The Urban Disaster

The International Federation of Red Cross and Red Crescent Societies has just published The World Disasters Report 2010 − Focus on Urban Risk. It’s excellent! Here are some excerpts (not much new to WatSan folk, but good that it’s out there for more people to read):

Chapter 5: “Urban risk to health”:

The rapid rise in the number of people living in urban centres and cities around the globe brings with it new forms of urban risk in the health sector. It is a tragic irony, but millions of people continue to be exposed daily to diseases that medical science has long known how to prevent and / or to cure. Acute respiratory infections, dysentery and diarrhoea, largely under control in cities in high-income countries, continue to exact a significant toll on the health and well-being of a disproportionate number of those who live in the sprawling slums of the developing world. …

The other end of the urban health spectrum can be found in low- and middleincome countries where most of the world’s impoverished urban dwellers live. In households lacking basic shelter services – water supply and sanitation in particular – the prevalence rate of diarrhoea among urban children soars, averaging 38 per cent in Pakistan, 33.3 per cent in Cameroon, 23.9 per cent in the Democratic Republic of the Congo and 32.3 per cent in Jordan. Diarrhoeal diseases account for nearly 2 million deaths out of a total of almost 10 million among children under the age of 5. …

In many cases and especially in the developing world, urbanization has taken place so quickly that governments have struggled to keep up when it comes to providing needed infrastructure. When people are crowded together in unsanitary conditions, disease thrives. A 2005 report in The Lancet estimated that nearly half the urban population in Africa, Asia and Latin America has one or more of the main communicable diseases associated with inadequate water and sanitation – including diarrhoea and worm infections.

and Chapter 7: “Urban governance and disaster risk reduction”:

The quality and capacity of local government in a city have an enormous influence on the level of risk that its population faces from disasters and, in particular, on whether risk-reducing infrastructure serves everyone including those living in low-income areas. Local or municipal governments also influence whether provision has been made to remove or reduce disaster risk from events such as floods and large-scale fires or to build into the city the capacity to withstand potential disaster events such as earthquakes. The quality and capacity of local government also have an enormous influence on the levels of risk from everyday hazards that can contribute much to mortality, injury or illness but that are not considered disasters, such as vector-borne diseases and traffic accidents. These risks are not an inherent characteristic of cities but the result of the limitations of their governments in meeting their responsibilities and, more broadly, of limitations of governance including the quality of their relations with the inhabitants and civil society organizations.

Most of what local governments do, or should be doing, is about reducing risks for their populations through ensuring services such as good provision for water, sanitation, drainage, solid waste collection, healthcare, all-weather access roads, electricity, emergency services and provision for transport and traffic management. They should also ensure health and safety standards are met. Even if provision for some of these are contracted to private enterprises or provided by higher levels of government, it is usually the responsibility of local government to coordinate or oversee their provision. Local governments that support meeting development needs reduce disaster risk.

BUT:
1,105,352
is the number of people reported killed in disasters in the ten years 2000−2009 (Table 2 in Annex 1), whereas
1,600,000
is the number of people killed by diarrhoea in one year − 1.5 million under-fives and 1.1 million over-fives [see Diarrhoea: Why children are still dying and what can be done (WHO/UNICEF, 2009) and Diarrhoea kills over a million over-fives each year (SciDev, 2009)].

Winston Churchill, Ancient Sewers, and the Future

I’ve come across this quote from Winston Churchill:

The farther backward you can look, the farther forward you are likely to see.

How far back can we go with sanitation? Well, there were sewers some 5000 years ago in the city of Moenjodaro (now a World Heritage Site) in present-day Sindh province, Pakistan – see Moenjodaro: A 5,000-year-old Legacy by Khurshid Hasan Shaikh and Syed M. Ashfaque (published by UNESCO, 1981), and Water supply and sewage disposal at Mohenjo-Daro by M. Jansen (World Archaeology 1989, 21 (2), 177−192).

So how much farther forward are we likely to see? Well, clearly not 5000 years, maybe 50 years at best. What are we likely to see? A highly urbanized world, for sure, probably a highly ‘periurbanized’ world. With what sanitation? Well, hopefully by then the world will have come to its senses and simplified sewerage with be the urban/periurban norm. Sewers in the past, simplified sewers in the future. But we shouldn’t wait for the future: we need to start installing simplified sewerage on a very large scale now. When are we going to realise this?

