Global costs and benefits of drinking-water supply and sanitation interventions to reach the MDG target and universal coverage

In 2010, the United Nations General Assembly and the UN Human Rights Council recognized access to safe drinking-water and sanitation as a human right. The concept of progressive realization inherent to the rights-based approach will result in intensified monitoring to be able to hold governments accountable for meeting their human rights obligations. Those still lacking access tend to be poor and marginalized groups. The Joint Monitoring Programme for Water Supply and Sanitation (JMP) progress report showed that, in 2010, the poorest households, as measured by wealth quintiles, have significantly lower access than households in the two highest wealth quintiles. In order to address these remaining challenges, further evidence is collected, compiled and analysed to support a greater allocation of resources to water supply and sanitation by decision makers and to select the most efficient interventions. The Sanitation and Water for All (SWA) partnership – launched in 2009 – is a global initiative to support countries in the scale-up of WSS services, especially those countries with low coverage or those most off-track to meet targets. To keep attention focused on meeting the MDG target, the "Sustainable sanitation: Five year drive to 2015" has been launched by the United Nations. Economic evidence is recognized as key for the achievement of the WSS goals – it helps justify increasing investment and expenditure, and it supports decisions to select efficient WSS options by explicitly comparing costs and benefits of a range of alternative WSS technologies and service delivery approaches. The present study aimed to estimate global, regional and country-level costs and benefits of drinking-water supply and sanitation interventions to meet the MDG target in 2015, and to attain universal coverage. These economic data will provide further evidence to support investment in water supply and sanitation systems and services, with a focus on services that are both socially efficient and financially sustainable. The results will help donors and governments of low- and middle-income countries to justify allocation of adequate budgets for such systems and services. [authors abstract]