First in Queue: How improving water access for the poor can help meet other Millennium Development Goals.


The United Nations Millennium Development Goals (MDGs) set to reduce by half the number of people without access to clean water by 2015 as target ten of goal number seven: ensure environmental sustainability. And—although this fact remains controversial*—this target was met three years early in March 2012. However, this is not a cause for complacency since, according to the 2012 report by the Joint Monitoring Program—the body that carries out MDGs target assessments—780 million people are still at the back of the queue for access to clean water. In the future, improving access to water for the remaining three quarters of a million people without it will need to become a bigger, more crosscutting priority because it has much more to offer than environmental sustainability.

To begin with, lack of access to sufficient amounts of clean water has serious health consequences that affect the achievement of MDGs four, five, and six: reducing child mortality, improving maternal health, and combating HIV and other diseases, respectively. In its 2008 report, the World Health Organization (WHO) estimates that one and a half million children die each year due to diarrhea, mainly in developing countries. These are preventable deaths caused by insufficient access to water. In addition, as was recently reported by IRIN news, for those low-income people suffering from HIV/AIDS, lack of water can entail the occurrence of secondary opportunistic infections like typhoid that can threaten their lives. Finally, water access can also considerably reduce the occurrence of water-washed diseases (diseases caused by water scarcity), time spent in illness, and vulnerability towards other infections. For example, a 2007 report by the Poverty Environment Partnership—an informal network of development agencies that aims at reducing poverty-environment issues in relation to the MDGs—showed that increased access to water during and after childbirth reduced postnatal infections of women in Tanzania.

Clean water supports health, which in turn supports people’s ability to work, buy food, and climb out of destitution. This directly affects the first MDG of eradicating extreme poverty and hunger. As elaborated in the 2001 book Environmental Problems in an Urbanizing World by researchers from the International Institute for Environment and Development (IIED), this is due to the fact that the poor usually engage in jobs that do not provide sick leaves. Therefore any time lost in illness is productive time lost. Moreover, health expenses form a major part of their income and, as they cannot afford the best treatments, they have prolonged periods of illness. These expenses can perpetuate the cycle of poverty. In addition, as opposed to the rich, the livelihoods of the poor are more dependent on water as they may be involved in water-intensive occupations like small-scale agriculture, brick making, laundry services, and construction work, as well as needing water for cooking, cleaning, and sanitation at home. Therefore lack of sufficient water can result in a significant loss of income.

Not all low-income households in developing countries can afford access to piped water. As a result, collecting water from a distant source takes up a lot of time during the day, a task usually carried out by women and girls. This reinforces existing economic and social gender imbalances and goes against the progress of MDGs two and three: achieving universal primary education and promoting gender equality and female empowerment, respectively. In her 2011 study based on the access to water by peri-urban communities, published in the International Journal of Urban Sustainable DevelopmentUniversity College London (UCL) lecturer Pascale Hofmann reports how women living in Chennai spend up to two hours collecting water, often facing long queues and variable operating hours. Moreover, children, especially girls, drop out of schools to help out with the household chores that their mothers are unable to finish. Indeed, the said 2007 Poverty Environment Partnership report showed that increased water access allowed women and their children to turn to more productive activities and reduce gender imbalances in employment and education. In Gujarat, India, women earned an additional Rs. 750 – Rs. 5,500 (US$ 15-102) per year through dairying, crafts, and tree nurseries. Meanwhile, in the Nokhalia District in Bangladesh the improvement in water and sanitation provision increased girls’ school attendance by 15 percent.

Currently, improving water access is an isolated target developed as a subset of the MDG for environmental sustainability. However, due to its combined impacts on mortality, health, wealth, education, and female empowerment, it has positive externalities that can drastically affect the progress towards achieving the first seven MDGs. As was argued by the Institute for Advanaced Development Studies (INESAD) researcher Ioulia Fenton in a 2011 Development Roast article, development ambitions beyond 2015 will need to recognize the inter-connectedness between the MDGs and their targets in a more holistic framework. And, given its nature as one of the most crosscutting issues in development, putting the remaining 780 million people first in queue for secure access to safe water should be a much higher priority.

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*The MDGs consider the technology used i.e. piped water or public standpipe to determine the quality of the water source (improved/ unimproved). This is tremendously problematic as it is not representative of the quality of water in those sources and, more often than not, the water in those pipes in contaminated. Sometimes, the pipes may exist but have no water. Other times, some water may be present but not sufficient to provide for everyone’s needs. The MDGs’ statistics do not account for the number of people with adequate water provision. Therefore, even within the population that apparently has access to water, it may not reflect the fact that their needs are being met adequately.

Can you think of ways in which the cross-cutting importance of water can be reflected in the international development agendas? 

Surabhi Karambelkar is a Research and Communications Intern with Institute for Advanced Development Studies (INESAD).

For your reference:

Cairncros, S. (2003). Editorial: Water supply and sanitation: some misconceptions. Tropical Medicine and International Health, 8(3), 193–195. doi:10.1046/j.1365-3156.2003.01027.x

[Available at-;jsessionid=8F4C1A0972B9123A1B4F95A4F03CC8A4.d03t04 ]

Hardoy, J. E., Mitlin, D. and Satterthwaite, D. (2001). Environmental Problems in an Urbanizing WorldEarthscan, London.

Hofmann, P. (2011). Falling through the net: access to water and sanitation by the peri-urban water poor. International Journal of Urban Sustainable Development, 3(1), 40–55. doi:10.1080/19463138.2011.577274

[Available at-]

Poverty-Environment Partnership. (2007). Linking Poverty Reduction and Water Management. Poverty Environment Partnership.

[Available at-]

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