UN MDG Summit − 2

Just a few of the many webpages and blogs on the UN MDG Summit:

1. Vivien Foster, World Bank (blog): ‘Infrastructure − paramount issue for Africa’ + excellent video.

2. WHO (webpage): Millennium Development Goals.

3. WaterAid (webpage): Heads of State and UN Secretary General urge action on sanitation and water.

4. Jesse Garcia, Transparency International (blog): Countdown to the millennium development goals summit.

5. Craig Fagan, Transparency International (blog): Live from the MDG summit, or perhaps not?

6. Anthony Painter (blog): Must try harder- NGOs verdict on MDG Summit.

7. IDS, University of Sussex (webpage): World leaders meeting at UN MDG Summit must agree new direction – check out the ‘Related publication’ at the foot of the page (it’s well worth reading).

8. BBC (webpage): Uneven progress of UN Millennium Development Goals.

9. The White House (webpage): Obama’s Remarks at Millennium Development Goals Summit.

10. Amnesty International (webpage): MDG Summit: World leaders fail to uphold rights of the poorest.

11. Simon Trace, Practical Action (blog): From the ‘Millennium Development Goal’ (MDG) summit in New York.

12. DFID (webpage): 2010 UN MDG Summit.

►The last of these, DFID’s news story, starts off like this:

With only five years to go, we can no longer afford to talk in vague terms about “accelerating progress” on the Millennium Development Goals (MDGs).
This September we are calling on world leaders to come together at the UN to agree in concrete terms a global development action plan to meet the millennium promise to halve global poverty once and for all.
In order to achieve this plan, we will need three things: accountability, credibility and political will.

No chance then.

The Economist, The Lancet and the MDGs

1. Read (1) The Millennium Development Goals: Global targets, local ingenuity, (2) Child malnutrition in India: Putting the smallest first, and (3) Household access to energy (The Economist, 25 September).

2. Watch The necessity of educating women (The Economist online, 23 September) – “the former president of Ireland on why the Millenium Development Goals are not being met, and why they are still worth pursuing”.

3. Read Soul searching at the UN (The Lancet, 25 September) – “the UN seems to be an institution suffering a crisis of confidence, looking inwards (with the exception of UNICEF), while the major players in everything from climate change to the financial crisis look elsewhere for strategic leadership”.

Sanitation videos

Watch all five videos (each 5−12 minutes) in the Sanitation Video Contest and also watch the Vanguard programme ‘The World’s Toilet Crisis’ (44 minutes) and the 3-part BBC Earthwatch programme on ‘CLTS in Bangladesh’ (total of 21 minutes) [links to these last two are given on the Sanitation Video Contest page]. Enjoy!

Sanitation at the UN MDG Summit

This week has seen the 3-day UN MDG Summit in New York – and it even has a song ‘Eight Goals for Africa’. How did Sanitation fare? Well, there’s the Factsheet on Goal 7 (‘Ensure enironmental sustainability’, which includes the WatSan targets) – specially prepared for the UN MDG Summit. Then there’s the Background Note for Round Table 3 ‘Promoting sustainable development’ which starts off with the question “What are the most cost-effective national policies to increase the availability of safe drinking water on a sustainable basis and to improve sanitation?” − the answer given is:

A sustainable development approach incorporates environmental sustainability issues ‒ such as increased access to basic services, including safe drinking water and sanitation, addressing biodiversity loss and ecosystem degradation, slum rehabilitation, along with managing the natural resource base ‒ into the design and implementation of coherent and effective national development strategies.

Achieving universal access to clean drinking water and sanitation is critical for reducing poverty and malnutrition, and realizing the gender and health-related MDGs. While notable progress has been made in increasing access to improved water sources, explicit efforts are needed to monitor water safety, accessibility, affordability and reliability (or continuity). Greater emphasis on sanitation is particularly urgent as access to sanitation is still far from being achieved in many countries.

The most effective national policies are those that catalyze, facilitate and support effective local action. Local management and community initiatives play a key role in ensuring and sustaining the success of enhancing water supply and sanitation services to poor communities. National strategies can prioritize sanitation and water coverage by, for instance, setting norms and targets, and locating them within the framework of integrated water resource management. Successful policies have focused on:
• Building local community arrangements and capacity for developing, maintaining and expanding new systems to ensure sustainability of the benefits.
• Mobilizing local leadership and participation of community women in local water management institutions as well as training local people in maintenance and repair.
• Establishing management committees or groups that manage water systems beyond the completion of projects, instituting user fee arrangements, as appropriate, to ensure financing for management, maintenance and repair.

