Sanitation, hygiene and drinking-water in the Pacific island countries
Converting commitment into action
World Health
Organization
Western Pacific Region
Pacific Islands Applied Geoscience Commission

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Sanitation, hygiene and drinking-water in the Pacific island countries
Converting commitment into action
World Health
Organization
Western Pacific Region
Pacific Islands Applied Geoscience Commission

---

WHO Library Cataloguing in Publication Data
Sanitation, hygiene and drinking-water in the Pacific island countries : converting commitment into action
1. Drinking water. 2. Sanitation. 3. Pacific Islands.
ISBN 978 92 9061 401 2
(NLM Classification: WA 670)
© World Health Organization 2008
All rights reserved.
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Contents
Abbreviations..................................................................................................................................................... vi
Acknowledgements ............................................................................................................................................ vi
Foreword ......................................................................................................................................................... viii
Understanding the Pacific islands ........................................................................................................................ 1
Overall sanitation and drinking-water status ................................................................................................1
Characterizing the Pacific island countries....................................................................................................2
Why this report?...........................................................................................................................................5
The status of sanitation coverage in the Pacific island countries .......................................................................... 8
What does sanitation mean in this report?....................................................................................................9
What is the sanitation coverage in the Pacific island countries? ..................................................................10
What is the sanitation trend in the Pacific island countries?........................................................................12
The status of drinking-water coverage in the Pacific island countries ................................................................ 14
What is the meaning of safe drinking-water? ..............................................................................................15
What is the status of access to improved drinking-water in the Pacific island countries?.............................16
Disparity in access to drinking-water and sanitation services......................................................................18
MDG sanitation and drinking-water targets: are the targets achievable
for the Pacific island countries? ......................................................................................................................... 20
Achieving the sanitation target will require a great effort! ..........................................................................21
Drinking-water does not appear to be in a better shape!.............................................................................23
Linking the MDG goals and targets to sanitation and drinking-water in the Pacific Islands........................25
Sanitation and drinking-water have a striking effect on health!......................................................................... 28
Climate change: how serious is it for the Pacific island countries?..................................................................... 32
The facts.....................................................................................................................................................33
What to do?................................................................................................................................................35
Integrated water resources management (IWRM) ............................................................................................. 36
Looking at the past and aiming at the future in sanitation and water development ........................................... 40
What happened in the Pacific island countries that prevented advancing
the sanitation and water agenda?................................................................................................................41
Major sector initiatives addressing the Pacific islands sanitation and water issues ......................................42
What comes next? ......................................................................................................................................45
What can WHO do to strengthen the sanitation and drinking-water agenda
in the Pacific Islands? ........................................................................................................................................ 48
SOPAC work and priorities in the Pacific ......................................................................................................... 50
Bibliographic references .................................................................................................................................... 52
Annexes ............................................................................................................................................................ 54
Annex 1 Sanitation coverage in the Pacific island countries, 1990 and 2006 ............................................54
Annex 2 Drinking-water coverage in the Pacific island countries, 1990 and 2006 ....................................55
iii

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Figures
Figure 1
Urban and rural population of the Pacific island countries, 1990, 2006,
and 2015 (projected)........................................................................................................................2
Figure 2
Under-five mortality rate per 1000 live births in the Pacific island countries,
Australia and New Zealand, and the world, 1990 and 2006 ...........................................................4
Figure 3
Life expectancy at birth in the Pacific island countries
and the developed Australia and New Zealand, 2002......................................................................4
Figure 4
Coverage with improved sanitation by Pacific island country, 2006...............................................10
Figure 5
Proportion of people using different types of sanitation practices
in the Pacific islands, 2006.............................................................................................................11
Figure 6
Trends in service levels for sanitation in the Pacific island countries ..............................................12
Figure 7
Coverage with improved drinking-water sources by Pacific island country, 2006 ..........................16
Figure 8
Proportion of people using different types of drinking-water sources
in the Pacific island countries, 2006...............................................................................................17
Figure 9
Trends in service levels for drinking-water in the Pacific island countries.......................................17
Figure 10
Urban and rural disparities in sanitation and drinking-water
in the Pacific island countries.........................................................................................................18
Figure 11
Urban and rural disparities in sanitation by country and total
for Pacific island countries.............................................................................................................19
Figure 12
Urban and rural disparities in drinking-water by country
and total for Pacific island countries..............................................................................................19
Figure 13
Projection of change in numbers of people served with improved sanitation
Figures
from 2006 to 2015 and MDG target in the Pacific island countries ...............................................21
Figure 14
Projection of change in numbers of people unserved with improved sanitation
from 2006 to 2015 and MDG target in the Pacific island countries ...............................................21
Figure 15
Projected proportion of people using improved sanitation in 2015
and respective MDG sanitation target by Pacific island country ....................................................22
Figure 16
Projection of change in numbers of people served with improved drinking-water
sources from 2006 to 2015 and MDG target in the Pacific island countries...................................23
Figure 17
Projection of change in numbers of people unserved with improved drinking-water
from 2006 to 2015 and MDG target in the Pacific island countries ...............................................23
Figure 18
Projected proportion of people using improved drinking-water sources in 2015
and respective MDG drinking-water target by Pacific island country.............................................24
Figure 19
Incidence rate of diarrhoeal diseases per 1000 population in the developed
Pacific countries, the developing Pacific island countries, and World, 2002 ...................................29
Figure 20
Pathways of human contamination from human and animal excreta,
and animal products ......................................................................................................................30
Figure 21
Incidence rate of diarrhoeal diseases per 1000 population in the Pacific island
countries and the developed Australia and New Zealand, 2002.....................................................31
Figure 22
Distribution of mortality due to different causes among children less
than five years old in a typical country of the Pacific (Fiji).............................................................31
Figure 23 Climate change and health interlinkages...........................................................................................34
iv

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Tables
Table 1
Improved and unimproved sanitation types of facilities ...................................................................9
Table 2
Improved and unimproved types of drinking-water facilities .........................................................15
Table 3
Influence of basic sanitation and drinking-water in achieving
the Millennium Development Goals...............................................................................................26
Table 4
The work of the WHO Western Pacific Regional Office in sanitation,
drinking-water and hygiene ...........................................................................................................49
Boxes
Box 1
The WHO and UNICEF Joint Monitoring Programme
for Water Supply and Sanitation (JMP)............................................................................................6
Box 2
The Sanitation Park Project ...........................................................................................................13
Box 3
The messages from UN-Water .......................................................................................................27
Box 4
Development of a sustainable water supply and waste treatment system
for a coastal Fijian village ..............................................................................................................39
Box 5
The Pacific Regional Action Plan...................................................................................................42
Box 6
The Pacific Wastewater Policy Framework and Pacific Framework for Action...............................43
Tables
Box 7
The Pacific Framework for Action on Drinking Water Quality and Health ...................................44
Box 8
Message from Beppu......................................................................................................................47
|
Boxes
Maps
Map 1
The Pacific island countries............................................................................................................. 3
v

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Abbreviations
ADB
Asian Development Bank
DALYs
Disability Adjusted Life Years
IPCC
Intergovernmental Panel on Climate Change
IWRM
Integrated Water Resources Management
IYS
International Year of Sanitation 2008
JMP
WHO and UNICEF Joint Monitoring Programme
for Water Supply and Sanitation
MDG
Millennium Development Goal
NGOs
Non-Governmental Organizations
RAP
Pacific Regional Action Plan on Sustainable Water Management
SOPAC
Pacific Islands Applied Geoscience Commission
UNEP
United Nations Environment Programme
UNICEF
United Nations Children's Fund
WHO
World Health Organization
WHO/WPRO WHO Western Pacific Regional Office
WMO
World Meteorological Organisation
Acknowledgements
The Western Pacific Regional Office
the latest health statistics used in this
of the World Health Organization and
report, as well as Jacqueline Sims and
Abbreviations
the Pacific Islands Applied Geoscience
Rifat Hossain, who have kindly
Commission (SOPAC) would like to
shared the recently-revised statistics
thank the authors of this document
on improved drinking-water and
for their dedication and commitment
sanitation, which was generated
in providing this crucial analysis of
by the WHO and UNICEF Joint
the current status of sanitation and
Monitoring Programme for Water
drinking-water in the Pacific island
Supply and Sanitation. Thanks to
countries. This document, prepared
Mr Tasleem Hasan for his reviewing of
by Jose Hueb, received extensive
the document and thoughtful inputs.
inputs and additional text prepared by
Steven Iddings and Marc Overmars.
Finally, we are deeply thankful for the
Terrence Thompson, Environmental
contribution of all those who provided
Health Regional Adviser for the Western
their professional experience, expert
Pacific Regional Office of the World
views and important support in the
Health Organization, coordinated this
preparation of this document. Special
activity, which involved the participation
thanks are due to the Australian
of experts and staff of several offices of
Government Overseas Aid Program
both organizations. Special mention
(AusAID), which provided financial
should be made of Colin Mathers,
support for the preparation of this
Rosebelle Azcuna and Therese Maria
document.
Reginaldo for their assistance with
vi

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vii

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Foreword

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The authors of this report should be
In 2006 Pacific leaders agreed that
commended for providing valuable
the water, sanitation and hygiene
insights into sanitation and drinking-
challenges facing the region should
water statistics in Pacific island
be critical priorities of the Pacific
countries. The information held within
Plan and addressed through
this report is timely, given the United
implementation of the Pacific
Nations declaration that 2008 be the
Regional Action Plan on Sustainable
International Year of Sanitation and
Water Management. In December
the real and very urgent need to guide
2007, Pacific leaders attending the
further action to progress and reach
Asia Pacific Water Summit in Japan
the Millennium Development Goals
reiterated their commitment to the
of cutting the proportion of people
provision of adequate sanitation and
without access to basic sanitation in
safe drinking-water for their people.
half, by the year 2015.
Regional leaders have also called for
Recent WHO and UNICEF statistics
increased regional cooperation to
reveal that only half of the total
share knowledge and build capacity in
population of the Pacific island
order to address challenges common
Foreword
countries are served with any form
to many island nations. While it
of improved drinking-water or
should be acknowledged that progress
sanitation. In Pacific island countries
is being made, substantially more
there are 6.7 million cases of acute
effort is urgently needed if the Pacific
diarrhoea every year. Of these cases
island countries are to achieve the
2800 result in death, and most of
Millennium Development Goals for
these are among children less than five
sanitation and drinking-water.
years of age.
ix

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Understanding
the Pacific islands

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Overall sanitation and
The subsequent sections of this
drinking-water status
chapter display some critical human
and health indicators suggesting
a disadvantaged portrait of the
Pacific islands in terms of health and
According to country coverage
development, as compared to the
statistics provided by WHO, UNICEF
developed countries of this region and
(2008) the numbers of people in the
the World average.
Pacific island countries1 served with
some form of improved sanitation
The good news is that major efforts
rose from 2.9 million in 1990
and relevant initiatives are under
to 4.0 million in 2006. Despite
way in the Region that might reverse
this impressive achievement, the
drastically this situation, as will be
proportion of people served in 2006
viewed in the subsequent sections of
was still barely 48% of the overall
this document.
population.
The term "Pacific island countries"
The status of drinking-water is not
or simply "Pacific islands" in this
Understanding
much different, with the current
document, unless otherwise stated,
proportion of people served with
refers to the Pacific Small Island
any type of improved drinking-water
Developing States (SIDS) listed in the
the
reaching 46%, leaving alone the
footnote of this page.
Pacific
fact that only 13% of the overall
islands
population has access to drinking-
Global analysis infers that access
water piped to the household through
to basic sanitation, safe drinking-
a piped distribution system.
water supply and good hygiene
behaviours has the potential to
These statistics, associated with a
prevent at least 9.1% of the disease
less than optimum management of
burden (in disability-adjusted
water resources may aggravate the
life years or DALYs ­ a weighted
gloomy perspectives brought about
measure of deaths and disability),
by climate change, which appears to
or 6.3% of all deaths in the world's
be exacerbated in the Pacific islands.
developing regions. Children suffer a
Drinking-water and sanitation relies
disproportionate share of this burden,
on water governance and water
as the fraction of total deaths,
resources management and this is
or DALYs, attributable to unsafe
closely linked with climate change in
drinking-water, inadequate sanitation
the Pacific islands.
or insufficient hygiene is more than
20% in children up to 14 years of age
(Prüss-Üstün A et al., 2008).
1
The Pacific island countries addressed in this report include 14
independent and self-governing countries in the Pacific Re-
gion. They are: Cook Islands, Federated States of Micronesia,
Due to differences in definitions
Fiji, Kiribati, Nauru, Niue, Palau, Papua New Guinea, Republic
of access and population estimates
of Marshall Islands, Samoa, Solomon Islands, Tonga, Tuvalu
used by countries and the WHO
and Vanuatu.
1

