WASHINGTON, DC, September 1, 2017 (ENS) – Countries will have to spend US$150 billion per year to reach the Sustainable Development Goal of access to safely managed water and sanitation services by 2030, finds a new report by The World Bank released at World Water Week 2017 in Stockholm.

This is a fourfold increase in water supply, sanitation, and hygiene (WASH) investments compared to what is spent today, a level of spending that is out of reach for many countries, threatening progress on poverty eradication.

In the West African country of Niger, the researchers found, most WASH investments go to the urban water sector, leaving 90 percent of the rural population without a toilet and 51 percent without access to improved water.

In Nigeria, 30 percent of the water points stopped working in the first two years, and more than 60 percent of the rural population live more than 30 minutes away from a working water source.

“Water and sanitation services need to improve dramatically, or the consequences on health and well-being will be dire,” says Rachid Benmessaoud, World Bank country director in Nigeria.

“Today, diarrhea is the second leading cause of death in children under five. Poor children also suffer from intestinal diseases, which together with under-nutrition and infections contribute to stunting. We are risking the futures of our children: their potential is being stymied by unequal or uneven access to the services they require to thrive,” Benmessaoud said.

Based on three years of field research, the report, “Reducing Inequalities in Water Supply, Sanitation, and Hygiene in the Era of the Sustainable Development Goals,” suggests that a complete change is required in the way countries manage water resources and provide key services.

A good start would be improved targeting to ensure the water and sanitation services reach those most in need. Water, health, and nutrition interventions need to be coordinated to make progress in the fight against childhood stunting and mortality.

In Indonesia, for instance, one of the 18 countries studied, only five percent of urban wastewater is safely treated and disposed of. The report found that children living in communities with open defecation during the first 1,000 days of life are 11 percentage points more likely to be stunted.

While improving water and sanitation alone does upgrade a child’s health, the impacts on a child’s future are even greater when these improvements are combined with health and nutrition interventions.

A variety of barriers to adequate water and sanitation arise.

Adnan Ghosheh, World Bank senior water and sanitation specialist, remembers a time not so long ago when everyone in Gaza could drink water from their tap. That was in the late 1990s, but so much water has been pumped out of the natural aquifer underneath Gaza since then that seawater has seeped in, making it too salty to drink. These and other factors mean that only 10 percent of Gaza’s population has access to safe drinking water, compared to 90 percent in the West Bank or about 85 percent in the Middle East and Northern Africa in general.

Raw or poorly treated wastewater, which comes from densely populated areas and refugee camps in Gaza, infiltrates the aquifer or goes to the Mediterranean Sea. As a result, you have a shortage of water coupled with high demand from a population that now numbers close to two million.

In the West Bank, there is also a challenge of access to water. There are some areas where the daily water consumption per person is just 25 liters while the World Health Organization recommends 120 liters per person per day. This is because inhabitants of the West Bank are not getting enough water from the supplier. The bulk supplier is Palestinian, but much of the resources in the West Bank are controlled by Israel. The demand is particularly acute in summer. In Hebron, the municipality is able to deliver water only once every 21 days, and this is generating discontent.

In the West Bank, local governments have control over political and administrative functions, but not fiscal authority. In the absence of stable fiscal transfer, they must rely on their own revenues from electricity and water to finance their operating budgets.

“Millions are currently trapped in poverty by poor water supply and sanitation, which contributes to childhood stunting and debilitating diseases such as diarrhea,” says Guangzhe Chen, senior director of the Water Global Practice of the World Bank.

“To give everyone an equal chance at reaching their full potential, more resources, targeted to areas of high vulnerability and low access, are needed to close the gaps and improve poor water and sanitation services,” Chen said. “This report provides a roadmap for closing that gap.”

The report, for the first time, pinpoints geographic regions within countries that have inadequate WASH services.

Researchers found a big difference between urban and rural areas. Across the 18 countries studied, 75 percent of people who lack improved sanitation live in rural areas, and only 20 percent of rural inhabitants have access to improved water.

In Ecuador, for instance, 24 percent of the rural population drinks contaminated water; 21 percent of children are stunted and 18 percent are underweight.

In Haiti, access to improved drinking water sources has declined in the last 25 years; access to improved sanitation is stagnant at 33 percent; and the number of households with access on premises to improved water has decreased from 15 to seven percent.

In Bangladesh, E. coli was present in about 80 percent of water taps sampled, a similar rate to water scooped up from ponds.