This seems to me to have too much of a rural focus. The three bullet points aren’t really that relevant for the large-scale infrastructure interventions needed in high-density low-income urban areas. And you can see that water gets more attention than sanitation.

What about Sanitation at the Summit?
It’s true that sanitation is mentioned in the ‘Outcome Document’ of the Summit Keeping the Promise: United to achieve the Millennium Development Goals, but it doesn’t figure that strongly. The new Global Strategy for Women’s and Children’s Health, launched at the Summit does better, with eleven references to sanitation, and there’s the ‘unofficial transcript’ “Everyone should have access to water and sanitation services that we in this room take for granted,” says Secretary-General on persistent, pressing challenge, not to mention the video of the ‘UN/MDG Maternal Sanitation Wrap’ at a ‘high level UN breakfast’. There was the ‘Partnership Event’ Addressing the Global Water and Sanitation Challenge: The Key to the MDGs on 22 September, but no info. on any outcomes (at least not yet). Almost all full of “platitudes [that] hog space that should be occupied by radical ideas” (to use a nice phrase in the Baobab blog of 20 September in The Economist).

There’s much more information on other websites − for example, read WaterAid’s newsroom item of 22 September ‘Heads of State and UN Secretary General urge action on sanitation and water’; see also the newsroom item of 8 September ‘Ten years on: hope stuck in the mire’ and the release of WaterAid’s new report Ignored: Biggest Child Killer – The World is Neglecting Sanitation.

What about Sanitation beyond the Summit?
I can foresee that the international sanitation agenda will be mainly dominated by Sanitation and Water for All (see here), Sustainable Sanitation – the 5-year Drive to 2015, and the United Nations Secretary-General’s Advisory Board on Sanitation (UNSGAB) (see here, for example), and this doesn’t fill me with much (if any) confidence that the MDG sanitation target will be met or that Sanitation for All will happen by, say, 2050. Of course, many other agencies (WaterAid, World Bank, ADB, WHO, UNICEF, Gates, SCF, Oxfam, …) will also be doing their bit (and some will be doing it better than others). However, what those without adequate sanitation need is better joined-up-thinking (and action, of course) – but where’s this going to come from, and how do we get it to those who need it?

Africa’s WatSan Progress

I’ve just come across the Africa Progress Report 2010 “From Agenda to Action: Turning Resources into Results for People” published in May by the Africa Progress Panel in Geneva. If, like me, you’ve not come across the Africa Progress Panel before, here’s what it has to say about itself:

The Africa Progress Panel brings together a unique group of leaders under the chairmanship of Kofi Annan. The Panel monitors and promotes mutual accountability and shared responsibility for progress in Africa. Its three focus areas are economic and political governance; finance for sustainable development, including ODA [Official Development Assistance]; and MDG achievement – notably in light of climate change. The work of the Panel aims to track progress and draw attention to critical issues and opportunities for progress in Africa.

The Africa Progress Report 2010 (page 30) has this to say on access to water and sanitation:

Remarkable advances have been made in several African countries, including Angola and Botswana, but overall progress on the continent is insufficient. … At current rates, Africa will achieve the targets only in 2040, with some of the poorer countries not meeting them before 2050.

The challenges are enormous. Despite an increase of 11 per cent since 1990, only 60 per cent of Africans have access to improved sources of drinking water and more than half still do not have access to improved sanitation facilities. In 14 countries, more than a quarter of the population still takes longer than 30 minutes to make one round trip to collect water. Disparities between rural and urban areas have also been growing fast.

Most African countries have established national task forces and developed plans to reach the MDGs on water supply and sanitation. But plans are often neither country-owned nor actively implemented. Despite increased activity on the intergovernmental level, including through meetings of the African Ministers’ Council on Water (AMCOW), the establishment of the African Water Facility (AWF), the dedication of the 11th AU Summit to water and sanitation, and the institutionalization of an annual African Water Week, African leaders have been slow to act at the national level. Many of the recommendations and commitments enshrined in documents such as the African Water Vision (2000), the Tunis Ministerial Declaration on Accelerating Water Security for Africa’s Socioeconomic Development (2008), and the Sharm El-Sheikh Commitments for Accelerating the Achievement of Water and Sanitation Goals in Africa remain unfulfilled. The 2010 targets included in the eThekwini Declaration, including the allocation of 0.5 per cent of GDP for sanitation and hygiene, will also be missed by most countries.