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and UNICEF Joint Monitoring
is still a major problem, there are
Programme for Water Supply and
serious challenges to be tackled with
Sanitation (JMP) respectively, the
regard to drinking-water, especially
sanitation and drinking-water
drinking-water quality, and that
coverage estimates presented here
preserving fresh water and adapting
may differ from those used nationally.
to climate change are essential to
human existence and to sustainable
development. However, the ability
Characterizing the
of the island countries to effectively
manage the sanitation and water
Pacific island countries
sector is constrained by their unique
characteristics of small size, fragility,
natural vulnerability, and limited
human and financial resources
The total population of the Pacific
(SOPAC, 2006).
island countries in 2006 was about
8.4 million people, most of them
Although the under-five mortality
living in rural areas (81%), speaking
rate has decreased nearly 22% from
approximately 1000 different
1990 to 2006 in the Pacific island
languages (Figure 1). These countries
countries, it is still considerably
are spread across 180 million square
higher than the world average.
kilometres of ocean, which represent
If global statistics can be used as
about 36% of the world surface.
a reference for the Pacific island
countries, the total number of deaths
Pacific island countries are no
in this region attributable to unsafe
different to any other in that the
water, inadequate sanitation and
lack of access to basic sanitation
insufficient hygiene is more than 20%
cislands
If the current trend is confirmed, the year 2015 will see the urban population of the Pacific island
acifi
countries nearly doubling that of 1990. The rural population will increase by 61% during the
P
same period of time.
the
FIGURe 1 Urban and rural population of the Pacific island countries, 1990, 2006, and 2015 (projected)
Understanding
Urban population
Rural population
12 000
(2007)
ivision
10 000
D
tion
Popula
8000
(thousands)
tionsNa
rural
ed
6000
and
7663
Unitom
6733
fr
urban
tion
4000
tion,
4763
Popula
trypopula
2000
counce:
1611
2039
1081
Sour
0
1990
2006
2015 (Projected)
Year
2

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ConverTing CommiTmenT inTo ACTion
AC
SOPce:
Sour
Understanding
the
Pacific
islands
tries
coun
island
Pacific
AP1M
3

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Although progress has been made in the Pacific island countries in reducing under-five mortality
over the last 16 years, it is currently over ten times that of developed countries such as Australia
and New Zealand.
FIGURe 2 Under-five mortality rate per 1000 live births in the Pacific island countries, Australia and New Zealand, and
the world, 1990 and 2006*
Pacific island countries
Australia, New Zealand
World
100
90
91
82
ths
80
ebirliv
70
71
64
1000
60
teper
50
yra
talit
40
mor
30
(2008b)
Under-5
20
WHO
10
ce:
9
0
6
Sour
1990
2006
Year
* Summary values weighted by population size
People in the less-developed countries of the Pacific islands live over 20 years less than those in
developed countries.
cislands
acifiP
FIGURe 3 Life expectancy at birth in the Pacific island countries and the developed Australia and New Zealand, 2002
the
1990
2006
90
80
82
80
Understanding
77
75
70
73
71
68
69
70 70
69
69 69
68
69
ears)
66
67 67
60
65
66
65
(y
63
61
62 63
63
61
61
th
60
57
58
50
55
yatbir
40
tanc
30
eexpeclif 20
(2008b)
10
WHOce:
0
Sour
ti
u
alia
Fiji
tu
teof
alu
Naur
Niue
Palau
uinea
Samoa
Austr
Zealand
Islands
Kiriba
Islands
Sta
G
Islands
Tonga
Tuv
Vanua
ew
New
Cook
ated
N
Marshall
Solomon
Feder
Papua
onesia,icrM Country
4

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ConverTing CommiTmenT inTo ACTion
of all deaths in children up to 14 years
of age (Prüss-Üstün A et al., 2008),
The Pacific Plan
and this number should be even higher
for children under 5 years of age.
The Pacific Plan is a planning process aimed at the full realization of the
Life expectancy is an important
Heads of States' Vision for the Pacific region. It is intended to strengthen
indicator of human development and
cooperation and integration between the countries of the region and
is closely related to the status of access
identify the areas where countries will gain the most from sharing resources
to basic sanitation and safe drinking-
of governance and aligning policies.
water, as demonstrated in numerous
research projects worldwide. Although
The Pacific Plan is intended to deliver real benefits to the people of the
some progress has been made from
Pacific by proposing concrete plans for the following key development
1990 to 2006 in the Pacific island
issues: economic growth; sustainable development; good governance; and
countries in increasing life expectancy,
security.
it remains considerably lower than
that of developed countries (Figure 3).
Fresh water management, basic sanitation and safe drinking-water impact
The influence of sanitation, drinking-
upon all the issues identified in the Pacific Plan, from fisheries to disaster-risk
water and hygiene on life expectancy
management.
is more prominent in the most
vulnerable age groups: children under
The Pacific Plan was endorsed by leaders at the Pacific Islands Forum meeting
five years old and people over 60
in October 2005. In addition, the leaders agreed in 2006, that water, sanitation
years of age (WHO, UNICEF, 2005).
and hygiene challenges facing the region be directly addressed under the
Improved sanitation services, better
Pacific Plan through the Pacific Regional Action Plan on Sustainable Water
hygiene behaviour and access to safe
Management (RAP).
drinking-water, especially by mothers,
are crucial in cutting child mortality
The Pacific Islands Forum was founded in August 1971 and comprises 16
and extending the life of the elderly.
independent and self-governing States in the Pacific. They are: Australia,
Cook Islands, Federated States of Micronesia, Fiji, Kiribati, Marshall Islands,
Understanding
Nauru, New Zealand, Niue, Palau, Papua New Guinea, Samoa, Solomon
Why this report?
Islands, Tonga, Tuvalu and Vanuatu. Forum leaders meet annually to develop
There are crucial initiatives promoting
collective responses to regional issues.
the
and supporting the development of
Source: Pacific Islands Forum Secretariat (2008)
P
water and wastewater in the Pacific
acific
islands. On the other hand, global
islands
water and sanitation assessments have
so far failed to address the status and
trends of the Pacific island countries.
Thus, the WHO Western Pacific
Regional Office and SOPAC decided
to prepare this report, which aims at
presenting the status of sanitation and
drinking-water in the Pacific islands as
a contribution to policy- and decision-
making towards enhanced sustainable
access to these crucial services. It is
important to highlight that this issue
is increasingly gaining visibility in
the region, which is confirmed by the
overwhelming attendance of Pacific
island leaders at the First Asia Pacific
Water Summit, held from 3 to 4
December 2007 in Japan. Six out of
the nine attending leaders were from
the Pacific.
5

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x1
The WHO and UNICEF Joint Monitoring Programme for Water
BO
Supply and Sanitation (JMP)
The statistics used to set the baseline and to monitor progress on access to improved
sanitation and improved drinking-water towards the MDG respective target are produced
by the JMP.This is the official mechanism adopted by the United Nations Secretary General
and the entire United Nations System to report on progress in the provision of improved
sanitation and drinking-water services to the world population.
The JMP's coverage statistics are based on household surveys including: USAID-
supported Demographic and Health Surveys (DHS); UNICEF-supported Multiple Indicator
Cluster Surveys (MICS); national census reports; WHO-supported World Health Surveys;
and other reliable national surveys that allow data to be compared. Prior to the adoption
of household surveys in 2000 as the basis for coverage reporting, coverage data were
provided by the water utilities and ministries in charge of drinking-water and sanitation
services. At that time, definitions of"safe water"and"basic sanitation"differed widely from
region to region and country to country. Commonly, too, coverage was counted according
to the numbers of built facilities, regardless of the fact that many of those might no longer
be in working condition or might not be in use.
From 2000, coverage assessments conducted by the JMP, using population-based
data gathered through household surveys and national censuses, give a much clearer
comparison between countries, as they record the percentage of people using well
defined improved facilities, as determined by face-to-face interviews.
The JMP's website (www.wssinfo.org) has an updated database of coverage statistics for
most countries. The data are periodically analysed and presented in a global report.
islands
Source: WHO, UNICEF (2005)
acificP
the
This report by no means is intended
be undertaken to fill out any existing
to replace major studies of the
gaps.
Understanding
water sector in this region or to
be a substitute to existing national
The drinking-water and sanitation
assessments or national official
coverage statistics presented in this
statistics on sanitation and drinking-
document are provided by the latest
water. It brings about a snapshot of
country statistics published by the
the overall sanitation and drinking-
WHO and UNICEF Joint Monitoring
water performance in the Pacific
Programme for Water Supply
islands using the JMP methodology
and Sanitation (WHO, UNICEF,
(Box 1), without the claim of
2008). They might differ from the
addressing exhaustively the causes of
official statistics of the Pacific island
current or past performance. It is felt
countries due to different criteria in
that other documents already address
defining access to drinking-water or
this issue and that future in-depth
sanitation or different methodologies
national sector assessments should
in estimating coverage.
6

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ConverTing CommiTmenT inTo ACTion
Understanding
the
Pacific
islands
7

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The status of sanitation
coverage in the Pacific
island countries

---

What does sanitation
mean in this report?
According to the UN Millennium
Project Task Force on Water and
Sanitation (2005), basic sanitation is
the lowest-cost option for securing
sustainable access to safe, hygienic,
and convenient facilities and services
for excreta and sullage disposal that
provide privacy and dignity while
ensuring a clean and healthful living
environment both at home and in the
TAble 1 Improved and unimproved sanitation types of facilities
neighbourhood of users.
Improved sanitation facilities*
Unimproved sanitation facilities
Monitoring access to basic sanitation
Flush or pour-flush to:
Flush or pour-flush to elsewhere**
The
according to this definition is currently
status
y
piped sewer system
Pit latrine without slab or open pit
not possible provided the limited level
y
septic tank
Bucket latrine
of
of information available at country
sanitation
y
pit latrine
Hanging toilet or hanging latrine
level or internationally. The WHO and
Ventilated improved pit latrine (VIP)
No facilities or bush or field (open
UNICEF Joint Monitoring Programme
Pit latrine with slab
defecation)
cover
for Water Supply and Sanitation
Composting toilet
age
works with the concept of access
inthe
to "improved" sanitation facilities
* Only facilities which are not shared or public are considered improved.
P
and uses this indicator as a proxy
** Excreta are flushed to the street, yard or plot, open sewer, a ditch and a drainage way.
acific
to measure progress towards the
island
achievement of the MDG sanitation
latter falls in the category of improved
countries
and drinking-water targets throughout
as defined by the above table.
the world. Improved and unimproved
The JMP calculates coverage estimates
technologies as defined by the JMP are
based on the outputs of household
provided in Table 1 (WHO, UNICEF,
surveys as opposed to reported data.
2006).
In the Pacific island countries, very
few countries practice household
The JMP considers that different
surveys providing statistics on
households sharing access to the same
access to drinking-water and basic
sanitation facility might not encourage
sanitation that are compatible with
use as this practice does not provide
the JMP methodology. Thus, national
privacy, and cleanliness might be
and regional analysis in this report
unattainable (WHO, UNICEF, 2004).
might be severely affected by lack of
Thus, those having access to shared
information that, otherwise, would
facilities are not counted as having
make it possible to establish a more
access to improved facilities even if the
reliable coverage trend over time.
9

