Sick water?

Regionally, there are large variations in progress towards this

MDG. For sanitation, the regions of Africa south of the Sahara

and southern Asia show the greatest disparity, with 330 mil-

lion and 221 million people without access to basic sanitation,

respectively. Not surprisingly, the regional variations in lack

of access are proportionally mirrored in the diarrhoeal dis-

ease data. Figure 16 presents the regional child mortality rates

from diarrhoea for which lack of access to sanitation is the

root-cause, modulated by regional differences in the capacity

of health services.

THE SANITATION LADDER

In their efforts to monitor progress in achieving the MDG wa-

ter and sanitation target, WHO and UNICEF designed the sani-

tation ladder. The sanitation ladder reflects incremental prog-

ress even in situations where it is not possible to achieve the

full MDG target. Poverty is the overarching determinant, and

the position of a community on the sanitation ladder therefore

relates to that community’s capacity to deal with wastewater

management as well. Not only do higher rungs on the ladder

reflect a better sanitation starting point for effective wastewater

management, but the corresponding improved socio-economic

status will also permit a greater capacity to manage wastewater

and invest in the necessary infrastructure.

Figure 16:

Child mortality rates by cause and region, 2004.

Source: WHO, 2008.

Child mortality rates

Percentage

High

income

countries

Americas

Western

Pacific

Europe

South East

Asia

Eastern

Mediterranean

Africa

Perinatal conditions

Diarrhoeal diseases

Respiratory diseases

Malaria diseases

Other causes