Emuel Vassey Reflection Paper

Last weekend, I happened to hear a discussion on the WGBH radio show Innovation Hub on global access to water (As Water Supplies Wane, What Next?). One of the guests, Professor Shafiqul Islam of Tufts University, posed the question, Is water a right or a property? Last semester, I took an environmental health class and did some reading about the Joint Monitoring Programme for Water Supply and Sanitation, which is a joint program between WHO and UNICEF, so I thought that this would be an interesting question to consider with regard to global governance. The constitution of WHO states, The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being (World Health Organization), so because access to safe drinking water is an integral part of that standard, it stands to reason that it is also a fundamental human right. Because of this, the Joint Monitoring Programme was set up by WHO and UNICEF to track progress toward meeting the Millennium Development Goals (MDGs) with regard to access to and improved water supply and improved sanitation. The 2012 Update was released very recently and reports that the MDG for water supply was apparently met in 2010. The report does, however, mention the caveat that the JMP assessment is made only on the basis of access to improved drinking water sources, defined as those that, by the nature of their construction, are protected from outside contamination, particularly fcal matter. It does not, however, mean that all improved sources are truly safe from contamination (UNICEF and World Health Organization, 2012).

Emuel Vassey Reflection Paper

I have some personal insight into this from a 2009 trip to India, in which I stayed with American friends living on a mountainside above a small pilgrimage town in the lower Himalayas. My friends have what JMP would consider an improved water source, as it is piped into the house, but their water supply is fed from a spring up the mountain, which is subject to rationing in the dry season and increased contamination during the monsoon. For drinking water, they have a large metal urn with a series of ceramic filtration disks, because despite the JMP classification, the water coming from the tap cannot be considered safe. Open sewers are the norm, and these drain down the mountainside into the same watershed that feeds the springs. In the town below, there is a municipal water pump, so the entire town, even those without an indoor tap, has access to an improved source according to JMP, but the town, being located in a small basin, receives runoff carrying potential contaminants from all the surrounding mountains. An open sewage ditch runs through the town, carrying wastes into the outflow of a sacred lake at the center of town and from there to settlements even further down into the valley. And yet, according to JMP, this is a level of development the international community can be proud of. A current article in the International Journal of Environmental Research and Public Health tries to address the deficiency in the JMP methodology and estimate more accurately the numbers of people still living without safe potable water. The authors used data from WHO/UNICEF to try to determine the proportion of the population now

Emuel Vassey Reflection Paper

designated as having an improved water source for whom that source is still likely contaminated. Their determination was that approximately 1.2 billion of the people JMP considers safe due to obtaining water from improved sources are still at risk of having fecal-contaminated water, leaving approximately 2 billion people worldwide still without access to safe water (Onda, LoBuglio, & Bartram, 2012). The articles authors do admit that their model likely overestimates the risk, but given that the JMP model most certainly underestimates, it is likely that the truth lies somewhere in between. The end result is that upwards of a quarter of the worlds population still does not have access to safe drinking water, and, according to the JMP progress report, the bulk of these people are concentrated in Sub-Saharan Africa. But if weve answered the question of water as a fundamental human right, these data still leave us with the question of how to account for this ongoing deficit in access and whether international governance has been a help or a hindrance in this regard. Another recent article, this one by Iris Borowy in the Journal of the History of Medicine and Allied Sciences, does not address the issue of safe drinking water specifically, but it does provide a theoretical framework for understanding the forces in international governance which have shaped efforts to address environmental concerns such as clean water and air. In it, Borowy describes two essential competing theories of development a localist and a globalist theory and gives a history and critique of how they have played out within international governance structures and the resultant effect on public health (Borowy, 2012).

Emuel Vassey Reflection Paper

Briefly, the localist theory holds that improved health is a natural outgrowth of economic development and that the burden for development of health infrastructures is, then, largely that of the sovereign local government as its economy grows, essentially absolving developed nations from any responsibility to redistribute their wealth or resources to poorer nations. Borowys criticism of this view is that it fails to take into account environmental degradation secondary to industrial development or that developing nations often do not have the resources to develop public health infrastructure concurrently with commerce-oriented infrastructure. The globalist theory, by contrast, holds that, particularly with regards to finite resources such as water, the wealthy nations have a responsibility both to curb consumption and to ensure that economic development in poorer nations focuses on sustainability. The localist theory was developed around the time of the birth of the United Nations and it is this view that has traditionally predominated in financial institutions such as the World Bank and in developed governments such as the US. The globalist model is a more recent development, based on the concept that there are limits to economic growth, particularly when considering finite resources, and on observations of unmitigated environmental degradation in developing nations where the focus had been on building industry, rather than on sustainable systems. While Borowy does note that external pressure, largely from non-state actors but also from the UN Development Programme, was the main force behind getting the World Bank to begin looking at human development factors in the 1990s, the view of

Emuel Vassey Reflection Paper

the World Bank, and by extension WHO, which relies heavily upon the World Bank and the United States for funding, is still shaped largely by the localist model, albeit with some modification. In the Innovation Hub broadcast, Dr. Islam also said that the estimated cost to provide universal access to drinking water was between 70 to 100 billion USD less than 1% of U.S. GDP but that the political will to make it happen simply doesnt exist at present. This fits well with Borowys explanation, since the localist model assumes that these issues will be sorted out by each state as its economy improves and, even given modifications over the past two decades, places less emphasis on ensuring that human development of this sort is an integral and co-equal part of any economic development plan. This, however, still leaves us with an unanswered question: When will we muster the will to make it happen?

Bibliography
As Water Supplies Wane, What Next? (n.d.). Retrieved June 26, 2012, from WGBH: Innovation Hub: http://www.wgbh.org/articles/As-Water-Supplies-Wane-Whats-Next-6574 Borowy, I. (2012). Global Health and Development: Conceptualizing Health Between Economic Growth and Environmental Sustainability. Journal of the History of Medicine and Allied Sciences. doi:10.1093/jhmas/jrr076 Onda, K., LoBuglio, J., & Bartram, J. (2012). Global Access to Safe Water: Accounting for Water Quality and the Resulting Impact on MDG Progress. International Journal of Environmental Reserch and Public Health, 9, 880-894. doi:10.3390/ijerph9030880 UNICEF and World Health Organization. (2012). Progress on Drinking Water and Sanitation: 2012 Update. World Health Organization. (n.d.). Constitution of the World Health Organization. Retrieved June 26, 2012, from http://apps.who.int/gb/bd/PDF/bd47/EN/constitution-en.pdf