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Nearly 40% of the Pacific island countries have coverage with improved sanitation below 50%.
FIGURe 4 Coverage with improved sanitation by Pacific island country, 2006
100
100
100
100
90
96
90
80
(2008)
70
71
67
World
,UNICEF
60
(62%)
(%)
WHO
50
Pacific
om
(48%)
frta
Coverage
40
45
daage
30
33
32
trycover
20
25
ycoun
10
nA
nA
nA
primar
0
ce:
Fiji
ti
u
alu
tu
Sour
teof
Niue
Palau
Islands
Kiriba
Islands
Naur
uinea
Sta
G
Samoa
Islands
Tonga
Tuv
Vanua
Cook
ew
ated
N
Marshall
Solomon
Feder
Papua
onesia,icrM
Country
countries
cisland
acifiP
What is the sanitation
the
It is important to highlight that there
in
coverage in the Pacific
is an overall perception among key
age
stakeholders in the region that the
cover
island countries?
sanitation coverage statistics provided
by the JMP, especially those for
high-coverage Pacific countries, seem
sanitationof
The sanitation coverage in the Pacific
exceedingly optimistic. For the future,
island countries (48%) in 2006
the JMP would be expected to refine
status
was far below the world average
its coverage statistics for the region by
The
of 62% (Figure 4). There is a huge
promoting the inclusion of questions
disparity in access to improved
and response categories on sanitation
sanitation services among the Pacific
and drinking-water in national sample
island countries. While less than a
surveys or census conducted in the
half of the population of countries
Pacific island countries.
such as Kiribati, Federated States
of Micronesia, Papua New Guinea
and Solomon Islands have access to
improved sanitation, Cook Islands,
Niue and Samoa have achieved full
coverage.
10

---

ConverTing CommiTmenT inTo ACTion
Open defecation is still a widespread practice in the Pacific Islands: over 16% of the entire
population defecates in the open.
FIGURe 5 Proportion of people using different types of sanitation practices in the Pacific islands, 2006
Open defecation
16%
(2008)
,UNICEF
WHO
Improved
omfr
sanitation
ta
facilities
da
48%
age
trycover
Unimproved
ycoun
facilities
34%
primarce:
Facilities shared among households
Sour
2%
In 2006, over a half of the Pacific Islands population did not have access to any type of
improved sanitation facility.
Thestatus
ofsanitation
Figure 5 indicates the status of the
cover
Pacific island countries concerning
age
types of sanitation practices. There
in
is evidence that the proportion of
the
people with access to flushing toilets
Pacifi
connected to sewerage systems with
cisland
adequate sewage treatment and sound
disposal might be used by just a
countries
fraction of the Pacific islands
population.
11

---

What is the sanitation
trend in the Pacific
with access increased from 2.9 million
to 4.0 million, a 41% increase (Figure
island countries?
6). However the huge population
growth over the same period of time
(see Figure 1) overshadowed such
Considerable progress has been made
a major achievement. The numbers
from 1990 to 2006 in expanding
of unserved increased over 30%,
access to improved sanitation in the
from almost 3 million in 1990 to 4.3
Pacific island countries: the population
million in 2006.
Despite a huge effort to increase the numbers of people served with sanitation services from 1990
to 2006 (about 1.2 million people gained access), the numbers of unserved increased about 45%
during the same period of time.
FIGURe 6 Trends in service levels for sanitation in the Pacific island countries
Improved facilities
Shared facilities
Other unimproved facilities
Open defecation
9000
8000
1301
7000
,(2008)
countries
6000
,UNICEF
936
2841
WHO
cisland
5000
omfr
acifi
(thousands)
ta
P
da
tion 4000
1932
161
age
thein
Popula 3000
trycover
age
109
2000
4041
ycoun
cover
2866
1000
primarce:
0
Sour
sanitationof
1990
2006
Year
status
The
12

---

ConverTing CommiTmenT inTo ACTion
x2
The Sanitation Park Project
BO
The Sanitation Park Project was developed to help demonstrate
different effective onsite sanitation technologies, such as a water
seal latrine, a septic tank with its soakage trench, a ventilated
improved latrine and a composting toilet. The Park was designed
to support communities in Fiji and the Pacific region to recognize
and solve their sanitation problems by examining and selecting
the sanitation system that would be the most appropriate to their
condition. Not only does it host a range of low-cost alternatives
for sanitation but it also provides information on initial costs,
constructiontechniquesandlong-termoperationandmaintenance
costs.
More interestingly, the Park was built at the Tamavua Campus of
the Fiji School of Medicine. This suggests an eloquent message
to health professionals and from health professionals about the
importance of good sanitation in preventing sanitation-related
diseases. Regional students from the Fiji School of Medicine are
The
able to take the information on available technologies back to
status
their countries and create further awareness in Pacific islands
of
communities.
sanitation
The implementation of the Park Project was led by the Fiji
Ministry of Health (MoH), Fiji School of Medicine (FSMed), World
cover
Health Organization, and the Pacific Islands Applied Geoscience
age
Commission (SOPAC). It was funded by WHO and the New Zealand
in
Agency for International Development (NZAID).
the
Pacific
Source: Bower, R, Crennan, L, Navatoga, A. (2005)
island
countries
13

---

The status of drinking-
water coverage
in the Pacific island
countries

---

What is the meaning of
safe drinking-water?
The United Nations Millennium
Project Task Force on Water and
Sanitation (Lenton R, Wright A, Lewis
K, 2005) defines safe drinking-water
as water that is safe to drink and
available in sufficient quantities for
hygienic purposes. The concept of
safety as defined by WHO (2006) is
based on the principle that a lifetime
of consumption will not represent any
significant risk to health, including
different sensitivities that may occur
between life stages. Howard &
TAble 2 Improved and unimproved types of drinking-water facilities
The
Bartram (2004) indicate that in order
status
to assure a basic use of drinking-water
Improved drinking-water sources
Unimproved drinking-water
of
(a minimum of 20 litres per capita per
sources
drinking-w
day for direct ingestion, hand-washing
Piped water into dwelling, plot or
Unprotected dug well
and cooking) the water should be
yard
Unprotected spring
ater
obtained from a source not farther
Public tap/standpipe
Cart with small tank/drum
cover
than 100 ­ 1000 metres or 5 to 30
Tubewell/borehole
Bottled water*
age
minutes total collection time. Ensuring
Protected dug well
Tanker truck
inthe
sufficient quantities of safe drinking-
Protected spring
Surface water (river, dam, lake, pond,
P
water also for bathing and laundry
acific
Rainwater collection
stream, canal, irrigation channels)
would require a minimum of 50 litres
island
per capita per day.
* Bottled water is considered improved only when the household has also access to an improved source of water for cooking
countries
and personal hygiene.
National statistics on access to safe
drinking-water according to the
above definitions are not normally
drinking-water sources and use this as
available. This is due to the fact that
a proxy to measure progress towards
comprehensive household surveys
the achievement of the MDG drinking-
(health, demography, etc), which are
water targets globally.
the basis for the coverage statistics
provided by the WHO and UNICEF
Improved and unimproved
Joint Monitoring Programme for
technologies as defined by the JMP are
Water Supply and Sanitation (JMP),
provided in Table 2 (WHO, UNICEF,
cannot handle this type of concern.
2006).
As for sanitation, the JMP works with
the concept of access to "improved"
15

---

What is the status of
Although three in five countries of
the Pacific island countries present
access to improved
coverage beyond 80%, it is important
to highlight the fact that only 13%
of the population count on drinking-
drinking-water in the
water piped to internal household
systems or household yards (Figure
Pacific island countries? 8). The absence of piped water to
the household hampers the ability of
the users to utilize drinking-water in
In 2006, only 46% of the population
sufficient quantities as to meet the
in the Pacific Islands had access to
basic demand not only for drinking,
improved drinking-water sources
cooking and hand washing, but also
(Figure 7). This represents almost a
for bathing and laundry. In addition,
half of the 2006 coverage attributed
piped drinking-water to the household
to the world population by the JMP.
is likely to be of better quality than
Although less populated countries
that from point source systems, as
present high coverage, the low
there is the possibility of carrying out
coverage of Papua New Guinea, which
effective centralized treatment by the
alone represents three quarters of the
service provider including drinking-
region's population, steers the average
water quality control. Piped water
coverage to levels comparable to those
to the household will also avoid the
of least-developed regions.
problem of recontamination of water
carried manually from point sources
to the household.
Over 60% of the countries in the Pacific region have coverage with improved drinking-water
sources higher than 80%, but the region's coverage average represents almost a half of the world
countries
coverage.
FIGURe 7 Coverage with improved drinking-water sources by Pacific island country, 2006
cisland
acifi
100
P
100
100
the
90
96
94
92
World
in
88
88
(87%)
80
age
70
cover
70
65
ater
60
(2008)
(%)
50
,UNICEF
Pacific
47
(46%)
WHO
Coverage
drinking-w
40
40
om
of
frta
30
da
status
age
20
The
trycover
10
nA
nA
nA
coun
0
ce:
Fiji
ti
u
alu
tu
Sour
teof
Niue
Palau
Islands
Kiriba
Islands
Naur
uinea
Sta
G
Samoa
Islands
Tonga
Tuv
Vanua
Cook
ew
ated
N
Marshall
Solomon
Feder
Papua
onesia,icrM
Country
16

---

ConverTing CommiTmenT inTo ACTion
Progress in providing access to
an astounding 54% of the whole
improved drinking-water sources to
population. The numbers of unserved
the inhabitants of the Pacific island
have grown by over 45% over the
countries over the last 16 years
same period, which means that people
(Figure 9) is modest as compared
are increasingly relying on unprotected
with the huge population growth
wells, rivers, etc., to satisfy their basic
experienced over the same period of
needs of drinking-water for domestic
time (see Figure 1). About 4.5 million
use.
people remained unserved in 2006,
For every eight people in the Pacific island countries, only one had access to piped water into their
dwelling, plot or yard in 2006 and only 46% had access to any type of improved drinking-water
facility.
FIGURe 8 Proportion of people using different types of drinking-water sources in the Pacific island countries, 2006
Piped to the household
13%
(2008)
,UNICEF
WHOomfrta
Other improved
da
33%
age
ycover
Unimproved
primar
54%
ce:
T
Sour
hestatus
ofdrinking-w
The progression of infrastructure for provision of centralized drinking-water systems piped to
households has practically stagnated in the Pacific island countries: only 300 000 gained access
to this type of service from 1990 to 2006 against an increase in population of 2.5 million people
ater
during the same period of time.
cover
FIGURe 9 Trends in service levels for drinking-water in the Pacific island countries
age
Piped water into the household
Other types of improved facilites
Unimproved facilities
in
9000
the
P
8000
acifi
cisland
(2008)
7000
countries
6000
,UNICEF
4543
WHO
5000
omfr
(thousands)
ta
3112
da
tion 4000
age
Popula 3000
trycover
2676
2000
ycoun
1931
1000
primarce:
800
1125
0
Sour
1990
2006
Year
17

---

Disparity in access to
drinking-water and
sanitation services
Examining the Pacific island countries
The disparity in drinking-water
as a whole, it is unmistakable that
coverage for urban and rural areas
there is a huge disparity in sanitation
in the Pacific Islands is similar to
and drinking-water coverage for urban
that of sanitation (Figure 12). Three
and rural areas (Figure 10).
particular countries present higher
disparity: Kiribati, Papua New Guinea
A closer look at the status of
and Solomon Islands.
sanitation coverage of the Pacific
island countries indicates that the rural
coverage with improved sanitation
is only 56% of the urban coverage
(Figure 11).
Drinking-water and sanitation coverage in rural areas of the Pacific island countries hardly reach a
half of the urban coverage.
FIGURe 10 Urban and rural disparities in sanitation and drinking-water in the Pacific island countries
Urban
Rural
100
countries
90
cisland
80
(2008)
acifiP
70
76
75
,UNICEF
thein
WHO
60
om
age
(%)
frta
50
da
cover
age
Coverage
40
ater
42
38
30
trycover
ycoun
20
drinking-w
primar
of
10
ce:
0
Sour
status
The
Improved drinking-water
Improved sanitation
18

---

ConverTing CommiTmenT inTo ACTion
Four out of the 11 Pacific island countries for which information is available have rural sanitation
coverage less than 60% of the respective urban coverage.
FIGURe 11 Urban and rural disparities in sanitation by country and total for Pacific island countries
Urban
Rural
100
100100
100100
100100 98
98
90
96
96 93
87
80
84
70
75
67
60
(2008)
(%)
61
50
55
52
,UNICEF
Coverage
46
WHO
40
42
41
omfr
30
tadaage
20
20
18
10
14
trycover
nA
nA
nA
ycoun
0
Fiji
ti
u
tu
Niue
alu
primar
Palau
Islands
Kiriba
Islands
Stateof
Naur
uineaG
Samoa
Islands
Tonga
Tuv
Vanua
ce:
ated
Cook
ewN
coundtries
Feder
Sour
Marshall
Solomon
Papua
cisland
Micronesia,
Pacifi
Country
T
Nearly 70% of the Pacific island countries present drinking-water coverage in both urban and
hestatus
rural areas above 80%. However, the most populated countries (Fiji, Kiribati and Papua New
Guinea) have coverage rates and urban/rural disparities similar to those of the world's least
developed countries.
ofdrinking-w
FIGURe 12 Urban and rural disparities in drinking-water by country and total for Pacific island countries
Rural drinking water
Urban drinking water
100
ater
100100
90 87
100
98
100
95
94
cover
90
94
94
94 92
88
88
age
80
79
in
77
70
76
the
P
60
65
acifi
(%)
c
50
53
(2008)
island
51
Coverage
40
43
,UNICEF
countries
38
WHO
30
32
omfr
20
age
10
trycover
nA
nA
nA
0
ycoun
Fiji
ti
u
tu
Niue
alu
Palau
Islands
Kiriba
Islands
Stateof
Naur
uineaG
Samoa
Islands
Tonga
Tuv
primar
ated
Vanua
Cook
ew
coundtries
ce:
N
Marshall
Feder
Solomon
Sour
Papua
cisland
Micronesia,
Country
Pacifi
19

---

MDG sanitation and
drinking-water targets:
are the targets achievable
for the Pacific island
countries?

