Lest we forget: Why investments in hygiene, sanitation and water are key to fighting COVID-19

September 28, 2020

     By Duncan Green     

Guest post by Muyatwa Sitali, Head of Country Engagement, Sanitation and Water for All

COVID-19 has taught us that a world where nearly half of its population do not have what they need to properly wash their hands at critical times is not a safe world.

We are delicately and dangerously connected. A disease which started in one city has touched every corner of the world in just a few months. Washing hands at critical times is a crucial defender of our health. If anyone of us is unable to do so because they lack soap, water, or both, then all of us are at risk of life-threatening diseases. Moving forward, when we build the future that we need, we should make sure to invest in the things that matter, however small or inconsequential they may seem.

COVID-19 has found a path of least resistance through communities where handwashing is a luxury, social distancing is nearly impossible and where the choice to buy a mask competes with the choice to buy food or medicines. Godfred Amankwa and Christian Fischer at the University of Oxford looked at the correlation between COVID-19 fatalities and poor water, sanitation and hygiene (WASH) services. Their findings, even if only drawn from Sub-Sahara Africa, are very telling. They “found a strong correlation between a higher case fatality rate and poorer access to safe drinking water as well as safe sanitation.” The correlation was stronger for poor sanitation, which typically has lagged even further behind access to water, even before COVID-19.

We, therefore, need an urgent break from the past to Build Forward Better.

Most water and sanitation infrastructure is in critical need of rehabilitation, restoration and maintenance. The construction of water and sanitation systems offers immense opportunities to employ thousands of young women and men, especially in urban areas where risks for political unrest can be rife when services continue to be abysmal. 

The more people can be connected to water and sanitation systems, the larger the customer base for service providers. Given that most people are willing to pay if they can get a good service, this, in turn, can increase the revenue for service providers and create a path for reduced dependence on government grants and subsidies.

In India, the Prime Minister’s flagship program, Swachh Bharat Mission (SBM) had a total impact of 7.55 million (full time employment equivalent) workers through direct and indirect employment effects. This was on an average of 1.51 million per year over the entire SBM period. The SBM was a program aimed at eliminating open defecation in India.

The critical question during and after COVID-19 is – how can governments support the sector given the impact of COVID-19 on the tax base as many people and industries have been affected? Basically, the cake to be distributed has significantly been reduced.

There is no silver bullet to resolving COVID-19 and the myriad small or big crises associated with it, including the aftershocks we are yet to see. For now, a good number of countries should take advantage of the fiscal space they have due to suspension of debt repayments to put their resources where it matters most – programs which protect our health, create jobs and make their economies resilient. The financial burden could have been worse had some governments not received a reprieve on their debt obligations.

The World Bank and the G20 agreed to the debt service suspension initiative (DSSI) for low-income countries. As of 8 September, 43 countries were said to be participating in this initiative with the possibility of more countries joining. Unlike the previous debt initiative which cancelled and reduced the actual debt stock of many countries, this new initiative pushes the debt payment obligations forward. This means these countries will not need to be servicing a considerable amount of their loans for some time, thereby gaining some amount of relief and fiscal space – hoping they don’t use this space to service loans from creditors who are not participating in the current initiative. Many commentators and debt campaigners would have preferred a total debt-write off which the initiative does not provide. For countries benefiting from the DSSI, how governments act to protect their revenues and manage this fiscal space will make the difference.  

Colleagues at WaterAid and EndWater Poverty also offer some suggestions for increasing development finance during this time. Among others, they call for a transformation in public finance in order to maximize revenues, curtail pilferage and in turn prioritize the SDGs including the water, sanitation and hygiene targets every year. They recommend action on tax evasion, climate finance and new taxes on carbon emissions as critical to creating additional resources. They also support the UN Secretary-General, UNCTAD and others who have called for a new allocation of IMF’s Special Drawing Rights to bolster developing countries’ foreign exchange reserves, stimulate economies and release funds for spending on health and public services.

Nearly 100 global leaders, including 14 Heads of States and Governments have called for serious attention to hygiene, water and sanitation during and after COVID-19.  As part of the Sanitation and Water for All partnership, they support mobilization and adequate investment in these three issues as fundamental pillars for a healthy population which is critical for growth. In addition, the World Bank and G20 recommend more spending in social, health and economic sectors. Will governments only invest in economic programs which do not help to insulate their economies from a future public health pandemic? Or will they invest in economic initiatives which simultaneously propel growth, support a healthy society and do not exacerbate the climate crisis? Investing in water, sanitation and hygiene services at scale promises to deliver on those three fronts. It is social spending with multiple benefits. 

But austerity will be the path taken by most governments, so there is a high risk that governments will demote investments in the primary factors that can help to cut the pathways of diseases including COVID-19. Taking money away from water, sanitation, and hygiene is akin to taking away firetrucks when the fire is still raging. Economies can ill afford deprioritized spending in water, sanitation and hygiene. If there are issues whose resources should be protected, ring-fenced and complemented during this crisis, water, sanitation, hygiene and health must be top of that list. 

Between November and December 2020, Sanitation and Water for All  partnership will hold three virtual Regional Finance Ministers’ Meetings for Africa, Asia and Latin America and the Caribbean. Ministers will discuss practical solutions to ensure they are making smart investments in a time of constricted budgets and austerity. They will look at real examples that maximize the economic opportunities offered by investing in water, sanitation and hygiene.  

Some of the  examples will be drawn from Water & Sanitation: How to Make Public Investment Work – A Handbook for Finance Ministers, which was launched this month.

Governments and their partners must invest in water, sanitation and hygiene as if our lives depend on them, because, well, they do!

September 28, 2020
Duncan Green