“When the well runs dry, we know the worth of water.
—Benjamin Franklin, 1746

Current Problem
1.4 billion people lack access to clean drinking water; 2.4 billion lack adequate sanitation facilities.

Preferred State/What the World Wants
Abundant supplies of clean, affordable water plus healthy sanitation facilities for 100% of humanity.

Like food, water is essential to life. Judging by the length of time you can do without either of the two, water is the more precious (you can live without food for a number of weeks; without water you are dead within days).

The global water situation has three interrelated facets: shortages, safety, and sanitation. Nearly 450 million people in 29 countries face a shortage of water (1). One billion are without access to safe drinking water, and 2 billion lack a sanitary way of disposing of human wastes (2). In addition, water is intimately related to health, malnourishment, poverty, and environmental health. For example, lack of access to clean, safe and affordable water and sanitation results in over 4 billion cases of diarrhea each year (3) that result in 1.7 to 2.2 million deaths (4), 90% of which are to children under five years of age.(5) Poor and malnourished people in rural areas often do not have enough access to water to either grow enough food to insure their adequate nourishment, or to increase the productivity of their food production systems so that they have a surplus and can therefore pull themselves out of poverty. For the vast majority of the poor people in the world who do not have access to adequate supplies of water (and access to water is a poverty issue— the rich, no matter where they are, have no problem obtaining water, or for that matter, food, energy, health care, etc.), the issue is not one of water resources or supply, but of access to the capital to obtain the technology needed to make the available water readily accessible.



On the positive side, the percentage of the world’s population with access to clean water supplies increased from 79 percent (4.1 billion) in 1990 to 82 percent (4.9 billion) in 2000.(6) At this rate of improvement it will take more than 70 years to get everyone in the world access to clean water. Meanwhile, millions will die—mostly in Africa and Asia.

As the Table below makes clear, the lack of access to safe water and sanitation results in ove 4 billion of cases of water-related diseases, and more than 2 million deaths, every year. Accompanying these diseases and deaths are large but poorly quantified adverse impacts on economic productivity.


Insufficient investment in water infrastructure over the past several decades has left almost 20 percent of the world’s people without access to safe water and 40 percent without adequate sanitation facilities. (7) Water supplies in much of the developing world are polluted due to contamination with untreated sewage (because sanitation systems are lacking or inadequate), chemical discharges, or agricultural chemicals that run off or seep down to water tables.(8)

Water Availability by Region, 2001 (1,000 M3 per capita/year)


Water Strategy 1: Develop Clean Water Infrastructure
On the supply side, a global campaign to create and upgrade infrastructure for clean water and sanitation would address problems such as water-related disease and pollution—and others. Providing training, materials, and organizational infrastructure for the local installation of the needed wells, water and sewage pipes; sanitation facilities; and water testing and purifying systems would boost employment levels throughout the developing nations; many people would gain useful skills and long-term jobs building and maintaining the new systems.

Such systems could supply water from protected springs, shallow wells, cisterns (rainwater collection containers), and tube wells with hand pumps, deep-dug wells, gravity systems, solar-powered pumped systems, or a combination of some or all of these. The systems would be locally built, staffed, and controlled, thereby building local capacity and insuring the systems’ ongoing operation. (Local control, where users are directly involved in making investment and pricing decisions, and therefore have a higher stake in outcomes, are more likely to use the resource wisely and demand higher quality service.(9)

Programs that involve the local population and provide tools and education for tapping into subterranean water tables have proven to be highly effective in rural regions of the developing world. A joint program of the Indian government, UNICEF, and local non-governmental organizations to equip communities with 2.2 million hand pumps succeeded in supplying water to more than 550 million Indians at an annual cost of $4.00 per person. Rural India’s access to potable water rose from 30 percent in 1980 to 80 percent in 1992 as a result of this program.

Likewise, urban access to clean and affordable water and sanitation facilities can be best enlarged, managed, and maintained through the use of neighborhood organizations and civic groups. Making water available to an urban district via a central water pipe and the neighborhood responsible for getting household connections installed as well as the metering and payment for the water used has a much higher chance of staying maintained. Local control of the connections to a public sewer or septic system for the sanitary disposal of wastes has similar positive results.

Water systems vary greatly in cost, depending on the level of involvement of the people being served. The more local communities are involved, the lower the short-term costs and the higher the long-term sustainability of the entire project—and the greater the benefits in building community capacity to deal with other local needs such as road construction, market centers, and schools for the community.(10)

Costs to install clean water and sanitation systems in developing regions range widely from less than $5.00 per person served to close to $100.(11) Other estimates put the cost of providing just clean water as high as $150 per person and that for providing sanitation at $50 per household.(12) The most recent field experience demonstrates that the cost of safe and reliable water supply and sanitation services in urban areas to be $35 to $50 per person and less than this in rural areas.(13) (Centralized water systems that provide clean water and sanitation in developed regions typically run $500 per person. (14))

The lowest cost figure ($5.00 per person) would result in a total required expenditure of $10 billion to meet the needs of all the people in the world who currently do not have access to clean water and sanitation. Using the highest figures would result in a total expenditure of $175 billion.(15)

Using the high end of the most recent field experience figures ($50 per person) as the benchmark, a worldwide program to provide clean water infrastructure would take an investment in materials, training, and water delivery and sanitation programs of $10 billion per year for 10 years. Such an investment would insure that all of the world’s people are provided with enough clean water and sanitation facilities to meet their needs for drinking, cooking, bathing, and waste disposal.