---

Achieving the sanitation target in 2015 in the Pacific island countries will
require an annual level of effort nearly five times higher over 2006 ­ 2015
Achieving the
than that over 1990 ­ 2006.
sanitation target will
FIGURe 13 Projection of change in numbers of people served with improved sanitation
from 2006 to 2015 and MDG target in the Pacific island countries
require a great effort!
Population served with improved sanitation in 2006
Projected population served with improved sanitation in 2015
Population served with improved sanitation in 2015 if MDG target is met
8000
In 2006, 4.3 million people in the
7000
7229
Pacific island countries did not
6000
have access to any type of improved
5000
sanitation. Of these, 3.9 million lived
(thousand)
4000
4603
tion
4041
in rural areas. Not much progress has
3000
Popula
been made over the period of time
2000
1990 ­ 2006: the numbers of unserved
1000
people increased from 3.0 million
0
in 1990 to 4.3 million in 2006, an
2006
2015
Year
inconceivable 43% increase.
FIGURe 14 Projection of change in numbers of people unserved with improved sanitation
from 2006 to 2015 and MDG target in the Pacific island countries
mDg
If this trend continues to 2015, the
Population unserved with improved sanitation in 2006
sanitation
Pacific island countries will miss the
Projected population unserved with improved sanitation in 2015
(2008)
MDG sanitation target by 2.6 million
Population unserved with improved sanitation in 2015 if MDG target is met
,UNICEF
people. Even if the target is achieved, the
8000
WHO
and
7000
omfr
drinking-w
numbers of unserved will amount to 2.5
ta
million people (Figures 13 and 14).
da
6000
age
5000
5100
trycover
ater
Since 1990, the average number of
(thousand)
4000
4303
tion
ycoun
targets:
people gaining access to improved
3000
sanitation has been about 74 000 a
primar
Popula
2000
ce:
2474
are
year. In order to achieve the target in
Sour
the
1000
targets
2015 there is a need to increase this
0
number to 354 000 a year from 2006
2006
2015
Year
achiev
to 2015.
able
forthe
Pacifi
cisland
countries?
21

---

Similar to the world situation, the Pacific island countries as a whole are not on track to achieve
the MDG sanitation target in 2015.
FIGURe 15 Projected proportion of people using improved sanitation in 2015 and respective MDG sanitation target by
Pacific island country
MDG sanitation target:
on track
not on track
Projected coverage in 2015
100
100
100
100
96
97
90
80
70
73
70
67
60
(2008)
(%)
50
,UNICEF
Coverage
46
47
WHO
40
39
omfr
30
34
tada
23
age
20
10
trycover
nA
nA
nA
ycoun
0
Fiji
ti
u
tu
teof
Niue
alu
orld
primar
Palau
Islands
Kiriba
Islands
Naur
uinea
W
Sta
G
Samoa
Islands
Tonga
Tuv
Vanua
ce:
Cook
ew
ated
N
coundtries
Sour
Marshall
Solomon
Feder
Papua
cisland
onesia,
Pacifi
icrM
Country
Five countries are on track to achieve
requirements. The Pacific islands have
countries?
the MDG sanitation target (Cook
normally a fragile ecosystem requiring
Islands, Niue, Samoa, Tonga and
careful consideration in selecting and
cisland
Tuvalu) (Figure 15). These statistics
maintaining sanitation technologies.
Pacifi
should be viewed however with
Some of the "improved" sanitation
the
caution as there is little information
technologies may be hazardous to
for
for the Pacific island countries about
both existing sources of drinking-
able
the quality of these services. The
water and the ecosystems surrounding
region is also exceedingly poor in
the Pacific islands. Sewage systems
achiev
terms of survey data, which might
being discharged untreated into the
targets
threaten considerably the solidity of
sea may inflict a serious impact on
the
the coverage analysis conducted at
the marine environment and may
are
country and regional levels. The other
affect the food chain through fish and
countries for which data is available
shellfish. Septic tanks with soakpits
targets:
are not on track.
and latrines below the water table
ater
may contaminate scarce groundwater
It is important to emphasize that
sources. There is a need to conduct
achieving the target does not mean
surveys in the Pacific islands that
drinking-w
necessarily an optimum level of
take these factors into account for an
and
services to all those having access
effective determination of different
to improved facilities. It is likely
levels of services and their relationship
that even if the targets are achieved,
with health and the environment.
sanitation
there will remain great challenges
mDg
to harmonize people's needs
with environmental and health
22

---

ConverTing CommiTmenT inTo ACTion
Drinking-water does
Achieving the MDG drinking-water target in 2015 in the Pacific island
countries will require an annual level of effort nearly 5.5 times higher over
2006 ­ 2015 than that over 1990 ­ 2015.
not appear to be in a
FIGURe 16 Projection of change in numbers of people served with improved drinking-
water sources from 2006 to 2015 and MDG target in the Pacific island countries
better shape!
Population served with improved drinking-water in 2006
Projected population unserved with improved drinking-water in 2015
Population served with improved drinking-water in 2015 if MDG target is met
8000
The average number of people
7000
7132
gaining access to improved drinking-
6000
water from 1990 to 2006 was about
5000
67 000 a year. Achieving the MDG
(thousand)
4000
4409
tion
drinking-water target in 2015 will
3000
3801
require an increase to almost 370 000
Popula
2000
a year from 2006 to 2015 (Figures 16
1000
and 17).
0
2006
2015
Year
If the current trend is confirmed, the projected numbers of unserved in
2015 will be almost the double of the unserved if the MDG drinking-water
target is achieved.
FIGURe 17 Projection of change in numbers of people unserved with improved drinking-
water from 2006 to 2015 and MDG target in the Pacific island countries
Population unserved with improved drinking-water in 2006
Projected population unserved with improved drinking-water in 2015
Population unserved with improved drinking-water in 2015 if MDG target is met
8000
(2008)
7000
,UNICEF
mDg
6000
WHOom
5000
sanitation
5294
frta
(thousand)
da
4000
4543
age
tion
3000
Popula
trycover
and
2000
2571
ycoun
drinking-w
1000
primarce:
0
Sour
2006
2015
ater
Year
targets:
are
the
targets
achiev
able
forthe
Pacifi
cisland
countries?
23

---

The Pacific island countries as a whole are not on track to achieve the MDG drinking water target
in 2015 as opposed to the world, which is on track.
FIGURe 18 Projected proportion of people using improved drinking-water sources in 2015 and respective MDG
drinking-water target by Pacific island country
MDG sanitation target:
on track
not on track
Projected coverage in 2015
100
100
100
97
90
97
93
93
88
86
80
70
75
71
60
(2008)
(%)
50
,UNICEF
Coverage
46
45
WHO
40
41
omfr
30
tadaage
20
10
trycover
nA
nA
nA
ycoun
0
Fiji
ti
u
tu
teof
Niue
alu
orld
primar
Palau
Islands
Kiriba
Islands
Naur
uinea
W
Sta
G
Samoa
Islands
Tonga
Tuv
Vanua
ce:
Cook
ew
ated
N
coundtries
Sour
Marshall
Solomon
Feder
Papua
cisland
onesia,
Pacifi
countries?
icrM
Country
cisland
Pacifi
the
Based on the JMP statistics, six
for
countries are on track to achieve the
able
MDG drinking-water target (Figure
18). The countries not on track to
achiev
achieving the target are: Fiji, Palau,
Papua New Guinea, Samoa and
targets
Solomon Islands.
the
are
targets:
ater
drinking-w
and
sanitation
mDg
24

---

ConverTing CommiTmenT inTo ACTion
mDgsanitation
Linking the MDG
complemented these targets. Goal 7,
goals and targets
Target 7C aims to "Halve, by 2015,
and
the proportion of people without
drinking-w
sustainable access to safe drinking-
to sanitation and
water and basic sanitation". As
demonstrated in earlier sections of this
ater
drinking-water in the
document, neither the sanitation target
targets:
for the Pacific island countries nor the
Pacific Islands
drinking-water target will be achieved
are
if the past trends are confirmed
the
towards 2015.
targets
The Millennium Development Goals
The implication of such an insufficient
achiev
and targets are part of the Millennium
progress extrapolates the water and
able
Declaration which was agreed by
sanitation sector as the overall MDGs
for
189 countries in September 2000.
are influenced by the sanitation
the
A resolution adopted by the United
and drinking-water targets as
Pacific
Nations General Assembly in 2005
demonstrated in Table 3.
island
countries?
25

---

TAble 3 Influence of basic sanitation and drinking-water in achieving the Millennium Development Goals
MDG Goals
Influence in achieving the goals
Goal 1: Eradicate extreme
Basic sanitation and safe drinking-water prevent illnesses which otherwise would affect
poverty and hunger
the productivity of the household members. Such illnesses, especially helminths, take away
calories from their hosts and make the poor less able to absorb nutrients in food.
Adequate sanitation and good drinking-water prevent water-related illnesses. Such
illnesses generate high health and economic costs which affect the capacity of the
community to combat poverty and hunger.
Ecosystems degradation due to inadequate sanitation hampers local-level development,
which affects especially the poor. This is particularly crucial for the Pacific island countries
where the ecosystems are fragile and highly susceptible of being harmed by inadequate
excreta disposal management.
Goal 2: Achieve universal
Having separate sanitation facilities for girls and boys in school increases girls' attendance.
primary education
This is not the reality of many primary and secondary schools in the Pacific island countries
and is a major area of concern which is directly related to the achievement of the targets
associated with this goal.
Goal 3: Promote gender
Sanitation facilities closer to home put women and girls at less risk of attack while
equality and empower
searching for privacy. Similarly, drinking-water is normally fetched by women and children,
women
which places an enormous burden on their quality of life and perspectives of personal
development.
Goal 4: Reduce child
Basic sanitation and safe drinking-water reduce considerably infant and child morbidity
mortality
and mortality.
Goal 5: Improve maternal
Basic sanitation, safe drinking-water and good hygiene behaviours are needed in health
health
care establishments to prevent contamination following delivery.
Goal 6: Combat HIV/
Basic sanitation and safe drinking-water help prevent diseases, including diarrhoeal
countries?
AIDS, malaria and other
diseases, trachoma and helminths. This is of fundamental importance, considering people
island
diseases
already debilitated by long-lasting illnesses such as HIV/AIDS.
Pacific
Goal 7: Ensure
Adequate treatment and disposal of wastewater contributes to better ecosystem
the
environmental
conservation and less pressure on scarce freshwater resources, which is of special
for
sustainability
relevance to coral islands and fragile ecosystems of the Pacific islands. Adequate excreta
able
management and wastewater disposal prevents contamination of groundwater and helps
minimize the cost of water treatment.
achiev
Goal 8: Develop a
Development agendas and partnerships should recognize the fundamental role that basic
targets
global partnership for
sanitation and safe drinking-water play in economic and social development.
the
development
are
Source: adapted from WHO/UNICEF (2004b)
targets:
ater
drinking-w
and
sanitation
Dgm
26

