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Title
WHO - Evaluation of the Costs and Benefits of Water
and Sanitation Improvements at the Global
Level
Abstract
The aim of this study was to estimate the economic costs and benefits of a range of
selected interventions to improve water and sanitation services, with results presented
for 17 WHO sub-regions and at the global level. Interventions evaluated include (1)
improvements required to meet the millennium development goals (MDG) for water
supply (by halving by 2015 the proportion of those without access to safe drinking
water), (2) meet the water MDG plus halving by 2015 the proportion of those without
access to adequate sanitation, (3)increasing access to improved water and sanitation
for everyone, (4) providing disinfection at point-of-use over and above increasing
access to improved water supply and sanitation (5) providing regulated piped water
supply in house and sewage connection with partial sewerage for everyone. Predicted
reductions in the incidence of diarrhoeal disease were calculated for each intervention
based on the expected population receiving these interventions. The costs of the
interventions included the full investment and annual running costs. The benefits of
the interventions included time savings associated with better access to water and
sanitation facilities, the gain in productive time due to less time spent ill, health sector
and patients costs saved due to less treatment of diarrhoeal diseases, and the value of
prevented deaths. The results show that all water and sanitation improvements were
found to be cost-beneficial, and this applied to all world regions. In developing
regions, the return on a US$1 investment was in the range US$5 to US$28 for
intervention 1, remaining at similar levels for interventions 2, 3 and 4. The main
contributor to benefits was the saving of time associated with better access to water
supply and sanitation services. When different cost and benefit assumptions were
used, the cost-benefit ratios changed considerably, but even under pessimistic
scenarios the potential economic benefits generally outweighed the costs. Due to
uncertainties in many of the data inputs, it is recommended to conduct detailed
country case studies as a follow-up to this global analysis.
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