Re: The e-Consultation on Hunger, Food and Nutrition Security

Ross Bailey WaterAid , United Kingdom

WaterAid’s submission to the UN post-2015 thematic consultation on food and nutrition

WaterAid an international organisation working to transform lives by improving access to safe water, sanitation and hygiene (WASH) in the world’s poorest communities. We work with partners in 27 countries in Africa, Asia, Central America and the Pacific region, and influence decision-makers to maximise our impact.

In addition to the contribution that WaterAid’s programmes make to the health and wellbeing of the communities in which we work, an important strand of WaterAid’s advocacy work is to promote the positive health impacts of access to WASH and highlight the importance of access to WASH in realising the Millennium Development Goals, particularly those relating to health
and nutrition. WaterAid contributes to the generation of evidence on the links between health and WASH through its research initiatives and partnerships.
WASH plays a fundamental role in improving nutritional outcomes. A successful global effort to tackle under-nutrition, in particular childhood under-nutrition, must therefore incorporate elements of WASH.

1. Links between WASH and under nutrition

Direct links: WHO estimates that 50% of malnutrition is associated with repeated diarrhoea or intestinal nematode infections as a result of unsafe water, inadequate sanitation or insufficient hygiene

  • Diarrhoea, largely caused by lack of water, sanitation and hygiene, is the second leading disease cause of death in children under-five globally, and its constant presence in low-income settings contributes significantly to under-nutrition.
  • Nematode infections such as soil-transmitted helminthiases, caused by lack ofsanitation and hygiene, affect around 2 billion people globally and can lead to diarrhoea, anaemia, protein loss and growth retardation.
  • Environmental (or tropical) enteropathy is a syndrome causing changes in the small intestine of individuals living in conditions lacking basic sanitary facilities and chronically exposed to faecal contamination. These changes to the intestine can lead to poor absorption of nutrients, stunting in children, and intestinal perforation.

Indirect links: The time taken to fetch water, and the cost of water purchased from vendors when it is not readily available in the home, impact on the amounts and quality of water consumed as well as on hygiene practices, which in turn impact on nutrition. Additionally, time spent sick with water-borne diseases or collecting water impedes educational attainment, which has a  significant impact on health, well-being and poverty over a lifetime and potentially over multiple generations.

2. WASH and nutrition post-2015

Clear outcome goals are essential for generating the political will, accountability and resources needed to tackle global development issues. An outcome goal that clearly sets out the vision for reducing global under-nutrition should therefore form part of the post-2015 development framework. Moreover, we have seen that outcome goals alone are insufficient to put in place the measures needed to achieve them, or to address challenges of inequalities within and between countries, which require customisable and ambitious approaches. A goal on nutrition should therefore be accompanied by time-bound targets that mitigate the challenges that contribute to under-nutrition, including those linked to behaviour change and the realisation of
human rights. Given the considerable impact of WASH on nutritional outcomes, it is crucial that such targets include WASH aspects.

Although the current MDG framework includes a standalone target on drinking water and sanitation, its separation from the outcome goals on health, nutrition and education contributed to a fragmented approach to these goals, encouraging vertical approaches and discouraging integrated, cross-sectoral approaches that can deliver greater and more sustainable impact.
WaterAid believes it is essential that the current discussions on the post-2015 development framework address these challenges, and formulate a framework that results in long-lasting improvements in nutrition and health, and ultimately, in elimination of poverty and attainment of overall well being.

WaterAid believes that any post-2015 goals must better reflect the central importance of WASH to human health, education, welfare and economic productivity and ensure their interconnectedness is reflected.

WaterAid recommends that the post-2015 goal framework should:

  • Include a goal on universal access to basic water and sanitation services as a fundamental human right.
  • Specify a target date for achieving universal access to basic water and sanitation services by 2030.
  • Ensure WASH targets and indicators focus explicitly on reducing inequalities by targeting poor and disadvantaged groups as a first priority.