---

ConverTing CommiTmenT inTo ACTion
x3
The messages from UN-Water *
BO
UN-Water is strongly committed to advancing the sanitation agenda on a worldwide basis. The proactive messages below are
in agreement with the needs and potentials of the Pacific island countries. They are:
mD
Sanitation is vital for health
gsanitation
Lack of toilets and the safe confinement of excreta away from hands, feet, drinking water and eating utensils, and lack of
hygiene, especially failure to wash hands after defecation, lead to the transmission of diarrhoeal disease. Provision of sanitation
is important for the prevention of illness of all kinds, and saves the huge costs of medical treatment.
and
drinking-w
Sanitation contributes to social development
Where sanitation facilities and hygienic behaviour are present, rates of illness drop, malnutrition in children is reduced, more
children, especially girls, attend school and learn better, and women's safety and dignity are improved.
ater
targets:
Sanitation is a good economic investment
Improved sanitation has positive economic benefits. Livelihoods and employment opportunities are enhanced, and the costs
are
to the community and to the nation of illness and lost productivity are reduced.
the
targets
Sanitation helps the environment
achiev
Improved disposal of human waste promotes environmental cleanliness and protects streams, rivers, lakes and underground
aquifers from pollution. Safely composted, excreta can be used as fertilizer.
able
for
Sanitation is achievable
the
Tried and tested appropriate technologies, programme models and people-centred approaches can be rolled out where there
Pacific
is the will to do so. The cost of meeting the MDG sanitation target is affordable.
island
countries?
* UN-Water is a mechanism of the United Nations to support states in their water-related efforts to reach the Millennium Development Goals. It was officially endorsed in 2003 for the follow-up
process of the 2002 World Summit on Sustainable Development.
Source: UN Water (2008a)
27

---

Sanitation and drinking-
water have a striking
effect on health!

---

Eighty-eight per cent of cases of
countries, the year 2002 saw the
diarrhoeal diseases worldwide are
incidence of 871 cases of acute
attributable to inadequate sanitation,
diarrhoea per thousand people (Figure
unsafe water and poor hygiene. This
19), causing the death of 2800 people.
results in 1.5 million deaths a year
More severe forms of diarrhoeal
worldwide, most of them children
diseases include cholera, typhoid and
less than five years old (Prüss-Üstün
dysentery.
A et al., 2008). In the Pacific island
The Pacific island countries present an incidence rate of diarrhoeal diseases 20% greater than the
world average and over four times higher than developed countries such as Australia and New
Zealand.
FIGURe 19 Incidence rate of diarrhoeal diseases per 1000 population in the developed Pacific countries, the developing
Pacific island countries, and World, 2002
1000
Sanitation
tion)
900
800
871
and
popula
drinking-w
1000
700
725
(per
600
ater
(2008)
diseases
500
have
WHOom
a
400
fr
striking
diarrhoeal
300
tisticssta
teof
effect
ra
on
200
209
on
based
100
health!
ce:
Incidence
0
Sour
Australia, New Zealand
Pacific island countries
World
(average)
World, Regions
The number of deaths due to diarrhoeal diseases in the Pacific island countries in
2002, most of them children under five, is equivalent to the crash and death of the
passengers of nine Boeing 747 jets a year.
29

---

Acute diarrhoea as well as other
Even "improved" sanitation types
waterborne or waterwashed diseases
of technologies can contribute to
are normally caused by pathogens in
the contamination route. Thus,
human and animal excreta, as well
defining the most adequate type of
as contaminated animal products.
sanitation facility requires a careful
The transmission of these pathogens
analysis on a case by case basis to
to humans occurs through "waves"
ensure that health issues are given
of contamination following myriad
due consideration. Certain types of
pathways. The unavailability of
improved technologies can be sound
adequate sanitation and safe drinking-
under a standpoint of health and
water services plays a crucial role
environment in some circumstances
in the different transmission chains
but can be a health and environmental
(Figure 20).
hazard in others.
The most direct route of contamination of humans with pathogens from human excreta is through hands (lack of basic
sanitation facilities, poor hygiene behaviours and lack of safe drinking water).
FIGURe 20 Pathways of human contamination from human and animal excreta, and animal products
Origin of contamination
Second wave of contamination
First wave of contamination
Third wave of contamination
health!
on
effect
strikinga
have
ater
drinking-w
and
Sanitation
.(2008)al
Aet
stün
Prüss-Üomfred
adaptce:
Sour
*Without due consideration to protection of groundwater sources
**Without adequate wastewater treatment and disposal
30

---

ConverTing CommiTmenT inTo ACTion
The statistics suggest that
the incidence rates of
The incidence rates of diarrhoeal diseases in the Pacific island countries are
approximately 4 to 5 times that of developed countries such as Australia and New
diarrhoeal diseases in the
Zealand
different countries of the
Pacific island countries do
FIGURe 21 Incidence rate of diarrhoeal diseases per 1000 population in the Pacific island countries and the
not present a huge disparity
developed Australia and New Zealand, 2002
between themselves, but are
Vanuatu
generally much greater than
892
that of developed countries
Tuvalu
785
in the same region (Figure
Tonga
839
21).
Solomon Islands
977
As a typical value, about
Samoa
841
10% of all deaths of
Papua New Guinea
881
children less than five years
old in the Pacific island
Palau
860
countries are attributable
Niue
831
to diarrhoeal diseases
Nauru
1015
(Figure 22). About 90%
of such diseases are
Micronesia, Federated State of
846
attributable to lack of
Marshall Islands
722
(2008)
sanitation, drinking-water
Kiribati
WHO
766
and hygiene. However,
omfr
despite the exceedingly
Fiji
772
tistics
high mortality figures due
Cook Islands
946
to lack of basic sanitation,
trysta
New Zealand
216
coun
safe drinking-water and
ce:
hygiene, the evidence
Australia
208
Sour
Sanitation
suggests that these statistics
might be underestimating
0
200
400
600
800
1000
1200
Incidence rate of diarrhoeal diseases (per 1000 population)
and
the real dimension of
drinking-w
the problem. There is an
indirect influence of these
risk factors on most of
ater
the other causes of death
FIGURe 22 Distribution of mortality due to different causes among children less than five years old in a
have
(Prüss-Üstün A et al., 2008)
typical country of the Pacific (Fiji)
and this is not shown in the
astriking
official statistics.
Other
effect
36%
on
health!
Injuries
3%
Pneumonia
11%
(2008)
Malaria
WHO
0%
omfr
Measles
0%
tisticssta
Diarrhoea
ce:
11%
Neonatal
Sour
HIV/AIDS
41%
0%
31

---

Climate change:
how serious is it
for the Pacific island
countries?

---

The facts
of global surface temperature. The
IPCC also reports that the global
Over the last 100 years, human
average sea-level rose at an average
activities related to the burning
rate of 1.8 mm per year from 1961
of fossil fuels, deforestation and
to 2003. The total rise in the sea level
agriculture caused a 35% increase in
during the 20th century was estimated
the carbon dioxide (CO2) levels in
to be 0.17 m. The average increase
the atmosphere, producing increased
of surface temperature projected
trapping of heat and warming of
for the end of the 21st century
the earth's atmosphere. The Fourth
(2090­2099) varies from 1.1 ­ 6.4
Assessment Report (AR-4) of the
degrees centigrade. The global mean
Intergovernmental Panel on Climate
sea level is projected to rise by 30
Change (IPCC) states that most of
to 60 centimetres by the year 2100,
the observed increase in the globally-
mainly due to thermal expansion of
averaged temperatures since the mid-
the ocean (WMO, UNEP, 2007). Some
20th century was very likely due to the
estimates are even more unfavourable,
increase in anthropogenic greenhouse
indicating a sea-level rise up to 88
gas (GHG) concentrations. Eleven of
centimetres in the Pacific island
Climate
the last 12 years (1995-2006) rank
countries by 2100 (Bates, B. et al.,
among the 12 warmest years in terms
change:
2008)
how
serious
isitforthe
Pacifi
cisland
countries?
33

---

FIGURe 23 Climate change and health interlinkages
Climate Change
Stratospheric ozone
Biodiversity loss and
Desertification and
depletion
ecosystem function
land degradation
UV exposure
Decline in several
Agroecosystem
Population
ecosystem services
productivity
displacement
Pressure on water resources
Altered precipitation
t/globalchange/en/.in
Salination
Reduction of
Contamination of
Diverse pathways
of groundwater
freshwater
availability
water sources
ww.who
http://w
om:fred
Impact on human health
adaptce:
countries?
Sour
cisland
acifiP
the
for
Climate variability and change cause
Climate change causes environmental
itis
death and disease through natural
hazards to human health through
disasters, such as variable rainfall,
different pathways, including
serious
cyclones, accelerating storm water
stratospheric ozone depletion, loss of
runoff, floods, droughts, and heat
biodiversity and desertification. Such
how
waves, which bring about a reduction
hazards have a great impact on fragile
in the availability of fresh water and
ecosystems such as those frequently
change:
a gradual decrease in water quality.
occurring in the Pacific islands posing
This is exacerbated in the Pacific
a serious threat to scarce water
Climate
island countries due to the fragility
resources (Figure 23).
and vulnerability of the water lenses
in the countries' islands. Common
vectorborne diseases, such as malaria
and dengue and other major killers,
such as malnutrition and diarrhoea
are also likely to become even more
serious if the climate change trends
are confirmed over the forthcoming
decades.
34

---

ConverTing CommiTmenT inTo ACTion
What to do?
The Pacific island countries have
with island vulnerability, from disaster
little influence, if any, in contributing
response to disaster risk reduction and
directly to global warming and thus
disaster management. This session
in reducing its causes. But the Pacific
emphasized the need for incorporation
leaders can voice their concerns
of risk reduction and coping with
through different communication
adaptation strategies into Integrated
mechanisms, especially with regard
Water Resources Management and
to endangered scarce water resources
Water Safety planning frameworks,
and as those being mostly affected
which are both being introduced in the
by this global crisis in relative terms.
Pacific island countries. The required
Climate change can be devastating in
adaptation and coping strategies have
Pacific islands due to rising sea levels,
been articulated under a specific theme
increase and intensification of natural
in the Pacific Regional Action Plan
disasters and the economic and health
on Sustainable Water Management
consequences they cause.
(Pacific RAP) (ADB and SOPAC,
The mitigation of greenhouse gases
2002).
provides a mechanism for slowing,
and perhaps eventually halting, the
A policy brief by the Global Water
build up of greenhouse gases in the
Partnership (GWP) on climate
atmosphere. A slowing of the warming
change adaptation considers that
rate could yield important benefits in
the best approach to manage the
the form of reduced impacts to human
impact of climate change on water
health and other systems; however,
is that guided by the philosophy and
the inertia in the climate system
methodology of Integrated Water
means that there will be a significant
Resources Management (GWP, 2005).
Climate
temporal lag between emission
Furthermore the GWP recognizes
reduction and slowing in the rate
that in addressing water shortages,
change:
of warming (WHO, WMO, UNEP,
as much attention should be given to
2003).
managing demand as to increasing
how
supply, by introducing more efficient
serious
Adaptation is another important
technologies as well as promoting a
response option and is directly under
culture of water conservation. The
is
reach by the Pacific island countries.
Pacific RAP provides the holistic
itfor
Actions with this regard should
framework for an integrated approach
the
enhance the resilience of vulnerable
that encompasses both coping with
Pacific
systems, thereby reducing potential
climate variability (flood and drought
damages from climate change
forecasting and management) as well
island
and climate variability. Important
as adaptation measures for future
countries?
measures should include the protection
climate change (planning).
of fresh water resources, design of new
water and sanitation systems and the
protection of existing ones taking into
account the expected consequences of
climate change. Drinking-water safety
planning and water quality monitoring
are essential for climate adaptation.
The Pacific Dialogue on Water and
Climate, held in preparation of the
3rd World Water Forum, called for a
change in the paradigm for dealing
35

