HOW THEY SEE IT Water: A fundamental global health issue

By JAN ELIASSON and SUSAN BLUMENTHAL
WASHINGTON POST
In the United States and Europe, people take it for granted that when they turn on their taps, clean water will flow out. But for those living in U.S. cities devastated by Hurricane Katrina, as in large parts of the world, obtaining safe water requires a constant struggle.
Water is essential to all aspects of life, yet 99 percent of water on Earth is unsafe or unavailable to drink. About 1.2 billion people globally lack safe water to consume, and 2.6 billion have inadequate sanitation. There are also stark comparisons: Just one flush of a toilet in the West uses more water than most Africans have to perform an entire day's washing, cleaning, cooking and drinking.
Water is an economic issue since it is essential for poverty reduction, agriculture, food and energy production, as well as recreation. It is a women's issue in the developing world because women often have primary responsibility for household water-gathering. Time spent hauling water robs women and girls of getting an education or engaging in meaningful work. It is a children's issue because water is essential for healthy development. A youngster dies every eight seconds from waterborne disease. And water is a national security issue because some of the world's conflicts today arise from disputes over arable land and water: The tragedy in Darfur, for example, was driven in no small part by tensions over access to water.
Most of all, water is a fundamental global health issue. Unsafe water and sanitation are now the single largest cause of illness worldwide, just as it has been a major threat to the health of people affected by Hurricane Katrina. A recent U.N. report has estimated that:
UAt least 2 million people, mostly children, die annually from waterborne diseases such as diarrhea, cholera, dysentery, typhoid, guinea worm and hepatitis as well as such illnesses as malaria and West Nile virus carried by mosquitoes that breed in stagnant water.
UMany of last year's 10 million child deaths were linked to unsafe water and lack of sanitation. Children can't fight off infections with bodies weakened by waterborne diseases.
UOver half the hospital beds in the developing world are occupied by people suffering from preventable diseases caused by unsafe water and inadequate sanitation.
If action is not taken now, 135 million people could die of water-related diseases by 2020. That's more than those expected to fall victim to the HIV/AIDS pandemic, which has already killed 23 million people worldwide. (Too, many AIDS deaths are linked to illnesses resulting from dehydration and diarrhea caused by unsafe water.)
The United Nations has set a Millennium Development Goal, to be reached by 2015, of reducing by half the percentage of people without access to safe drinking water and basic sanitation. There is a long way to go to reach this goal. That's why the U.N. General Assembly has declared the next 10 years to be the International Decade for Action on "Water for Life" to focus on this vital issue.
When poor people are asked what would most improve their lives, water and sanitation are repeatedly among their highest priorities. The recent decision by the Group of Eight to double economic assistance for Africa could help if a significant portion addresses these problems. Developing countries should involve citizens in decision making about how best to get improved water and sanitation services. Developed nations should work with these ideas so improvements can be sustained over the long term.
Global coalition
All nations must share knowledge and experiences in public education, disease prevention, emergency response strategies, the application of new technologies and training. A global coalition of organizations, businesses and individuals must be mobilized across the public and private sectors for infrastructure development and innovation.
Time is of the essence. By 2025 the world's population is projected to increase from 6.4 billion to 8.4 billion, when 3.4 billion people could live in countries where water is scarce. With coordinated efforts and funding, the U.S. Gulf Coast region will, we hope, restore its water and sanitation systems within months. But unless we soon implement a global action plan for water with increased awareness, activism and resources, large numbers of people worldwide will continue to suffer and die needlessly for generations to come for want of clean water.
X Eliasson, former Swedish ambassador to the United States, is president of the U.N. General Assembly. Blumenthal, who served as assistant surgeon general of the United States, is a clinical professor at the Georgetown and Tufts University schools of medicine and a retired rear admiral.