Water Strategy 2: Improve Efficiency of Water Use
More than half the fresh water used in the world on a daily basis today could be saved. The largest users could potentially realize the biggest gains in efficiency. For example, agricultural irrigation consumes 70 percent of the world’s fresh water (81 percent in the U.S.).(15) (17) The world’s irrigated land—some 270 million hectares—is highly productive, supplying about 40 percent of the world’s food on less than 20 percent of the arable land.(18) But over 90 percent of this land is irrigated by the least efficient, most wasteful water delivery technique: flooding.

More efficient irrigation techniques include drip irrigation and micro-sprinklers--which instead of flooding fields and ditches, deliver water a drop at a time to plant roots where it is needed—and avoiding irrigation during the daytime, when water loss from evaporation is at its peak. Replacing flooding with such techniques could save more than 70 percent of the water used in irrigation. In some instances, water savings exceeding 95 percent have resulted from the use of drip irrigation.(19),(20)

Just a small fraction (less than 1 percent) of these huge savings would make more than enough water available to meet the needs of all the people in water-short areas—as well as increasing the amount of irrigated land in the world by 40 to 50 percent. It’s easy to see how tightly joined are water and food issues: the increased productivity from these additional irrigated lands could produce enough food for another 2 to 4 billion people over the world’s current population, depending on how it is used. “Leftover” water (the water saved from previous use patterns) could be used to recharge groundwater that has been historically depleted at unsustainable rates.

Low-cost equipment to monitor soil moisture is already saving one-third to two-thirds of all irrigation water without loss of crop yields in places that have implemented this approach. This strategy has the added benefits of reducing pumping costs, soil erosion, and chemical runoff. (21)

Making the transition to more efficient irrigation practices will require an investment in technology. To provide incentives for that investment, water needs to be priced more accurately to reflect its worth or replacement value. For example, in the 1980s in California’s Central Valley, irrigation water cost $3.50 per acre-foot (an acre of land covered with one foot of water). According to a U.S. Department of Agricultural study of the same period, the cost should have been $1,100 to reflect the true, unsubsidized cost of this water.(22) Today, this price should be at least twice this to just reflect inflation (not including depletion or increased needs elsewhere in society). The cost of irrigation water in the late 1990s in California for most farmers was still $20 or less per acre-foot.(23)

Once the cost of water was at economically rational level, the overall cost of a water conservation program could be borne by its beneficiaries. To accelerate the transition, a worldwide program to increase water efficiency in agriculture would be subsidized at $2 billion per year for ten years. The amount would also be used to finance increases in the amount of irrigated land worldwide, as described in the Food for All strategy. One way the water conserving irrigation program could be done is through micro-loans to small farmers, especially those in sub-Saharan Africa.

Other large users of water, from industry to homes, can make similar gains in water use efficiency. Water-intensive industrial processes need to be replaced. With more accurate pricing of water and other incentives, this can happen quickly. Households can cut their water use by 20 percent to 70 percent through the use of low-flow or composting toilets, low-flow showerheads, and aerators. For example, the amount of water needed by toilets in the U.S. has been reduced in the last twenty years by close to 75 percent as new efficiency standards have come into force.(24)

It’s encouraging that despite enormous growth, the entire U.S economy used less water for all purposes in 1999 than it did in 1980. Many additional increases in water use efficiency are possible. Both industry and households can increase their water use efficiency through the use of cisterns to catch rainwater and grey water for toilet flushing and other functions that do not require pure water.

Addressing leakage is another strategy for water efficiency. Most urban areas throughout the world are losing 10 to 50 percent of their water supply to leakage; the average U.S. city loses 25 percent.(25) Mexico City’s water system loses 1.9 billion cubic meters of water every year due to leakage; when it replaced 350,000 leaky toilets with more efficient ones, it saved enough water for 250,000 people’s needs.(26) An investment in repairing leaks, purchasing new pipes and maintaining existing and new pipe structures would pay for itself in conserved water in a few years in nearly every city in the world. Both New York City and Boston have saved hundreds of millions of gallons of water (close to 25 percent of total annual water use for Boston) through leak repair and other efficiency improvements. Jerusalem reduced its annual consumption of water by 14 percent from 1989 to 1991 simply by instituting a leak detection and repair system.