---

Integrated
water resources
management (IWRM)

---

integr
ated
w
Protecting water resources in Pacific
and agricultural uses in several
ater
resources
islands requires that the activities to
islands. The increased rate of
improve access to safe drinking-water
groundwater abstraction needed
and basic sanitation are sustainable
to meet rapid population growth
management
and protect the diverse and fragile
can jeopardize the sustainable
nature of the islands and their
recharge rate of groundwater in face
(
ecosystems. The best approaches to
of an ever increasing demand. In
iWrm
provide sanitation and drinking-water
addition, inadequate excreta disposal
)
services in each Pacific island need
practices, industrial waste and the
to be based on thorough studies that
use of fertilizers and pesticides
take into account the following major
have contributed extensively to the
aspects: demand and use of water over
contamination of groundwater, surface
time; source availability; competing
water and coastal receiving water vital
demands; environmental and
for food production.
health impacts; population growth;
financial and human resources; and,
Integrated Water Resources
institutional capacity.
Management (IWRM) is a planning
and management approach that is
Most Pacific islands have serious
fundamental to the future sustainable
limitations regarding the availability
management of water resources
and management of sustainable
for the Pacific islands. It is an
freshwater. Groundwater and
instrumental management approach
rainwater represent the only feasible
to tackle existing difficulties and
sources of water for both domestic
37

---

(iWrm)
management
resources
aterw
ated
constraints in a cross-sectoral and
IWRM is a challenge, but in the
effective manner to meet the growing
Pacific island countries it needs to be
integr
water needs of the Pacific islands. It
a fundamental management approach
aims at ensuring the management of
to sustaining their fragile water
both water and land resources through
resources, upon which all life depends.
intersectoral collaboration between
the different government bodies,
multilateral and bilateral agencies,
NGOs, private sector and the civil
society.
38

---

ConverTing CommiTmenT inTo ACTion
x4
Development of a sustainable water supply and waste
BO
treatment system for a coastal Fijian village
This three-year collaborative project supported by New Zealand's International Aid and
Development Agency (NZaid) is devoted to working with coastal Fijian villagers at Votua
on the Coral Coast of Viti Levu to develop sustainable water supply and waste treatment
solutions to protect public health and reduce contaminant loadings to coastal waters.
Deteriorating water quality along the Coral Coast is causing a range of environmental,
health, and economic problems. Expansion of tourist facilities, along with associated
immigration and rapid population growth in Fijian villages (2.7% per year), is causing
increased faecal contamination of coastal waters with great health risks for both the local
community and tourists. Elevated nitrogen concentrations in coastal waters and over-
fishing have increased proliferation of Sargassum macroalgae in the lagoons and fringing
reefs, threatening the sustainability of the reef. The livelihoods of the communities living
along the coast and the sustainability of the local tourist industry are at stake.
The project addresses the water supply, sanitation, human health, hygiene, and
environmental protection needs in coastal village of about 350 people using a
participatory approach.Water quality has been monitored to identify contaminant sources
and assess health and environmental risks. A new water supply and reticulation system
has been successfully implemented in the village in association with an AusAid-funded
climate change adaptation programme. Water meters (household and toilet cistern)
have been used to monitor water usage as well as blackwater and greywater generated
in the village. New greywater treatment and disposal systems have been implemented
in the village using coconut husks as a pre-filter vermiculture system. Blackwater from
the village are being treated in septic tanks linked to a constructed wetland treatment
system. The two stage vertical then horizontal-flow treatment wetland is currently being
integr
built in the valley behind the village where there is available land, and low permeability
clay soils to seal the base of the wetland. Reuse of treated wastewaters for ornamental
ated
flower and fish production is also being implemented as part of the project. Composting
water
toilets are proposed for some of the outlying houses, and improved piggery location,
resources
production facilities and waste management practices have been promoted around the
village. Health and hygiene issues in the village have been evaluated through household
and school visits, women's evening meetings, local clinic and health nurse records, and
management
household diaries.
The project involves three New Zealand agencies, NIWA (National Institute of Water and
(iWrm)
Atmospheric Research), ESR (Environmental Science and Research), and Christchurch
consultancy ecoEng Ltd working in close collaboration with the Institute of Applied
Sciences at the University of the South Pacific. It is funded via the Ministry of Research
Science and Technology through the NZAid Overseas Development Assistance
Contestable Fund.
Source: Tanner, C et al. (2008)
39

---

Looking at the past
and aiming at the future
in sanitation and water
development

---

What happened in the
Pacific island countries Sanitation and drinking-water
service providers face challenging
that prevented
constraints to sustaining drinking-
water and sanitation services
advancing the
provision due to lack of both
human and financial resources.
sanitation and water
This restricts the availability
of experienced staff, sufficient
investment and effectiveness of
cost-recovery.
Looking
agenda?
Sanitation and drinking-water
atthe
Different forums identified the main
services governance is highly
past
constraints that historically hampered
complex due to interwoven social,
and
water development in the Pacific
cultural and legal governance
aiming
islands. Such constraints address
structures and the specific socio-
mainly the broad aspects of water
political and cultural structures
atthe
resources management. The text here
relating to traditional community,
future
is an adaptation of the summary
tribal and inter-island practices,
in
of constraints presented by SOPAC
rights and interests.
sanitation
at the 3rd World Water Forum in
Kyoto 2003 (ADB and SOPAC, 2002)
Although major efforts have
and
expanded to address also specifically
been made to generate strategic
w
sanitation and drinking-water issues:
instruments for the development
ater
development
of water resources management
Small island countries have
in the Pacific Islands, there
uniquely fragile and scarce water
is a lack of specific strategic
resources due to small size, lack
planning to advance the
of natural water storage and
sanitation and drinking-water
vulnerability to natural and
development process, orienting it
anthropogenic hazards. Such
to the achievement of the MDG
resources are severely harmed by
sanitation and drinking-water
inadequate sanitation systems and
target.
uncontrolled water use.
41

---

Major sector initiatives countries. Such commitments were
normally structured under a broad
addressing the Pacific
perspective of water resources
management as a holistic approach
to establish sound and sustainable
islands sanitation and
approaches aimed at preserving the
scarce water resources available
water issues
in Pacific Islands and thus protect
public health. Boxes 5 to 8 in this
report summarize the main strategic
The past few years have seen an
instruments and agreements reached
unprecedented period of discussion
over the past few years.
and high-level strategic commitment
aiming at the advancement of the
An example of such high-level
water agenda in the Pacific island
commitments was provided by the
x5
The Pacific Regional Action Plan
BO
The Pacific Regional Action Plan on Sustainable Water Management (Pacific RAP) was
officially endorsed by 18 countries, 16 at Heads of State level at a high-level regional
consultationinFiji,August2002(ADB,SOPAC,2002).ThePacificRAPprovidesacoordinated
and agreed approach to water resources management and has significantly driven
water up the national and regional agenda. Although it does not deal specifically with
sanitation or drinking-water, it places sanitation as part of a broad strategy of integrated
water resources management, which is crucial to the preservation of fragile ecosystems
and scarce water resources, common to most Pacific islands.
The Pacific Regional Action Plan consists of six thematic categories as follows:
development
ater
Theme 1 ­ Water Resources Management: water resources assessment and
w
monitoring; rural water supply and sanitation; IWRM and catchment
and
management.
Theme 2 ­ Island Vulnerability: disaster preparedness; dialogue on water and
climate.
sanitationin
Theme 3 ­ Awareness:advocacy;politicalwill;communityparticipation;environmental
understanding; gender.
future
Theme 4 ­ Technology: appropriate technologies; demand management and
the
conservation; human resources.
at
Theme 5 ­ Institutional Arrangements: institutional strengthening; policy, planning;
legislation.
aiming
Theme 6 ­ Financing: costs and tariffs; alternative models; role of donor organizations
and
and financing institutes.
past
the
Each theme is addressed by key policy statements and respective actions, including the
at
definition of roles and responsibilities accordingly. Since its development, this coordinated
approach has already proved successful in implementing projects or providing technical
Looking
assistance to Pacific island countries. Many of the partnership activities have also resulted
in increased donor collaboration and harmonization on in-country action plans and
strategies.
Source: SOPAC (2004)
42

---

ConverTing CommiTmenT inTo ACTion
Asia Pacific Water Summit, held
challenges common to many island
from 3 to 4 December 2007 in Beppu
nations.
City, Japan. The Pacific leaders
attending the Summit reiterated their
For the near future, taking into
commitment to effective sanitation
account the world commitments with
and safe drinking-water (Box 8). The
regard to the International Year of
Policy Brief, prepared by the Asia
Sanitation (2008) and the great needs
Pacific Water Forum Secretariat and
in terms of sanitation and drinking-
adopted at the Summit, gives special
water development in this region,
recognition to the isolated nature of
there will be also a need to develop
small island developing states (SIDS)
specific strategic instruments to
and calls for increased regional
advance the sanitation and drinking-
cooperation to share knowledge and
water agenda in the Pacific island
build capacity in order to address
countries.
x6
The Pacific Wastewater Policy and Pacific Framework for Action
BO
A Regional Wastewater Management Meeting was held from 10 to 15 October 2001 in
Majuro, Marshall Islands, sponsored by the governments of Belgium, New Zealand and
Taiwan, China. The meeting was attended by representatives of 15 Pacific island countries
and area (American Samoa, Cook Islands, Federated States of Micronesia, Fiji, Kiribati,
Marshall Islands, New Zealand, Niue, Papua New Guinea, Palau, Samoa, Solomon Islands,
Tonga, Tuvalu and Vanuatu) and various external support agencies to complete the Pacific
Wastewater Policy Statement and the Pacific Wastewater Framework for Action.
Looking
The Vision statement associated with these initiatives is to "Protect the health of the
people and safeguard the fragile islands environment through improved, effective and
atthe
efficient management of wastewater."
past
and
The guiding principles which compose this Framework for Action are the following:
aiming
1.
National wastewater management policies and regulations will be appropriate and
at
acceptable to the people and cultures of the Pacific Islands.
the
2.
Appropriate national institutions, infrastructure and information will support
future
sustainable wastewater management.
3.
Better access to funding will improve service delivery, and develop the private
insanitation
sector.
4.
Community participation in wastewater management and sanitation will ensure
equitable benefit with recognition of socio-cultural sensitivities.
and
5.
Viable and sustainable levels of skilled and knowledgeable people within the
w
wastewater sector and communities will improve wastewater management.
ater
development
Such principles are substantiated by 26 policies covering a broad range of issues, including
sanitation. The Pacific Wastewater Framework for Action converts such policies into a
structured set of 36 crucial actions linked to the above principles and policies.
Source: SOPAC et al (2001)
43