So political will is lacking and the main reason why Africa’s so far behind on the MDGs, not external aid as Jeffrey Sachs claims (see blog of 17 September).

And here’s an excerpt from the speech by Angela Merkel, the German Chancellor, at the ‘High-Level Plenary Meeting of the UN General Assembly on the Millennium Development Goals’ which has been taking place this week in New York:

There is one thing that we all have to accept: the primary responsibility for development lies with the governments of the developing countries. It is in their hands whether aid can be effective. Therefore, support to good governance is as important as aid itself. Today's emerging economies show that development policy can ultimately only be successful if there is national stewardship and national implementation. This also applies to mobilising the necessary resources. ODA funding can, apart from emergency situations, only be a contribution to national resources, never a substitute for them.

[I’m waiting to see what the outcomes of this ‘High-Level Plenary Meeting’ (better known to most of us as the UN MDG Summit) might be. Just more weasel words? We’ll have to wait and see − at least Secretary General Ban Ki-moon has been making the right sort of noise: Lack of access to safe water perpetuates poverty (to be fair, he did mention sanitation)].

‘Improved’ WatSan

Jeremy Allouche and Lyla Mehta (of IDS) have written an interesting piece in the Eldis Environment News Group Exchange Blog (17 September): Water and sanitation for all: the need to go beyond numbers and beyond the MDGs, which questions the appropriateness of the JMP definitions of improved WatSan − though I wouldn’t go as far as suggesting that CLTS interventions might count as ‘improved’ if they are “just be pits in the ground, and not with slabs or pour flushes”. That apart, it’s a good read.

MDGs

This week’s issue of The Lancet has a paper and a couple of commentaries on the MDGs, all free-to-view and doubtless in preparation for next week’s UN Summit on the Millennium Development Goals in New York:

The Millennium Development Goals: a cross-sectoral analysis and principles for goal setting after 2015 by The Lancet and the London International Development Centre Commission (the ‘webappendix’ to this paper is a particularly good review of progress/lack of progress on all the MDGs, though nothing new on WatSan),

The MDG decade: looking back and conditional optimism for 2015 by Jeffrey Sachs, and

Africa faces an uphill struggle to reach the MDGs by Wairagala Wakabi.

Sachs says:
All of the estimates [of costs needed to implement a basic primary health system in a low-income setting], when appropriately updated to 2010 conditions, suggest a cost of around US$50–60 per person per year in current dollars … [whereas] the plausible level of domestic resource mobilisation for public health is of the order of $15 per person per year. … That leaves a financing gap of around $40 per person per year to be filled by external donors. … Many large donors are letting poor regions down. … Most poor countries are ready to lead domestically, and have the management and technical capacities to do so with local skills
and internal technical support when needed. The key limiting factor for success is external aid. If the high-income countries build on their successes of the past decade, and deliver a mere 0.1% of GDP for health-sector official development aid as part of a larger overall aid programme, they and their low-income partners will celebrate great MDG successes as of 2015.

So, if low-income countries don’t meet all the health targets of the MDGs, then it’s all the fault of the high-income donor countries? I don’t think so!

Wakabi, a Ugandan journalist, certainly doesn’t put the blame on donor countries, more on the low-income countries: “Despite scoring some notable successes, funding shortfalls and a sapping of political will are stymying progress towards attaining the health MDGs in Africa” – shortfalls, that is, in local funding and a lack of local political will.

Toiling for toilets

There’s a “feature” article in this week’s British Medical Journal: Toiling for toilets by Rebecca Coombes (a BMJ associate editor) – quote: “Sanitation has been the poor relation of the millennium development goals, but without it the chances of meeting many of the other goals are much reduced”. Nothing new, but a useful piece of advocacy (and good for medics to read).

CLTS and STEPS

The STEPS [Social, Technological and Environmental Pathways to Sustainability] Centre at the University of Sussex has just published a working paper on CLTS: The Dynamics and Sustainability of Community-led Total Sanitation: Mapping Challenges and Pathways. Here’s a quote:

Even though CLTS has the makings of a development success story, many obstacles remain before it can truly be said to offer a viable route to meeting the MDGs. For example: How does CLTS accommodate dynamism and complexity inherent in social-technological-ecological systems? How are women’s, children’s and men’s often diverging needs accounted for? How can CLTS be scaled up to become a major force rather than an approach characterised through piecemeal, scattered projects? Are there lingering assumptions and power relations that hinder or obstruct the spread of CLTS? In short – how sustainable is CLTS, and in what ways is the notion of sustainability understood? This paper offers some perspectives that may help structure thinking around these questions.

