Memorandum submitted by Dr Andrew Cotton
1. Dr Andrew Cotton is a Public Health Engineer
with over 25 years experience in international development work
in water, sanitation and urban upgrading. He works at the Water,
Engineering and Development Centre (WEDC) at Loughborough University
where he is Director of DFID's Resource Centre in Water, Sanitation
and Environmental Health (known as WELL). This submission focuses
primarily on sanitation in relation to DFID and the UK aid programme.
HOW ARE
WE DOING?
MILLENNIUM DEVELOPMENT
GOALS AND
TARGETS
2. There is a strong focus at the global
level on the Millennium Development Goals (MDGs) and their associated
targets. The prime focus is around poverty reduction and the UK
government position is clearly aligned with this. There is a strong
degree of inter-relation between the MDGs and water and sanitation
contribute to most of the goals (eg child health, education, HIV
and other diseases, gender, environmental sustainability). Because
neither water nor sanitation are headline goals, there needs to
be a strong advocacy effort for the contribution the sector makes.
3. Why do water and sanitation? The health
impacts are generally understood. Diarrhoea causes 1.5 million
children under the age of 5 to die each year; of this, 88% is
attributable to poor water, sanitation and hygiene. Provision
of latrines can reduce diarrhoea by over 30%, and handwashing
after defecation by over 40%.
4. The UK government through DFID was a
prime mover behind one of the major achievements at the World
Summit on Sustainable Development in Johannesburg 2002, namely
adopting a global target for improving access to sanitation. This
is reflected in the global headline figures: 1.2 billion lack
access to safe water and 2.4 billion lack access to adequate sanitation.
The level of interest of the British public in water and sanitation
can be partly gauged through looking at donations to key charities:
for example, WaterAid's voluntary and total income have now both
nearly doubled over 2002-05. The British public and corporate
sector see water and sanitation as "a good thing to be doing".
5. It is likely that the world will meet
the drinking water target; however, to meet the sanitation target
it will have to double the rate of improvement since 1990. Of
the approximately 120 million children born in the developing
world each year half will live in households with no access to
improved sanitation facilities.
6. South-East Asia is "where most toilets
aren't", with India and China predominating due to their
large populations. However, the rate of progress to improve sanitation
has doubled since 1990 although much remains to be done. In Sub
Saharan Africa, the trends are of much greater concern, as things
appear to be going backwards. Coverage has only risen by 5% since
1990 and this has been outstripped by population growth such that
the number of people unserved has actually increased by 111 million
over the period.
SANITATION
7. At current levels of progress it is very
unlikely that the sanitation target will be met. It is therefore
doubly important for donors including DFID to make sanitation
a priority area for attention. "Doing sanitation" is
quite different from "doing water". For example:
— Demand for sanitation is much
less clearly expressed than for other services including water;
peoples' awareness of the importance of sanitation can be very
low.
— It's not just physical infrastructure
which delivers the benefits of sanitation; it is as much about
behaviour change as it is about constructing latrines, without
which there will be little, if any, health benefit. Sanitation
has important social, cultural and religious dimensions which
have to be taken fully into account.
— Institutional problems abound:
Lack of sound institutional frameworks is a significant cause
of failed sanitation provision: sanitation rarely has a clear
institutional "home", resulting in responsibilities
being fragmented across a range of ministries and departments
(eg water, health, education, local government). This leads to
difficulties with policy development, programming, and implementation.
An important consequence is that even where demand is created,
problems can arise in ensuring that there are adequate supply
side mechanisms (for example, in relation to micro-finance, technology,
appropriate levels of support) to respond to the demand.
— Sanitation is a primarily a household
issue involving building simple toilets and promoting handwashing
with soap. So it is not rocket science. Policies and programmes
need to re-orientate to focus on the household in relation to
the articulation of latent demand and in looking for affordable
solutions. However, in densely populated urban settlements this
is more complex and supporting infrastructural interventions will
often be necessary—but this should revolve around the needs
of the household.
8. This gives rise to a number of inconvenient
problems for donors operating in an environment where there is
increasing pressure on internal management and administration
costs. Understandably, these can act as dis-incentives to engage
with sanitation. For example:
— Behaviour change is long term and
requires concomitant commitments of support to the "softer"
issues of promotion and capacity development rather than physical
infrastructure.
— Sanitation does not require major
capital investment in centralised networked infrastructure; rather,
it is distributed in nature as is the necessary investment and
technical support.
— Whilst large amounts of finance are
needed to fill the sanitation gap, from a donors point of view
programme-based disbursement for sanitation is potentially very
piecemeal and messy when compared to supporting large scale centralised
infrastructure programmes in other sectors. If you want an easy
way to disburse large amounts of money, then you don't do sanitation—or
at least not sanitation that targets the poor in countries that
are most off-track.
— The institutional fragmentation of
responsibility for sanitation means that it is less amenable to
aid instruments such as sector-side approaches (SWAps) which,
at first sight, may appear to offer an easy solution. So it is
less attractive than, for example, doing a SWAp in the education
sector where a single ministry predominates.
