Intent to Impact – Diluted Safe Water Monitoring

Abstract

In early 2012, the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) made an important announcement: “The world has met the Millennium Development Goal (MDG) target of halving the proportion of people without sustainable access to safe drinking water, well in advance of the MDG 2015 deadline” (WHO/UNICEF, Millennium development goal drinking water target World Health Organization. United Nations Children’s Fund, Geneva, 2012a). Major news organizations heralded the accomplishment. The editors of The Lancet used the occasion to draw attention to underachievement other MDG targets but still acknowledged the water announcement as “some good news to celebrate” (The Lancet, Lancet 379(9820):978. doi:10.1016/S0140-6736(12)60412-7, 2012). There was little celebrating, however, among many who work at the intersection of water and health. This is because the way progress is measured on the MDG water target—by counting those that have access to “improved water supplies”—does not fully address water quality, quantity and sustainable access—key components of the target that are fundamental to human health. Overly simplistic metrics used to monitor progress on important health and development goals can be misleading. Monitoring that relies on poor indicators can exaggerate progress. Even worse, however, inadequate assessments of environmental health interventions can undermine the proper allocation of scarce resources to where they can best advance the intended goals. This chapter describes how existing monitoring of water supplies in low-income settings fails to address the key health-based conditions that the MDG water targets sought to encourage. Its aim is to use the inadequacy of international water monitoring as a case study to demonstrate the critical need to carefully align targets with conditions that are most likely to advance the overall goals, and the potential consequences of failing to do so.