Good down-to-earth stuff!

The list of all STEPS working papers is here. A few of the WatSan-relevant ones are:

Liquid Dynamics: Challenges for Sustainability in Water and Sanitation

Going with the Flow? Directions of Innovation in the Water and Sanitation Domain

On the Edge of Sustainability: Perspectives on Peri-urban Dynamics

Back-end users

Here’s an interesting commentary on sanitation: Back-end users: the unrecognized stakeholders in demand-driven sanitation by Ashley Murray and Isha Ray of UC Berkeley (recently published online in the Journal of Planning, Education and Research). This is the Abstract:

Inadequate wastewater and fecal sludge treatment, disposal, and end use systems are arguably the greatest obstacles to achieving sustainable urban sanitation in unserved regions. Strategies for planning and implementing urban sanitation are continually evolving. Demand-driven sanitation with household and community participation is broadly thought to be the way forward. We are skeptical that more time and resources spent garnering household and community demand for sanitation will amount to the much-needed improvements in the treatment and end use components of sanitation systems. We propose shifting the incentives for sanitation from “front-end users” to “back-end users,” thereby leveraging demand for the products of sanitation (e.g., treated wastewater, fertilizer, alternative fuel) to motivate robust operation and maintenance of complete sanitation systems. Leveraging the resource value of wastewater and fecal sludge demands a reuse-oriented planning approach to sanitation, an example of which is the Design for Service approach presented in this commentary.

“Design for Service” is defined as “a five-step planning approach that results in a site-specific, reuse-oriented sanitation scheme. The ultimate reuse (or “service”) of the wastewater/fecal sludge is the starting point for the planning process”. The five steps are:

1. Generate a list of all of the potential “services” (e.g., irrigation, fertilizer, energy generation) that wastewater, fecal sludge, and treatment by-products can provide.
2. Assess the demand for these services in and around the city of interest.
3. Assess the business-as-usual performance of the provision of these services according to economic, social, and environmental indicators.
4. Design sanitation infrastructure for the provision of that service where it can have the greatest marginal impact.
5. Assess the intrinsic environmental and cost characteristics of the technology options available for rendering the wastewater/fecal sludge/treatment by-products suitable for the service of choice.

The paper details the rationale for each of these five steps.

As the authors say in their Conclusions, “designing for reuse exacts a nontrivial time and resource cost on sanitation planning processes” − but, if it increases the chance of system success/sustainability, then it’s clearly worth doing. Up to now we’ve concentrated on the “front-end users”. It’s clearly time to bring the “back-end users” into the sanitation planning process.

Energy and Monkeypox

There’s a good article on energy in the developing world − Power to the people – in the 4 September issue of The Economist. Quote: “Around 1.5 billion people, or more than a fifth of the world’s population, have no access to electricity, and a billion more have only an unreliable and intermittent supply.” Not too dissimilar to WatSan provision then.

The same issue has an article on emerging infections – No good deed goes unpunished. Smallpox is being replaced by monkeypox, at least in the DRC (see the original PNAS paper here). Similar to rotavirus and norovirus (see blog of 27 June 2009)?

Global Atlas of Helminth Infections

Check out the Global Atlas of Helminth Infections website (developed by the London School of Hygiene and Tropical Medicine and the Partnership for Child Development). This is “an open-access information resource on the distribution of soil-transmitted helminths and schistosomiasis”. Country maps are currently available only for Sub-Saharan Africa, but will eventually be available also for Latin America and Asia.

Note: there are better life-cycle diagrams on the CDC website – Ascaris, Trichuris, hookworms, and schistosomes.

World Water Week

Last week (5−10 September) was World Water Week in Stockholm – an annual event ably organized by the Stockholm International Water Institute (SIWI) and with now a good emphasis on sanitation. There were many parallel sessions and side events, so impossible to attend everything. Here are just some of the events I found interesting…

Sunday

Wastewater use in agriculture this afternoon and early evening. The afternoon session was
on “Reducing the Risks of Wastewater Irrigation: Strategies and Incentives” based, more or less, on the following three recent publications:

1. Improving Wastewater Use in Agriculture: An Emerging Priority (World Bank, 2010)
2. The Wealth of Waste: The Economics of Wastewater Use in Agriculture (FAO, 2010)
3. Wastewater Irrigation & Health: Assessing and Mitigating Risk in Low-income Countries (Earthscan/IDRC, 2010)