9. DFID's Water Action Plan and its associated
updates have consistently emphasised sanitation and this is to
be applauded, as is the regular reporting from the 12 PSA countries
in sub Saharan Africa. This needs to translate into action through
DFID's country programmes; whilst it is early days yet (although
2015 fast approaches), it is important for the water/sanitation
reports from the PSA countries to be scrutinised and questioned
as to what is actually going on and what is the on-the-ground-reality
of UK's commitments. Civil society organisations such as WaterAid
are in an excellent position to provide this vigilance.
10. This presents major challenges to which
there are no easy answers. Sanitation is difficult to do and it
still badly needs champions.
FINANCING AND
AID INSTRUMENTS
Sanitation
11. Issues of cost recovery and subsidy
have been widely discussed. Without rehearsing the argument again,
I would like to raise the following points particularly with respect
to sanitation.
12. Subsidy is a national issue. Whilst
the rights and wrongs of subsidies for sanitation are debated
and pronounced upon at international level, it is national (or
state) government that decides, accepting that external conditionalities
may come in to play.
13. Policies for subsidy must be coherent.
Sanitation rarely has a clear "institutional home" with
the result that different programmes in the same area may have
different rules for subsidy; this creates confusion and lack of
credibility. Donors need to be particularly sensitive to this.
14. Finance for subsidies has to be used
effectively. There are not enough resources to go round. A sound
general principle emerged at the AfricaSan meeting in 2002: subsidise
only that for which nobody else will pay. The implications in
terms of priority are
— do not give direct subsidies for
the construction of household latrines. Targeting subsidies towards
the poor in latrine construction programmes has proved to be a
problem.[161]
Inappropriate, expensive designs may result, and more importantly,
the approach does not encourage ownership and use.[162]
There are other potential mechanisms for finance that should be
looked at first, such as households' own resources (may be very
limited) and loan/credit schemes.
— sanitation marketing: subsidise the
generation of demand and sanitation promotion
— sanitation as a business: subsidise
capacity building of sanitation service suppliers. If demand is
created, there has to be a supply mechanism with sufficient capacity
to fulfil that demand—who will build the latrines that householders
want and can afford? Local masons and small enterprises are the
key suppliers.
DFID'S PRIORITISATION
AND THE
PSA
15. Average coverage in the 12 DFID target
countries in sub Saharan Africa are: rural water 39%; rural sanitation
26%; urban water 80%; urban sanitation 49%. Nigeria and Ethiopia
will have the greatest impact on the achievement of the MDG targets
across Sub-Saharan Africa as they have low coverage with respect
to large populations. DFID's selection of PSA countries is therefore
appropriate for water and sanitation; selecting four "special
focus" countries, including Nigeria and Ethiopia, is a very
positive development. This commitment has to be retained and translated
into action by the country programmes over the period to 2015
without excessive chopping and changing of priorities.
16. Focus on water and (particularly) sanitation
does have to be set in the context of country-led processes, whereby
national planning instruments such as PRSPs or their equivalent
define focus areas for national development planning and donor
support. This can risk becoming a self-fulfilling prophecy particularly
in the "first generation" PRSPs: for example, if sanitation
is not a priority in the PRSPs, it is not supported, and it may
become convenient to hide behind the mantra of "country-led
processes". This fails to address the issue.
17. This argues for support to advocacy
which is still quite weak in the sector despite the campaigns
of organisations such as WaterAid.
DFID'S ORGANISATIONAL
CAPACITY FOR
SUPPORT
18. In March 2005 the Secretary of State
pledged to double sector expenditure in water and sanitation;
in the White Paper (July 2006) this commitment is further increased
to £200 million by 2010. This is clearly to be welcomed and
will raise UK from its position in 2004 where globally the largest
bilateral donors in the sector were France, Germany, Japan, Netherlands
and the US.
19. How will this be achieved? DFID's PSA
commitments envisage an increasing aid budget and downward pressures
on DFID staff numbers including specialist advisers. The PSA targets
refer to the requirement to deliver efficiency savings of £420
million by 2008.
20. This does have major implications on
aid delivery and hence the role of DFID's cadres of professional
advisers. An environment in which there is pressure to reduce
"headcount" whilst increasing the overall aid budget
is not conducive to taking on additional complex sector issues
such as sanitation. I previously noted that sanitation needs champions.
The Bangladesh country programmes has been noticeable in its support
for innovative approaches to national sanitation development and
the presence of enthusiastic advisers prepared to champion the
issue are doubtless important.
21. DFID's strategy therefore emphasises
"working with others" including the African Development
Bank, World Bank and European Development Fund. This does fit
well with the overall development objective of improving donor
alignment and harmonisation, in accordance with the Paris Declaration.
22. Fewer advisers will be handling more
aid money through partnerships or direct budget support. This
will inevitably lead to greater problems concerning lack of institutional
memory and internalised knowledge within DFID. Partnerships need
to be serviced, otherwise lessons cannot be internalised for future.