---

x7
The Pacific Framework for Action on Drinking Water Quality and Health
BO
The Pacific Framework for Action on Drinking Water Quality and Health has been endorsed by the Ministers of Health for
the Pacific island countries through the Samoa Commitment (March 2005) and they have recommended this framework for
implementation. The recommendations and actions envisaged in this strategic instrument are structured under the six themes
of the Regional Action Plan (RAP) for Sustainable Water Management (Box 5). The recommendations are:
1.
Protection of water sources such as springs, rivers, groundwater and rainwater catchments from contamination and
overuse must be a priority to ensure quality and quantity.
2.
Technical support should be provided to develop national drinking-water quality standards that are dynamic and
implemented in stages as necessary.
3.
The use of Water Safety Plans should be encouraged in the region, and countries should be supported with manuals,
guidelines and training on the use and implementation of this tool.
4.
Effort should be expanded at regional and national level to assess risks posed by toxic chemicals and pathogens in
drinking-water.
5.
Human resources should be developed for drinking-water safety, including drinking-water quality monitoring, data
management and information systems.
6.
Research should be promoted and supported, and the scientific knowledge base should be strengthened to support the
development of effective, efficient, and equitable policies and plans related to drinking-water quality and health.
7.
Emergency preparedness plans should adequately address drinking-water quality issues, and water safety plans should
address risks posed by potential emergencies.
8.
The fragile environments of very small islands and their role in managing source water quality and quantity should be
respected and protected.
9.
Human resources should be developed to strengthen countries' capacities for raising community awareness related to
water quality and health risks, source water protection, household-level water treatment and safe storage.
10. Community awareness and community-based action programmes on safe water supply and sanitation should be
developed and expanded in rural and remote areas and in urban areas alike (e.g. Healthy Islands Programme, etc.).
11. Community-based water quality testing and source-protection programmes should be supported in rural and remote
areas as well as in urban areas.
12. Government awareness should be raised and political commitment should be strengthened to support actions for safe
development
water supply and sanitation.
ater
13. Technical assistance and training should be provided for strengthening drinking-water quality management (including
w
monitoring, operation, calibration and maintenance of any related equipment).
and
14. Adequate equipment for drinking-water quality management (particularly field test kits for remote areas, hardware/
software for data management) should be provided.
sanitation
15. Research should be supported to develop appropriate field-test kits for use in remote and rural areas.
in
16. Adequate equipment for water and wastewater treatment should be provided.
17. Rainwater harvesting programmes should be supported by improving water quality through approaches such as "first-
future
flush" devices and community-based water quality testing.
theat
18. National and regional partnerships should be built to develop standards and guidelines and legislation in order to ensure
provision of safe drinking-water, and to establish national water quality committees that could oversee development of
aiming
water safety plans.
and
19. Communication and information exchange between agencies involved with water quality data collection should be
strengthened. This should include exchange and joint analysis of drinking-water quality data and disease surveillance data
past
between water supply agencies and health authorities.
theat
20. Governments should, as a priority, develop and implement appropriate financial mechanisms to support sustained
supplies of safe drinking-water and sanitation services to both rural and urban communities to fulfil the MDG target on
Looking
water and sanitation.
21. External agencies should be encouraged to support specific activities in the region where governments are unable to
sustain provision of safe drinking-water and sanitation services.
Nearly one hundred actions addressing the above recommendations were formulated as part of this framework.
Source: WHO/WPRO (2005)
44

---

ConverTing CommiTmenT inTo ACTion
What comes next?
At the same time that the sanitation
Drinking-water is also a major issue
and drinking-water agenda is
in the Pacific island countries as this
comprised in existing comprehensive
is one of the few regions in the world
water resources management
where the MDG drinking-water target
initiatives, there is a lack of strategic
will not be achieved, if the trend of the
Looking
instruments to address specifically
past years continues up to 2015.
basic sanitation, safe drinking-water
atthe
and hygiene needs in the Pacific
Although this document is not
past
island countries. The Pacific Regional
intended to be prescriptive with
Action Plan (Box 5) is currently the
regard to specific measures to address
and
overarching strategic framework,
the huge sanitation and drinking-
aiming
which is viewed as a coordinating
water challenges in the Pacific island
instrument, grouping other major
countries, the following can be viewed
atthe
initiatives into a coherent framework
broadly as a recommended way
future
for integrated water resources
forward:
management in the region. Current
in
active initiatives include the Pacific
1. Make use of the Asia Pacific
sanitation
Wastewater Policy Framework and
Water Summits, of which the first
Pacific Framework for Action (Box 6)
one organized by the Asia Pacific
and
and the Pacific Framework for Action
Water Forum was held in Beppu
w
on Drinking Water Quality and Health
in 2007 (Box 7), with the second
ater
(Box 7). Although such instruments
one planned for Singapore in
development
address major water and wastewater
2010. These high-level discussion
issues, they are not intended to
platforms are crucial occasions
address specifically approaches and
to mobilize political support
technologies dealing with affordable
for strategic actions required
and appropriate excreta management
to achieve the MDG sanitation
options which might be the only
and drinking-water target in the
feasible alternative to make it possible
Pacific island countries, under the
the achievement of the MDG
framework of the Pacific Plan.
sanitation target in this Region.
45

---

2. Implement a sound sanitation
and drinking-water monitoring
and evaluation system for the
Pacific island countries, capable
of collecting, analyzing and
disseminating population-
based information on access to
sanitation and drinking-water
in close collaboration and
consultation with the WHO
and UNICEF Joint Monitoring
Programme for Water Supply
and Sanitation (JMP). Such a
system should provide recurrent
information on the following:
access to sanitation and drinking-
water services; drinking-water
quality; hygiene behaviours;
water-related diseases.
3. Revise the existing strategic
instruments addressing the
expansion and improvement of
access to sanitation and drinking-
water services in the Pacific island
countries, taking into perspective
the Pacific Regional Action
Plan, and make the required
adjustments conducive to the
attainment of the sanitation and
drinking-water MDG target.
4. Promote and support the inclusion
development
of national drinking-water
aterw
safety plans into the national
and
development planning process
for the Pacific island countries
as a crucial measure to improve
sanitation
drinking-water quality generated
in
by the existing and future islands
future
water supply systems.
the
5. Promote the establishment of
at
national sanitation, hygiene and
drinking-water assessments under
aiming
the framework of the Pacific
and
Regional Action Plan (Pacific
past
RAP) taking into account the
the
need to conduct such assessments
at
within the perspective of
sustainable integrated water
Looking
resources management. Such
assessments should provide
valuable insights into the current
national planning processes
throughout the Pacific islands.
46

---

ConverTing CommiTmenT inTo ACTion
Box 1 Message from Beppu
x8
Message from Beppu
BO
The Pacific leaders attending the First Asia-Pacific Water Summit organized from 3 to 4 December 2007 in Beppu City, Japan
reiterated their commitment to effective sanitation and safe drinking water. Ten heads of state, 31 ministers, and representatives
from 36 countries committed to the following:
We, the leaders of the Asia-Pacific, coming from all sectors of our societies and countries, meeting at the historic inaugural Asia
Pacific Water Summit, in the beautiful city of Beppu, in the hospitable Oita Prefecture of Japan, do hereby agree to:
y
Recognise the people's right to safe drinking water and basic sanitation as a basic human right and a fundamental aspect
of human security;
y
Reduce by half the number of people who do not have access to safe drinking water by 2015 and aim to reduce that
number to zero by 2025;
y
Reduce by half the number of people who do not have access to basic sanitation in our region by 2015 and aim to reduce
that number to zero by 2025, through the adoption of new and innovative sanitation systems that are not as water reliant
as current methods;
y
Accord the highest priority to water and sanitation in our economic and development plans and agendas and to increase
substantially our allocation of resources to the water and sanitation sectors;
y
Improve governance, efficiency, transparency and equity in all aspects related to the management of water, particularly
as it impacts on poor communities. We recognise that while women are particularly vulnerable, they are also resilient and
entrepreneurial, hence, should be empowered in all water-related activities;
y
Take urgent and effective action to prevent and reduce the risks of flood, drought and other water-related disasters and
to bring timely relief and assistance to their victims;
y
Support the region's vulnerable small island states in their efforts to protect lives and livelihoods from the impacts of
climate change;
Looking
y
Exhort the Bali Conference to take into account the relationship between water and climate change, such as the melting
of snowcaps and glaciers in the Himalayas and rising sea levels, which are already having an impact on some countries
at
in the region;
the
y
Establish concrete goals for the 2008 Toyako G8 Summit to:
past

commit to support the developing countries to achieve their MDG targets on water and sanitation; and
and

take immediate action to support adaptation to climate change by developing countries;
aiming
y
Empower a high-level coordinating mechanism in our cabinets and where possible, appoint a minister in charge of water
to ensure that all issues related to water and sanitation would be dealt with in a holistic manner;
at
y
Respect and strengthen the region's rich history of water-centered community development, including the rehabilitation
the
of urban waterways and protecting the environmental integrity of rural watersheds;
future
y
Work together with other like-minded institutions, entities and individuals in order to achieve our collective vision of
in
water security in the Asia Pacific region.
sanitation
We will support the Policy Brief as prepared by the Asia Pacific Water Forum family.
and
We encourage all governments to make all efforts to implement its recommendations.
water
development
We have the will and courage to realise our vision.
Source: APWF (2007)
47

---

What can WHO do to
strengthen the sanitation
and drinking-water
agenda in the Pacific
Islands?

---

TAble 4 The work of the WHO Western Pacific Regional Office in sanitation, drinking-water and hygiene
Area
Description
Promotion of
The main focus is to highlight the basic right of all citizens to health protection through access to safe
and advocacy
water supply, basic sanitation, and good hygiene behaviours. WPRO has been a major partner of relevant
for access to
water supply
multilateral and bilateral agencies in organizing crucial high-level events and facilitated major international
and sanitation
commitments with this regard (e.g. East Asia Ministerial Conference on Sanitation and Hygiene (EASAN),
services
Ministerial Conference on Health and Environment, etc).
Drinking-water
Drinking-water quality standards: support to countries in training and preparation of their own drinking-
quality
water quality standards in light of the WHO Guidelines for Drinking-Water Quality.
Water Safety Plans (WSPs): support to countries in training and preparation/implementation of WSPs.
Household Water Treatment and Safe Storage (HWTS): promotion, training and support to formulation
and implementation of HWTS plans at country level.
Sector
National sector assessments: support countries in establishing national sector assessment processes and
information
preparing national sector assessment reports;
National sector monitoring: support to the implementation of national information systems aimed at
collecting, analysing and disseminating drinking-water and sanitation coverage data according to the JMP
methodology.
What
Health care
The WHO Western Pacific Regional Office provides guidance and support to countries in sound
can
waste
management of health care waste, including alternatives to incineration. Although this is crucial to all
WH
countries, it is even more crucial to Pacific islands, where aquifers are highly susceptible to contamination by
odo
chemicals or micro-organisms from inadequate management of hazardous waste.
tostrengthen
Water supply
The work of the WHO Western Pacific Regional Office in this area is focused mainly on preparedness and
and sanitation
prevention, support to drinking-water quality improvement in emergency areas and technical advice during
in emergencies
the
and disasters
and after emergencies.
sanitation
Normative
The WHO Western Pacific Regional Office prepares norms and guidelines and adapts global documents
aspects and
according to the especial needs of the WPR's countries. Training in the different areas are also organized and
and
training
imparted by the Western Pacific Regional Office based on expressed needs of Member States.
drinking-w
ater
The basic aim in the Pacific Islands
Action ­ Water for Life, and in line
agenda
of the WHO Western Pacific
with the efforts of the International
Regional Office is to pursue efforts to
Year of Sanitation.
inthe
improve and protect health through
P
promotion and support to provision
In coordination with WHO
acific
of sustainable access to safe drinking-
Headquarters and in collaboration
islands?
water supply, basic sanitation services
with key partners, the WHO Western
and sound hygiene behaviours to
Pacific Regional Office provides
the poor and unserved, according to
support to the advancement of action
the international commitments for
on the different aspects of sanitation,
the attainment of the Millennium
drinking-water and health as indicated
Development Goals, the Decade for
in Table 4.
49

---

SOPAC work and
priorities in the Pacific

---

The Pacific Islands Applied
Water and Climate Resource Centre.
Geoscience Commission (SOPAC)
The focus is on capacity building and
is an intergovernmental, regional
wise practice promotion.
organisation with 21 member
countries, including 15 Pacific island
Sanitation and drinking-water
countries and territories: Cook Islands,
services are addressed by the Asset
Federated States of Micronesia, Fiji,
Management component (CLP2)
Guam, Kiribati, Nauru, Niue, Palau,
and include drinking-water supply
Papua New Guinea, the Marshall
and wastewater disposal asset
Islands, Samoa, Solomon Islands,
management. Regional programmes
Tonga, Tuvalu and Vanuatu, including
have been established on drinking-
Australia and New Zealand, as well
water quality monitoring (WQM),
as four associate members: American
drinking-water safety planning (WSP),
Samoa, French Polynesia, New
water demand management (WDM),
Caledonia and Tokelau. SOPAC's
rainwater harvesting (RWH) and, in
work is carried out through its
general, the sustainability of water
Secretariat, based in Suva, Fiji.
and wastewater technologies for both
urban and rural systems.
SOPAC provides applied scientific
SoP
and technical support, guidance
The Governance component (CLP3)
ACwork
and advice to member countries in
pulls together a number of different
three technical programme areas:
areas which together attribute to
and
priorities
Community Lifelines, Ocean and
better institutional arrangements
Islands, and Community Risk. The
in the water sector. These include
in
water sector under the SOPAC's
national level policies, plans and
the
Community Lifelines Programme
strategies; institutional instruments
Pacific
(CLP) has a structure consisting
such as legislation and institutional
of Resources Management, Asset
strengthening; multi-stakeholder
Management and Governance. For the
national water partnerships; IWRM
water sector, these translate into water
and catchment level management;
resources management (CLP1), which
community level water governance;
includes rainwater, surface water and
awareness raising and education
groundwater resources assessment,
initiatives; and advocacy for
development, management and
community participation and gender.
protection, with a particular emphasis
The Governance component also
on water resources management in
includes regional and global high-
climatic extremes. This component
level advocacy and awareness with
includes climate adaptation with
SOPAC playing a coordinating role as
regard to water resources issues.
facilitators of the Pacific Partnership
Initiative on Sustainable Water
Main programme results are the
Management which involves national
Pacific Hydrological Cycle Observing
stakeholders and external support
System (HYCOS), the Pacific Island
agencies in the region.
Climate Update (ICU) and the Pacific
51

