognised "basket of goods" in poverty assessments conducted by most governments across the world, for example — and involves elements that every single human being requires to survive," said Dr Guy Hutton, UNICEF Senior Adviser for WASH, who has led the report.