There is a limit to what can be outsourced in order to retain
and manage internal knowledge within and between Policy Division
and Country Offices. The spectre is that over-reliance on "silent
partnerships" degenerates to a perception by recipients of
"DFID as an ATM".
23. Out-sourcing of advisory capacity has
obvious attractions, particularly as country programmes and Policy
Division are at liberty to source this advice globally. There
has been a reduced demand for advisory and policy development
services from country programmes, accessed through DFID's UK-based
Resource Centre in water and sanitation over the last 5 years.
24. Further erosion of advisory capacity
is clearly a major challenge to progress and it is not clear what
DFID—and other donors in a similar position—intend
to do about it given the overall lack of capacity that exists
in the water and sanitation sector.
LACK OF
CAPACITY: A
SECTOR-WIDE
PROBLEM
25. It is arguable that lack of institutional,
organisational and individual capacity in the sector is a more
serious constraint than lack of finance.
26. Estimates exist regarding the cost of
achieving the MDG targets in water and sanitation and there are
calls both for more effective use of existing funds and an increase
in the overall financial allocation to the water sector. The level
of funding required raises a number of important related issues
around capacity—or lack of it: how easy is it to actually
spend money on what is needed at the scale required? Issue to
be carefully addressed include, for example:
— How effective are national governments
at disbursing existing funding to the sector? Absorptive capacity
is a consideration in programme design, but lack of detailed understanding
of how this translates into practice at lower (decentralised)
levels of government can stymie the potential impact.
— Which multilateral organisations
have the genuine capacity to disburse finance at the scale required?
This is particularly relevant to DFID's key development partners
such as UNICEF and the African Development Bank. Shifting money
is always possible, but ensuring that it is targeted at some of
the most needed but tricky interventions (including sustainable
rural water supply and sanitation) is a real challenge.
27. This has underlying implications for
the timescale to achieve all that is required. Whilst there are
concerted efforts address this—including by DFID—it
is bound to affect achievement of time-bound targets, whether
these are:
— input targets eg ramping up of spending
commitments by donors
— output targets eg increased coverage
of water and sanitation
— outcomes eg sustainable water and
sanitation services.
28. There are serious capacity development
constraints at several levels, certainly in respect of water and
sanitation, and also much more generally:
29. University and tertiary education.
At risk of generalising, there are difficulties with engineering
curricula in developing country universities that, in the case
of water and sanitation, tend to be inappropriate for the local
circumstances. A key area for future work is to develop more appropriate
curricula that are appropriate, fit-for-purpose and recognised
as being first rate. There is an opportunity to link with professional
associations and institutions. There is a tendency to view non-high
tech solutions as second best. This is not true; the basis of
engineering planning and design is what works best in a particular
context; you cannot take blue print solutions and apply the one-size-fits-all
principle—and the same applies to so-called appropriate
technology solutions. The change is long term, but it is the next
generation of professionals who will have real influence on national
level implementation of improved service delivery for the poor.
The solutions need to be rooted in local society and its economic
and social needs.
30. Local resource centres. There
is a lack of capacity to develop and apply appropriate solutions
and this is where local sector-based resource centres have an
important role at regional, national and sub national levels.
Very often, the solutions to, say, "75% of the problem"
are available locally. The capacity issues are around picking
these up, disseminating, transferring knowledge and working out
how to modify and apply the solutions in particular institutional
and social contexts. This requires a particular type of capacity
to be developed; it is a research and development capacity—which
is not necessarily the PhD but can be provided through local and
regional resource centres and universities. In water and sanitation,
the development and support to sector resource centres to enable
them to attract business and function as financially viable entities
is crucial to achieving national water and sanitation targets.
31. Overall the commitment of DFID to training
and capacity building seems to have reduced over 20 years. Cut
backs in DFID funding of formal training on Master programmes
has had a number of longer term effects. For example, in the 1980s
Malawi had three Chief Engineers responsible for water and sanitation
for the whole country. All had been trained on the WEDC Masters
programme at Loughborough University and subsequently been promoted
to these high positions. These people develop strategy and implement
programmes for better service delivery to the poor, so we had
the potential for real development influence on the lives of poor
people which has now lost support. Other former Masters students
return on visits to UK in order to procure goods and services
for their country, having been exposed to UK engineering practice
on their Masters programme. This is not to advocate a return to
the past; many training providers now offer a range of delivery
methods including distance learning programmes. The educational
aspect merits much more serious consideration than it has received
of late.
32. An interesting downside to the very
welcome increase in budget for the UK Aid Programme is that some
key capacity building activities may be lost because the budgets
are too small to warrant the effort of administration. It is time
to take this seriously.
October 2006
161 In the past this has been the focus of many sanitation
programmes; there are endless variations, with subsidies for substructures
(the pit), slabs, superstructures, and various combinations of
these. Back
162
There are many examples: in Cuttack, India, an NGO programme
constructed latrines whose value was greater than the house to
which they belonged (the "8000 rupee toilet for the 5000
rupee house"). Most were unused. Back
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