Sebastian D'souza  /  AFP file
Housewife Kashibai collects drinking water from a house next to a open sewer in Bombay's Matang Rushi slum. Some 2.5 billion people lack access to adequate sanitation, according to the United Nations.
updated 3/20/2009 5:55:22 PM ET 2009-03-20T21:55:22

The world is neglecting a crisis over poor sanitation even as it makes progress in providing clean water, which means that diarrhea and related illnesses such as malnutrition will continue to kill at an alarming rate, experts said Friday.

About 1 billion people do not have access to safe drinking water, and 2.5 billion people lack access to adequate sanitation, according to the United Nations. But the World Water Council, organizer of a forum in Turkey this week, said investment in sanitation rarely amounts to more than 0.3 percent of global GDP, even though latrines and sewers are relatively cheap and play a key role in preventing disease.

"There's not really a recognition amongst a broader public and particularly health communities around the world of the crucial role that sanitation plays," said David Trouba of the Water Supply and Sanitation Collaborative Council.

The Geneva-based group estimates that 1.2 billion people, more than half of them in India, defecate in the open, a custom that can spread disease because bacteria is easily transmitted to people through flies or other contact.

The World Water Forum on the banks of the Golden Horn inlet in Istanbul has drawn thousands of activists, engineers and officials from governments and private companies to discuss ways to manage water resources as demand soars. The event, which is held every three years, ends Sunday.

Taboo about excrement slows progress
Some participants said the conference should focus more on sanitation, noting that a cultural taboo about the unsavory topic of human excrement was hampering efforts to save lives. According to some estimates, diarrhea kills 5,000 children, most of them under the age of 5, every day.

"The lion's share of attention and funding still goes to water," said Rose George, author of "The Big Necessity," a book about the health crisis surrounding the disposal of human waste. She said celebrities such as actor Matt Damon and rapper Jay-Z had promoted clean water projects, but few celebrities or politicians were willing to associate themselves with sanitation campaigns.

"They're quite happy to pose in front of a shiny tap, but nobody wants to go and stand in front of a latrine," said George, who compared the problem to the struggle to break down the silence surrounding the HIV virus, which causes AIDS, in the 1980s.

The sanitation problem is increasingly urban, as more than half the world's population lives in cities, forum organizers said. Poor sanitation and filthy discharges into water supplies drive up health costs and kill fish, inflicting poverty on downstream communities.

Guy Fradin, a governor of the World Water Council, said emphasis on sanitation was greater at the forum in Istanbul than at the last conference, in Mexico City in 2006. He praised Istanbul, which has at least 12 million inhabitants, for improving sanitation by cleaning up the Golden Horn and the Bosporus Strait, which splits the city, over the last 15 years.

"Sanitation and access to water are completely linked," he said.

Education is as important as funding
Experts agreed that educating people about the importance of sanitation was as critical as providing the resource. In addition, Caroline Boin of the International Policy Network, a London-based research center, said one overlooked aspect of water provision and sanitation was the role of private vendors who use donkeys and containers to sell water to poor people without access to water mains.

"They need to be allowed to operate in the formal economy, where they access credit easily, expand and refine their activities," Boin said.

Copyright 2009 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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