---

---

Bibliographic references
ADB and SOPAC (2002) Pacific regional action plan on sustainable water
management. Endorsed at the Regional Consultation Meeting in Sigatoka, Fiji
from 29 July to 3 August 2002.
Asia-Pacific Water Forum (APWF) (2007) Message from Beppu - Ministerial
Conference on Sanitation and hygiene, Beppu December 2007. http://www.apwf.
org/project/result.html
Bates, B.C., Kundzewicz, Z.W., Wu, S., Palutikof, J. (2008) Climate Change and
Water. Technical Paper of the Intergovernmental Panel on Climate Change, IPCC
Secretariat, Geneva.
Bower, R, Crennan, L, Navatoga, A. (2005) The sanitation park project. Fiji,
SOPAC (SOPAC Technical Report No. 386)
Forum Pacific Islands Secretariat (2008) The Pacific Islands Forum and its
Secretariat (http://www.forumsec.org.fj/pages.cfm/about-us/)
Bibliogr
GWP (2005) GWP Policy Brief 5 on Climate Change Adaptation. Global Water
aphic
Partnership, Stockholm.
references
Lenton R, Wright A, Lewis K. (2005) Health, dignity and development: what will
it take? Water and Sanitation Task-force for the Millennium Project.
Prüss-Üstün A et al. (2008) Safer water, better health: costs, benefits and
sustainability of interventions to protect and promote health. World Health
Organization, Geneva.
SOPAC (2004a) Pacific brief for the report of the secretary-general to CSD 13 ­
views from national and regional consultations and initiatives. Suva, Fiji Islands,
SOPAC.
SOPAC (2004b) Water and sanitation issues and strategic responses in the pacific:
Pacific brief for the report of the Secretary-General to CSD 13. Fiji (unpublished).
SOPAC (2006) Pacific position paper in preparation of the 4th World Water
Forum ­ final report. SOPAC, Fiji. (http://www.sopac.org/tiki-download_file.
php?fileId=515)
SOPAC et al. (2001) Pacific wastewater ­ a framework for action. Finalized at
the Regional Wastewater Management Meeting, Majuro, Republic of Marshall
Islands, 2001.
53

---

Tanner, C et al. (2008) Development of sustainable water supply and waste
treatment systems for a coastal Fijian village. National Institute of Water and
Atmospheric Research (NIWA), Hamilton, New Zealand.
UN Water (2008a) Sanitation: a wise investment for health, dignity, and
development ­ Key Messages for the International Year of Sanitation. (http://
www.wsscc.org/fileadmin/files/pdf/WASH_advocacy_materials/IYS/Key_
messages_booklet.pdf)
UN Water (2008b) Tackling a global crisis ­ International Year of Sanitation
2008. (http://esa.un.org/iys/docs/IYS_flagship_web_small.pdf)
Howard G, Bartram B, (2004) Domestic water quantity, service level and health.
Geneva, World Health Organization.
WHO (2006) Guidelines for drinking-water quality. First addendum. Vol. 1,
Recommendations. ­ 3rd ed. Geneva, World Health Organization.
WHO (2008a) Table extracted from WHO database concerning 2002 statistics.
World Health Organization (unpublished).
WHO (2008b) World Health Statistics 2008. World Health Organization,
Geneva.
WHO, UNICEF (2004a) WHO and UNICEF Joint Monitoring Programme for
Water Supply and Sanitation ­ Policies and Procedures. Geneva, World Health
Organization (unpublished).
WHO, UNICEF (2004b) Meeting the MDG drinking water and sanitation target
references
- a mid-term assessment of progress. Geneva, World Health Organization.
aphic
WHO, UNICEF (2006) Meeting the MDG drinking water and sanitation target:
Bibliogr
the urban and rural challenge of the decade. Geneva, World Health Organization.
WHO, WMO, UNEP (2003) Climate change and human health - risks and
responses. Geneva, World Health Organization.
WHO/SEARO (2008) Regional Framework for action to protect human health
from effects of climate change in the South East Asia and Pacific Region. (http://
www.searo.who.int/en/Section260/Section2468_14335.htm)
WHO/WPRO (2005) Pacific framework for action on drinking water quality and
health. Finalized at WHO Regional Workshop on Drinking Water Standards and
Monitoring in Pacific Island Countries held at Fiji, February 2005.
WMO, UNEP (2007) Climate change: synthesis report. (http://www.ipcc.ch/pdf/
assessment-report/ar4/syr/ar4_syr_spm.pdf)
World Health Organization and United Nations Children's Fund Joint
Monitoring Programme for Water Supply and Sanitation (JMP) (2008) Progress
on Drinking Water and Sanitation: Special Focus on Sanitation. UNICEF, New
York and WHO, Geneva, 2008.
54

---

Annexes
Annex 1 Sanitation coverage in the Pacific island countries, 1990 and 2006...................................56
Annex 2 Drinking-water coverage in the Pacific island countries, 1990 and 2006...........................57
Annexes
55

---

Annexes
Annex 1 Sanitation coverage in the Pacific island countries, 1990 and 2006
Sanitation coverage (%)
Population (thousands)
Total
Urban
Rural
Unimproved
Unimproved
Unimproved
Pacific island countries
Year
oved
oved
oved
oved
oved
oved
oved
ation
ation
oved
oved
ation
Total
Urban
Rural
impr
ed
ec
ed
ec
ed
ec
unimpr
impr
unimpr
impr
Shar
unimpr
def
Shar
unimpr
def
Shar
unimpr
def
Total
unimpr
Total
Total
Total
Total
Other
Open
Other
Open
Total
Other
Open
1990
16873 14410
2463
100 0
0
0
0
100
0
0
0
0
100
0
0
0
0
Australia
2006
20530 18146
2384
100 0
0
0
0
100
0
0
0
0
100
0
0
0
0
1990
3411
2890
521
88
12
new Zealand
2006
4140
3573
567
1990
18
10
7.5
96
4
100
0
0
0
0
91
9
Cook Islands
2006
14
10
3.5
100
0
0
0
0
100
0
0
0
0
100
0
0
0
0
1990
724
301
423
68
32
87
13
55
45
Fiji
2006
833
428
405
71
29
87
13
55
45
1990
72
25
47
22
78
4
17
57
26
74
7
26
41
20
80
2
13
65
Kiribati
2006
94
48
46
33
67
8
12
47
46
54
13
0
41
20
80
2
25
53
1990
47
31
17
75
25
88
12
51
49
Marshall Islands
2006
58
39
19
Micronesia, Federated 1990
96
25
71
29
71
54
46
20
80
States of
2006
111
25
86
25
75
61
39
14
86
1990
9.2
9.2
0
nauru
Annexes
2006
10
10
0
1990
2.3
0.7
1.6
100 0
0
0
0
100
0
0
0
0
100
0
0
0
0
niue
2006
1.6
0.6
1.0
100 0
0
0
0
100 0
0
0
0
100 0
0
0
0
1990
15
4.7
10
61
39
76
24
54
46
Palau
2006
20
6.9
13
67
33
96
4
52
48
1990
4131
543
3588
44
56
2
36
18
67
33
10
19
4
41
59
1
38
20
Papua new Guinea
2006
6202
835
5367
45
55
2
36
18
67
33
10
19
4
41
59
1
38
20
1990
161
34
127
98
2
100 0
0
0
0
98
2
Samoa
2006
185
42
143
100 0
0
0
0
100 0
0
0
0
100
0
0
0
0
1990
314
43
271
29
71
98
2
18
82
Solomon Islands
2006
484
83
401
32
68
98
2
18
82
1990
95
22
73
96
4
98
2
96
4
Tonga
2006
100
24
76
96
4
98
2
96
4
1990
9.5
3.9
5.6
77
23
83
17
74
26
Tuvalu
2006
10.5
6.1
4.4
90
10
93
7
84
16
1990
149
28
121
Vanuatu
2006
221
53
168
1990
5843
1081
4762
49
51
2
33
16
76
24
6
13
5
43
57
1
38
18
Total*
2006
8344
1611
6733
48
52
2
34
16
75
25
6
15
4
42
58
1
39
18
*The statistics for Australia and New Zealand were excluded from totals
56

---

ConverTing CommiTmenT inTo ACTion
Annex 2 Drinking-water coverage in the Pacific island countries, 1990 and 2006
Drinking-water coverage
Population (thousands)
Total
Urban
Rural
(%)
(%)
(%)
(%)
(%)
(%)
(%)
tion
(%)
tion
(%)
tion
Pacific island countries
Year
oved
oved
oved
oved
oved
oved
Total
Urban
Rural
connec
connec
connec
impr
unimpr
impr
unimpr
impr
unimpr
Total
Total
Total
Total
Total
Total
Household
Household
Household
1990
16873
14410
2463
100
0
100
0
100
0
Australia
2006
20530
18146
2384
100
0
100
0
100
0
1990
3411
2890
521
97
3
100
0
100
82
18
new Zealand
2006
4140
3573
567
100
0
100
1990
18
10
7.5
96
4
99
1
87
13
Cook Islands
2006
14
10
3.5
96
4
98
2
88
12
1990
724
301
423
48
52
17
43
57
32
51
49
7
Fiji
2006
833
428
405
47
53
20
43
57
32
51
49
7
1990
72
25
47
48
52
24
76
24
46
33
67
13
Kiribati
2006
94
48
46
65
35
36
77
23
49
53
47
22
1990
47
31
17
96
4
95
5
97
3
Marshall Islands
2006
58
39
19
96
4
Micronesia,
1990
96
25
71
88
12
93
7
86
14
Federated States of
2006
111
25
86
95
5
95
5
94
6
Annexes
1990
9.2
9.2
0
nauru
2006
10
10
0
1990
2.3
0.7
1.6
100
0
100
0
100
100
0
niue
2006
1.6
0.6
1.0
100
0
100
0
100
100
0
1990
15
4.7
10
88
12
73
27
98
2
Palau
2006
20
6.9
13
88
12
79
21
94
6
1990
4131
543
3588
39
61
11
88
12
61
32
68
4
Papua new Guinea
2006
6202
835
5367
40
60
12
88
12
61
32
68
4
1990
161
34
127
91
9
99
1
89
11
Samoa
2006
185
42
143
88
12
90
10
87
13
1990
314
43
271
69
31
11
94
6
76
65
35
1
Solomon Islands
2006
484
83
401
70
30
14
94
6
76
65
35
1
1990
95
22
73
100
0
100
0
100
0
Tonga
2006
100
24
76
100
0
100
0
100
0
1990
9.5
3.9
5.6
91
9
92
8
89
11
Tuvalu
2006
10.5
6.1
4.4
92
8
94
6
92
8
1990
149
28
121
60
40
38
93
7
80
53
47
28
Vanuatu
2006
221
53
168
1990
5843
1081
4762
47
53
14
76
24
53
40
60
5
Total*
2006
8344
1611
6733
46
54
13
76
24
53
39
61
4
*The statistics for Australia and New Zealand were excluded from totals
57

---

Photo credits: © Marc Overmars, SOPAC

---

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World Health
Organization
Western Pacific Region
Pacific Islands Applied Geoscience Commission
United Nations Avenue, 1000 Manila, Philippines
Private Mail Bag, GPO, Suva, Fiji
www.wpro.who.int
www.sopac.org

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