Summary I. Introduction II. Rationale for USAID Support of Water and Sanitation Programs III. Current Situation in Developing Countries and the Role of International Donors IV. Guidance for the Development of the Drinking Water and Sanitation Programs in Developing Countries: Major Issues V. Water in the Context of General Economic Development Wednesday, 11-Jul-2001 16:58:31 EDT

The combination of unsafe drinking water and inadequate sanitation facilities constitutes one of the major causes of death and disability among the poor in developing countries. Safe, convenient water supply and adequate sanitation is a fundamental component of broad-based economic growth strategies. Lowering mortality and morbidity from water and sanitation-related diseases is a goal in itself; it can also lead to increased productivity and decreased absenteeism among members of the labor force and can reduce the time and energy burden on the household, leading to more time for crop cultivation, child care, and income-generating activities, as well as more regular school attendance.

The availability of a minimum of 20-40 liters of relatively safe water per person per day is essential to achieve sustained health improvements in developing countries. Where this minimum is not readily available and where inadequate domestic water and sanitation creates significant health problems, USAID will consider funding projects for-improvements in water and sanitation. The following criteria will guide USAID's investment in the area:

1. Evidence of need and effective demand: The need for improved water and sanitation is clearly indicated by high prevalence of disease caused by (a) insufficient water, (b) consumption of highly contaminated water, and/or (c) inadequate or inappropriate sanitation systems; and consumers are willing to (a) support recurrent costs through some combination of fees, contributions, and local or national budget allocations, and (b) cover some portion of the investment costs to improve traditional systems or build new ones. Where consumer are unable to make such a commitment, but the absence of basic water and sanitation systems poses a public health hazard for the community at large, the government must demonstrate a commitment to shoulder a substantial portion of the investment costs, as well as those recurrent costs which the community cannot cover in the short-run while local arrangements for financing are being developed. A.I.D. will not fund projects where there is inadequate assurance that the community can and will support operation and mainte-nance costs of the system within a reasonable time frame.

2. Institutional responsibility and capacity. The local or national institutions responsible for national domestic water supply and sanitation policy must have the responsibility, personnel, and budgetary resources to ensure the construction, expansion and continued operation and maintenance of the improved water and sanitation systems. At a minimum, there must be evidence that the institution can be strengthened to the point where it can assume such responsibility with only modest outside support.

3. Infrastructure: Roads and other aspects of transportation and communications must be sufficiently developed to permit routine contact with local communities for the purposes of supervision, technical assistance, maintenance, and the delivery of fuel and spare parts. Alternatively, the technology adopted in the improved water and sanitation systems must be such that the system can be maintained by the community without outside assistance or supervision.

Where these conditions are met, USAID will consider funding water and sanitation programs to improve health in rural areas as well as market towns, secondary cities, squatter settlements, and urban centers. Development Assistance funding for these programs is available from Section 104, the Health and Population Account and when part of rural development activities, from Section 103, the Agriculture, Rural Development and Nutrition Account; in addition, Economic Support Funds and the Housing Guarantee Program can support domestic water and sanitation projects, principally in urban areas.

As noted above, USAID will not support water supply and sanitation programs whose operation and maintenance costs cannot be financed over the long-term by some combination of consumers, the local community, and the regional and central government. Where possible, consumers themselves should bear primary responsibility for covering all costs, since it is under these conditions that the systems are most likely to remain in operation over the long-term. USAID will give particular attention to identifying and promoting opportunities for private sector involvement in the construction, operation, and maintenance of water and sanitation systems and in the manufacture of related equipment.

Among the factors that will guide the design of USAID-supported domestic water and sanitation projects designed to improve health are the following:

• a minimum of 20-40 liters of relatively safe water per capita per day;
• improvements in water quality (as opposed to quantity) where improvements can be introduced at reasonable cost without compromising the reliability of the system;
• selection of a technology that can be maintained and operated easily and is acceptable within the local culture;
• measures to promote water conservation and reuse;
• project design and implementation that responds to the needs of the community and, wherever feasible, encourages or requires active community involvement in all phases of the project;
• sustained educational efforts to instruct users in proper water use and hygiene;
• a demonstrated means of financing and ensuring operations and maintenance of the project over the long-term;
• training of community level workers and of personnel at the regional and national level in the maintenance, operation and repair of water supply and sanitation systems;
• technical assistance or training, as required, to improve the administration of water supply and sanitation systems.

In addition, USAID encourages attention to other factors which may have implications for domestic water supply and sanitation, including: the strength of existing institutions that govern the allocation of water resources; opportunities to incorporate water supply and sanitation activities into primary health care, agriculture (irrigation) and other programs; and the implications of rapid urbanization for existing water supply.