The early evening session was the launch of the Second Information Kit on the 2006 WHO Wastewater Use Guidelines – not yet online (but my part is here). My presentation was on choosing a sensible value for the maximum tolerable additional burden of disease – i.e., the maximum DALY loss per person per year (pppy). The default value used for this in the 2006 WHO Guidelines is 10−6 pppy for this, but this is very ‘extravagant’ and I recommended a value of 10−4 DALY loss pppy as it reflects epidemiological reality in developing countries and some industrialized countries (e.g., Australia and the USA) much more closely. [Actually this also applies to Drinking-water Quality Guidelines, but that’s a real can of worms – for WHO, US EPA and the EU, amongst others − waiting to be opened…]

Tuesday

I attended the lunchtime side event on “What knowledge do we need to do better on Sanitation?” This was basically how the London School of Hygiene and Tropical Medicine and its partners see how their ‘Sanitation and Hygiene Applied Research for Equity’ (SHARE) research consortium, funded by DFID, will progress. Check out the SHARE website when it gets going by the end of the month (in the meantime there are some details here).

Then I went to the afternoon seminar on “Water quality issues and new approaches in Latin America”. Interesting couple of papers – one on water and wastewater problems in Mexico City by Dr Blanca Jiménez (UNAM). The other was by Professor Eduardo Jordão (Federal University of Rio de Janeiro) on the use in Brazil of UASBs + some form of secondary treatment serving populations of 20,000−1,500,000 – but little mention of costs or cost-effectiveness, and no mention of high-rate anaerobic ponds.

As I was rushing from the lunchtime session to the afternoon session my colleague Dr Jan-Olof Drangert (University of Linköping, Sweden) shoved a leaflet into my hand – all about his new website Sustainable Sanitation for the 21st Century, which comprises a free e-book and a set of PowerPoint presentations for training professionals in the sanitation and water sector. There’s a certain EcoSan emphasis, but it’s certainly very well worth taking a look. You can download the PowerPoints as ppt files, so you can use them as they are or select which slides you want to use in your own presentations. Excellent idea!

Wednesday

I went to the workshop on “Improved water use efficiency through recycling and reuse” and gave a presentation on Natural wastewater treatment and carbon capture. Professor Emeritus Takashi Asano (UC Davis), in a keynote presentation, told us all about water demand and wastewater recycling and reuse in California – a complex system necessitated by building a megacity (Los Angeles) in a desert and by California being the nation’s major table-food (vegetables, fruits) producer. Then Dr Ashley Murray (UC Berkeley) gave a really interesting paper on wastewater-fed aquaculture: set up a local business to grow fish in maturation ponds and the business returns half its net profit to the wastewater treatment works (waste stabilization ponds) to help pay for O&M – a very neat concept which she developed in Ghana.

Thursday

Interesting morning session on the “Five-Year countdown to the water and sanitation MDG targets: status, trends and challenges”. The main findings of the 2010 JMP Report and the 2010 GLAAS Report were presented, and there was considerable discussion on how WatSan monitoring should progress. Good data are, of course, essential but, while I think they can tell us what to do in some areas, they don’t/can’t in other areas. For example:

(1) While they tell us that there are still far too many open defecators and so helping communities to become OD-free (i.e., to move to fixed-place defecation) is really important, it’s equally important that the fixed defecation place they move to is at least improved sanitation, but so often it’s not.

(2) They can’t tell us a lot about the future, but we know from the World Urbanization Prospects: The 2009 Revision that almost all population growth in the next few decades will be in urban areas of developing countries (see blog of 28 August for the figure showing this). This means that, while we can’t forget about rural sanitation, we’re going to have to concentrate on sanitation in high-density low-income slum and non-slum urban areas. Is the world remotely prepared for this? No, it is not.

►One statistic that came out this morning was that, as we’re unlikely to meet the MDG sanitation target, there’ll be around 2.7 billion people at the start of 2016 who’ll need ‘improved’ sanitation. Now that’s a hideously sobering thought: in purely numeric terms we’ll be back where we started in 2000…

Not a brilliant note to finsh World Water Week on. Just, depressingly, more of the same. Clearly we’re going to need, and sooner rather than later, an annual World Water & Sanitation Week. Sanitation really does need to be mainstreamed more, not just mostly left to side-event organizers. Anyone in SIWI listening?

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PS: check out the World Water Week videoclips on the WaterCube!