Despite tremendous efforts in the last two decades to provide improved water and sanitation services for the poor in the developing world, today, 2.4 billion people world-wide still do not have any acceptable means of sanitation, while 1.1 billion people do not have an improved water supply.

These are just two of the major findings from The Global Water Supply and Sanitation Assessment 2000, launched today by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF).

The Assessment is being launched as 500 public health, water and sanitation experts meeting in Brazil call on the world to roll-out a major effort – VISION 21 – to correct the "shameful" water and sanitation situation that plagues millions of people in developing countries.

The Assessment has found that:

• Around a quarter of the 4.8 billion people in developing countries are without access to improved sources of water, while half of them are without access to improved sanitation services.

• Of the 4.9 billion people worldwide who have access to water supply services, around 3 billion have the convenience of access through house connections or yard taps.

• There are 4 billion cases of diarrhoea in the world every year, with 2.2 million deaths, mostly among children under five. Safe water, adequate sanitation and hygiene can reduce diarrhoeal disease by between one-quarter and one-third of these cases.

• Rural services still lag far behind urban ones, but delivering affordable services to the rapidly growing numbers of urban poor remains a formidable challenge.

• There are huge inequities in the amounts invested in improving services to the better-off sections of urban society compared with investments in providing basic services for the unserved poor.

"Access to safe water and to sanitary means of excreta disposal are universal needs and, indeed, basic human rights. They are essential elements of human development and poverty alleviation and constitute an indispensable component of primary health care," write WHO Director-General Gro Harlem Brundtland and UNICEF Executive Director Carol Bellamy in the introduction to the Report.

Yet the Assessment makes clear that many people are being deprived of this right. It has further found that:

• The tariff charged by the water agencies in developing countries is not sufficient to cope with the costs of producing and distributing water. In Africa, Asia, and Latin America and the Caribbean the ratio between the unit average tariff and the unit production cost is respectively 0.8, 0.7 and 0.9.

• In Africa, 30% of the rural water supplies are not functioning at any one time. In Asia, and Latin America and the Caribbean, the numbers are, respectively, 17% and 4%.

• In the developing regions of the world, treatment of wastewater is applied in only a small number of systems. Only about 35% of the wastewater is treated in Asia, while the figure is 14% in Latin America. Only a negligible percentage of treatment has been reported in Africa. Even in industrialized countries, sewage is not universally treated.

• In large cities of developing countries, the percentage of unaccounted-for water is very high, around 40%. Most of this water is simply lost before reaching the potential user. The consequences are particularly serious to the poor living in marginal areas where the water will be wasted before reaching them.

• Not all the water distributed in large cities is safe. A number of cities reported that most samples violated water quality standards.

"It is shameful, a scandal that almost half of the world’s population does not have access to adequate sanitation," said Dr Richard Jolly, Chair of the Water Supply and Sanitation Collaborative Council (WSSCC), a Geneva-based international organization for water supply and sanitation professionals.

Consequently, beginning 24 November, in Foz do Iguacu, Brazil, 500 water and sanitation experts are meeting to agree on a worldwide programme to address this situation, based on the VISION 21 "Water for People" initiative. VISION 21, launched in March 2000 (see background note attached), aims to:

• By 2015, reduce by half the number of people without access to hygienic sanitation facilities and adequate quantities of affordable and safe water. In concrete terms, this will mean delivering improved water services to almost 300,000 people every day for the next 15 years, and improved sanitation facilities for around 400,000 a day.

• By 2025, achieve universal access to hygiene, sanitation and water services.

"In the Indian State of Gujarat, for example, we have shown that rolling out water and sanitation services according to the precepts of VISION 21 has had a dramatic impact on the health and well-being of the state’s citizens. It is also bringing down the costs of improved water and sanitation services and mobilizing local resources to handle local problems," according to Dr Jolly.

Under the theme "Vision 21: From Shared Vision to Shared Action", the Global Forum in Foz do Iguacu is being hosted by the Government of Brazil and the State of Parana, with the cooperation of the Inter-American Association of Sanitary and Environmental Engineering (AIDIS) and secretariat assistance of the Brazilian Association of Sanitary and Environmental Engineering (ABES).

The Geneva, Switzerland-based WSSCC is an independent, international organization for water supply and sanitation professionals, with more than 1,000 members in 130 countries. At the Brazil meeting – the Fifth Global Forum of the WSSCC – participants from more than 100 countries will develop implementation programmes based on experiences in India and in 20 other countries where VISION 21 has been tested.

VISION 21 was launched by the Water Supply and Sanitation Collaborative Council (WSSCC) at the Second World Water Forum and Ministerial Conference in The Hague in March 2000 and is now rolling out in different parts of the world.

In the Indian State of Gujarat, for example, empowered citizens’ groups will be the driving force in a major campaign to combat drought and water scarcity. The VISION 21 process of people-centred planning has developed into a State-wide action plan, in which Government has accepted the role of facilitator and is creating a new Gujarat Water Authority with strong stakeholder participation.

According to the WSSCC, VISION 21 presents the first real opportunity to make substantial inroads into the water and sanitation backlog by mobilizing people’s own energy and initiative. At the Global Forum, donors, NGOs, resource centres, UN and other external support agencies will join community representatives, local authorities and government agencies from all continents to work out how they can collaborate more effectively to reach the agreed goals.

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