Access to Sanitation

Alan Duncan Excerpts

Monday 26th November 2012 Commons Chamber

[Jim Dobbin (Heywood and Middleton) (Lab/Co-op)]

I congratulate the hon. Member for Belfast East (Naomi Long) on choosing this subject for the debate. I should also like to thank the Minister, who I am sure has okayed my contribution this evening.

[The Minister of State, Department for International Development (Mr Alan Duncan)]

Of course.

[Jim Dobbin]

I speak as the co-chair of the all-party parliamentary group on child health and vaccine preventable diseases. The other co-chair is Lord Avebury. I tabled an early-day motion recently on this subject, and it now has quite a number of signatures. I am also vice-chairman of the Council of Europe public health committee.

Diarrhoea is the most common cause of childhood illness and kills about 760,000 children each year. Around 90% of those deaths are caused by a lack of access to safe water, adequate sanitation and hygiene. Those deaths are preventable. Vaccines against rotavirus, the most common and severe diarrhoea in children, are critical, and their availability is a major development in public health. However, those vaccines should not be seen as a silver bullet for tackling diarrhoea; nor can they address the other health impacts of a lack of sanitation.

Reducing deaths from the top killers of children requires the prioritisation of interventions across different sectors, including health, nutrition, hygiene, water and sanitation. We must apply the package of prevention and treatment solutions that we know to be effective, and this must be built on solid collaboration between health systems and the water and sanitation sector.

This was reinforced last year when I visited health care facilities in Bangladesh and Kenya, where we were launching a programme of vaccination. I witnessed extremely successful vaccination programmes in both countries, which were helping to protect children against terrible diseases such as pneumonia. During my visit, however, I was struck by the poor levels of basic sanitation and access to clean water at many of the health care facilities we visited. This emphasised to me how important it is to ensure that preventive measures such as vaccines are coupled with improvements in sanitation and access to clean water.

I also saw on these visits small wards packed with up to 25 children, with the mothers in the same ward. I saw three babies in one incubator, and I saw a single oxygen cylinder with five or six lines coming out of it. It is all the basic stuff that is missing there. The vaccination was great—it is absolutely superb—and the efforts of the medics and nursing staff in each of these hospitals was just brilliant. The common basic hygiene and sanitation, however, are just not there.

It so happens that I will be in Geneva tomorrow with the Earl of Dundee, who is the chairman of my Council of Europe committee. We are going to be in discussions with the World Health Organisation, UNESCO and the Global Alliance for Vaccines and Immunisation. The issue of sanitation is one that we want to raise, because this is a global problem that needs to be tackled globally. I wanted to make only a short contribution; I will be interested to hear the Minister’s response.

[The Minister of State, Department for International Development (Mr Alan Duncan)]

I thank the hon. Member for Belfast East (Naomi Long)for calling what I think is the second debate this year on this important issue. Making progress on the appalling world statistics on access to sanitation is vital to the health and well-being of poor people. I commend the hon. Lady for her efforts on this topic. If I may put it this way, I think she has become one of Parliaments supreme champions—if not Parliament’s main champion—on this issue.

It is truly shocking that in 2010, 2.5 billion people—nearly 40% of the global population—remained without access to the improved sanitation that would have protected their health. Even more shocking is the fact that 1.1 billion people have no form of toilet at all. This is why the UK Government have given sanitation such a high priority. The previous Secretary of State announced in April this year that the UK would increase its ambition and reach 60 million people with sustainable access to water, sanitation and hygiene. As I said in my speech in March, providing these services is the bread and butter of development. I have seen for myself in my visits to countries such as Yemen and Bangladesh, which the hon. Member for Heywood and Middleton (Jim Dobbin) has mentioned, how effective DFID sanitation programmes are on the ground.

[Mr Russell Brown (Dumfries and Galloway) (Lab)]

On the commitment given back in April, I appreciate that we are just six or seven months on, but is the Minister in any position at all to tell us what progress has been made towards that 60 million target in 2015? Is progress really being made?

[Mr Duncan]

Since the announcement was made only recently, it is probably a little premature to report on progress because results come after the investment has been made in the area, but I undertake to keep the hon. Gentleman and the House fully informed of our progress. Through debates such as this, we will continue to treat this as a highly important topic.

We know the enormous impact that the lack of a basic toilet has on people’s health and livelihoods. People who do not have adequate sanitation are far more likely to get sick than those who do, and it is often young children who suffer the most. The World Health Organisation estimates that up to 2.4 million deaths could be avoided each and every year simply by providing good sanitation, safe water and good basic hygiene.

Poor sanitation does not only cause sickness. As the hon. Lady pointed out, women who lack toilets are at a much higher risk of sexual and other violence as they try to find secluded and private places. Without a decent toilet, women and girls cannot manage their menstrual periods privately and with dignity. Having nowhere to safely clean and dry their rags can lead to reproductive tract infections, which can be the most horrid things.

