Maintenance: A hidden cost for water and sanitation services

One of the World Health Organisation's (WHO) millenium goals is to halve the proportion of people without sustainable access to safe drinking water and basic sanitation by 2015. Globally, 420 million people in developing countries need improved access to water and 1052 billion people need improved sanitation by 2014 to meet the target. While access is improving in many countries, the sanitation part of the target is likely to fall short by 550 million people. A new report on the costs of achieving these goals highlights the often forgotten cost of maintaining supplies and services.

Poor access to safe drinking water and sanitation have considerable health and environmental impacts. Diarrhoeal disease, for example, causes significant health problems in many areas affected by poor sanitation. Amongst the world’s poor, those with access to water and sanitation services have greater economic growth. Evidence also suggests that progress towards the water and sanitation target would contribute significantly to meeting WHO targets on the reduction of child mortality, the prevalence of major infectious diseases, improving maternal health and improving the quality of life for slum populations. It would also have an impact on reducing poverty and hunger, saving productive time in agriculture, and empowering women and girls.

A study carried out by the WHO and the World Bank estimated the cost of achieving the WHO’s water and sanitation target by 2014. The study explored the impact of high cost technologies, such as piped water to individual homes, as well as low-cost technology solutions including pit latrines. In contrast to many studies, this study also considered the cost of maintaining services as well as providing new services. Maintaining existing services is crucially important, but is often ignored in cost estimates. Annual cost estimates, calculated taking 2005 as the starting year, indicate an annual spend on new services of 18 billion US dollars. The annual spending required to maintain existing services is estimated at 54 billion US dollars. Service needs are not uniformly distributed amongst urban and rural populations: a greater proportion of new coverage is needed in rural area, while maintenance programmes are more likely to be needed in urban areas.

Important policy decisions will need to be made regarding investment in water and sanitation programmes. Getting the most out of such programmes means ensuring both the maintenance and improvement of existing services. However, this hidden cost will contribute considerably to the overall price tag of meeting the millennium development goal. Some of the cost could be offset by using lower technology solutions for the provision of new services, but this will also reduce the health and environmental impacts of such projects. Such lower technology solutions may also receive less use from local populations, further reducing their health and environment benefits.

The study recommends that the preferences of service users should be considered in the planning of water and sanitation services. Cost estimates used to evaluate the benefits of programmes should include the operation, maintenance and replacement costs of existing coverage as well as new services and programme costs. Cost estimates also indicate the areas where there are the greatest shortfalls in funding and highlight the needs of rural areas in Africa and Asia.