LCID member Steve Cockburn’s article for Progress on World Water Day, arguing that we’ve failed to learn the lessons of Victorian Britain when it comes to improving health in the world’s poorest countries. Original article here.
If ever asked to explain the value of politics and popular campaigning in improving people’s welfare, two historical examples come to mind – the mass campaign to abolish the slave trade and, less glamourously, the introduction of London’s Victorian sewers.
The first example is well known, but the second has much to teach us on a day like today – UN World Water Day – when we remember 40 per cent of the world’s population who don’t have access to clean water and a safe toilet. The situation faced by citizens of London, Liverpool or Leeds 150 years ago.
In those days, the rates of child mortality in London were worse than those found in the world’s poorest countries today – about one in three British kids died before their fifth birthday from diseases like cholera and typhoid. Many died because, without proper sanitation facilities, people were quite literally drinking their own shit.
Then came two developments that helped spark the greatest sustained improvement in child survival ever seen. A scientific breakthrough when Dr John Snow (no, not that one) discovered the link between cholera and contaminated water in Soho, and – a few years later – a political breakthrough when parliament finally resolved to invest heavily in a city-wide sewerage system.
Political change did not just happen because of accumulating evidence : the crisis finally reached leaders’ doorsteps. In 1858, the Thames got so clogged up with human waste that parliament was abandoned because of the stench and the fear of disease. On return, the chequebook opened, sewers were progressively built, and a public health revolution was unleashed.
Why is this relevant today? Because we seem not to have learned our lessons in our approaches to public health in the world’s poorest countries. I’ve seen few greater disconnects between evidence and action, at home or abroad, as in the neglect of sanitation in international development policy.
We rightly protest if a domestic target on child poverty is missed by a few years. So how about a global target set to be missed by 200 years, like the one to halve the proportion of people lacking access to safe sanitation in Africa ?
The evidence suggests we should be outraged. Diseases related to unclean water and sanitation cause 28 per cent of child deaths worldwide, are the reason cited by half the girls in Africa who drop out of school, and cost Africa 5 per cent of its GDP every year in lost productivity.
Yet the share of aid for this issue has been falling, its presence in international discussions about poverty reduction minute, and big name champions of the issue absent. Remarkable when investment in this area provides so many opportunities to unlock extraordinary development gains.
Even our very own DfID – more progressive than most – are far from blameless. Despite taking positive steps in developing a global partnership to tackle sanitation, it’s failed to permeate their priorities by any measure. Funding has grown, but will flatline from next year, despite continued growth in the aid budget.
Such flawed policy-making is hard to explain. Sanitation is neither glamourous nor popular – remember ‘In The Loop’s Malcolm Tucker hectoring a minister for talking about diahrroea on the radio – but glamour is not what development is about.
This weekend tens of thousands of campaigners in 70 countries brought together by the international End Water Poverty campaign mobilised in the first global campaign action to demand action on sanitation. They formed The World’s Longest Toilet Queue, standing up for 2.6 billion people waiting on our policy-makers to get their act together and realise their right to health and dignity.
Whether this will be the start of efforts to reverse the neglect of the sanitation crisis depends on how much policy makers will listen to their voices, make practice match evidence, and be prepared to talk dirty and mean it.
To add your voice, join the Queue online at www.worldtoiletqueue.org
Steve Cockburn is an anti-poverty campaigner and member of Labour Campaign for International Development.