We know from the United Kingdom’s own history the importance of sanitation to the economy and health of our people. This very Chamber was closed during the “great stink” of 1858. Not long afterwards, improvement in the treatment of London’s sewage led to a great improvement in the health of our capital city. We also know from the World Bank that providing sanitation in poor countries will deliver broader economic benefits, and will mean that such countries do not suffer unnecessary economic losses. It has been estimated that countries lacking widespread access to sanitation lose between 1% and as much as 9% of their GDP every year.

The world is frequently faced with natural disasters. Last month, we saw Hurricane Sandy wreak havoc in the Caribbean before hitting the eastern seaboard of the United States. Floods, in particular, lead to disease because people have to live with dirty flood waters containing pathogens from waste that has not been disposed of. That is what leads to devastating epidemics of cholera and other diseases. Good sanitation is essential to reducing the unacceptable human cost of such disasters. It can be critical in helping communities to rebuild themselves more quickly after floods. Work supported by the Department for International Development during the 2010 floods in Pakistan showed that sanitation could really help a community to recover.

How can we start to tackle the huge unmet needs for sanitation? Well, we can start by listening to women. Sanitation is important to them, often much more important than it is to men. One study in Indonesia found that, in urban communities, women listed sanitation as their second priority for improving their communities—after improved job opportunities—while men ranked it seventh.

We need to foster and respond to demand. A latrine that is wanted is one that will be used and maintained. Approaches based on demand, such as a programme called Community-Led Total Sanitation, are proving very effective in ensuring the uptake of sanitation. We also need to keep sanitation simple. Expensive and water-hungry sewerage systems are not the answer if we want to improve sanitation for poor people. Simple technologies, such as pit latrines, are affordable and effective ways of providing the safe sanitation that we want to see.

As was mentioned by the hon. Member for Dumfries and Galloway (Mr Brown), the United Kingdom’s ambition is for 60 million people to have sustainable access to water, sanitation and hygiene in the countries that are furthest from meeting the millennium development goal. We have a strong track record of supporting those basic services. A portfolio review of water, sanitation and hygiene projects supported by DFID showed that UK aid in the sector was well targeted at the poorest.

The principal means by which the UK will meet our target of 60 million people is through programmes developed and managed by our offices in African and Asian countries. We currently have sanitation and water programmes in 15 countries. We are looking into how we can expand our existing programmes, and have already identified additional results that could be achieved in Ethiopia, Liberia, Sierra Leone, Tanzania and Zimbabwe. That builds on the successful experience of our country programmes. For example, our support in Bangladesh through UNICEF has reached more than 30 million of the poorest people in that country. We are continuing our support in Bangladesh by working through BRAC, a major national non-governmental organisation with a good record of helping the poorest. The Department also funds programmes to deliver improved sanitation through other interventions. For instance, in Yemen we are funding a nutrition programme, implemented by UNICEF, which will provide sanitation in 300 schools and benefit nearly 250,000 children.

We will achieve those results through a number of partnerships with organisations such as the Water and Sanitation Program, Water and Sanitation for the Urban Poor, and WaterAid. To complement those activities, we have been exploring the potential of new programmes to reach more people who currently lack access to sanitation, in more countries, through partnerships with the UN, civil society and the private sector.

In response to the hon. Member for Heywood and Middleton, the UK Government are the leading donor of the Global Alliance for Vaccines and Immunisation, which delivers new and underused vaccines to the world’s poorest countries. UK support alone will vaccinate 80 million children and save 1.4 million lives by 2015. GAVI will roll out the rotavirus vaccine as part of its programme, protecting against diarrhoea which, as the hon. Gentleman said, is one of the leading child killers in the world, accounting for 450,000 deaths each year. With UK support, GAVI plans to help the vaccination against rotavirus of up to 50 million children in at least 40 of the world’s poorest countries by 2015.

We need solid evidence to underpin our investments, and to that end the Department for International Development is funding key research programmes to improve our evidence base. The sanitation and hygiene applied research for equity programme is developing new and robust evidence on the benefits of sanitation, and on how sanitation and hygiene behaviours can be improved most effectively. The Department has started a new programme of operational research to improve value for money and efficiency in our programmes. As part of that, we will test and evaluate innovative ways of providing sanitation services to poor people in urban areas, in partnership with the Bill and Melinda Gates Foundation.

Support for sanitation is also about creating the right incentives for Governments to mobilise their own resources. In June this year, the UK Government sent a strong message of our political commitment with the recognition of the right to sanitation. The Government will place an emphasis on the delivery of basic sanitation services to poor people in the long term. We will continue to invest in programmes to provide sanitation, and use the Sanitation and Water for All partnership to encourage other donors, Governments in developing countries, and civil society to do the same.

I say to you, Madam Deputy Speaker, all hon. Members, and in particular the hon. Member for Belfast East who initiated this debate, that the Government will do their utmost in this area. I hope that Members of the House will continue to support us in that essential work.

Question put and agreed to.