Costs and Benefits
Together, the proposed initiatives for Clean Water Infrastructure and Water Efficiency would cost the world $12 billion per year for ten years. This is about 34 percent of what is spent worldwide on bottled water, (27) 1.3 percent of the world’s total annual military expenditures, or about 6 percent of what is being spent on illegal drugs in the world each year.(28) It is also 10 percent of what the U.S. spends per year on alcohol.(29)

water for all

The potential benefits are far-reaching. With adequate water supplies and sanitation, productivity would rise on farms as frequent time-consuming trips for water are eliminated, and across societies, as debilitating water-borne diseases are reduced or eliminated as major health perils. A recent study by the UNDP disclosed that women in the developing world spend more than 40 billion hours per year collecting water.(30) Valuing this time at $1.00 or even 50¢ per hour covers the cost of this strategy in a few months.

Universal access to clean water would save several million lives and avoid serious illnesses in at least 500 million people each year.(31) Assuming that providing clean water resulted in saving one million lives per year, and each of those lives were valued at the U.S. rate of $6 million, the total savings to the world would be $6 trillion per year. Even if we lower the value of a life to $1 million per person, as we did in analyzing the costs and benefits of the Food for All strategies, the resulting value to the global economy would drop to a “mere” $1 trillion, with a payback on investment of less than 5 days.(32) Lowering it still further to $100,000 would generate $100 billion and result in a payback time of about 37 days. And a monetary value on a human life of $10,000 would pay back the entire investment in one year.

Another way of counting the value of a human being and the loss to society from their death or impairment from disease is a UN-devised measuring device called “disability-adjusted life years (or DALYS). This seeks to measure the burden of disease a society bears— measuring the number of years of healthy life lost to illness. One study estimates the loss due to just diarrhoeal diseases as between 40 million and 80 million disability-adjusted life years.(33) Valuing the life of a person at an absurdly low level of $500 (the annual income of a poor person in a poor country) gives us the cost to society of up to $40 billion.(34) A $12 billion investment to eliminate a $40 billion cost would seem like a return on investment worthy of serious consideration. Given that this study only pays attention to diarrhoeal diseases, the return on an investment in clean water and sanitation would be much higher.

Given adequate food, water, and sanitation, the foundations for spectacular gains in human health and well-being are in place. As you will see in other strategies found here, there are additional ways for improving human health that can also bring huge economic rewards.

“At any given time, close to half the population in the developing world are suffering from one or more diseases associated with inadequate provision of water and sanitation services…”

“One flush of a standard U.S. toilet requires more water than most individuals, and many families, in the world use for all their needs in an entire day.”
— Paul Hawken, Amory Lovins, and Hunter Lovins

When drinking water, think of its source.
— Chinese proverb

"Thousands have lived without love, not one without water."
—W. H. Auden

“Not too far in the future, we're going to see a move to surround and commodify the world's fresh water. Just as they've divvied up the world's oil, in the coming century there's going to be a grab.”
— Maude Barlow, Council of Canadians

1. World Commission on Water for the 21st Century, (in UNESCO Sources March 2000. P.3) The Global Water Supply and Sanitation Assessment 2000, World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF).
2. World Development Report 2003 (Washington DC, The World Bank, 2003, p. 7).
3. State of the Environment and Policy Retrospective 1972-2002 (UNEP 2003. p.153) and WHO, Removing Obstacles to Healthy Development (Geneva, WHO, 1999).
4. Ibid.
5. F. Rijisbrman, “The Water Challenge,” Copenhagen Consensus Challenge Paper, 5-2004, p. 2.
6. State of the Environment and Policy Retrospective 1972-2002 (UNEP 2003. p.153)
7. UNDP, Human Development Report 2003, (New York, UNDP, 2003, p. 257).
8. State of the Environment and Policy Retrospective 1972-2002 (UNEP 2003. p.153)
9. A number of hand pumps installed in poor rural areas of the world have been poorly maintained and break down after a short period of use. This is because of top-down projects that do not involve the people who will use the pumps. In F. Rijisbrman, “The Water Challenge,” Copenhagen Consensus Challenge Paper, 5-2004,
10. D. Narayan, The Contribution of People’s Participation, Evidence from 121 Rural Water Supply Projects, Environmentally Sustainable Developmental Occasional Paper Series No. 1, (Washington DC, The World Bank, 1995), p. 59.
11. D. Narayan, The Contribution of People’s Participation, Evidence from 121 Rural Water Supply Projects, Environmentally Sustainable Developmental Occasional Paper Series No. 1, (Washington DC, The 12. World Bank, 1995), p. 59.
World Bank, World Development Report 1994: Infrastructure for Development (Oxford, Oxford University Press, 1995 p. 11 and p. 83) and: Kofi Annan, Progress Made in Providing Safe Water Supply and Sanitation for all During the 1990s. Report of the Secretary-General. Economic and Social Council, Commission on Sustainable Development, 8th session.
13. Peter H. Gleick, “Global Freshwater Resources: Soft-Path Solutions for the 21st Century,” (Science, November 28, 2003, p. 1527).
14. Ibid.
15. $150 billion for clean water and $25 billion for sanitation, assuming 4 people per household.
16. FAO, Water and Food Security, (Rome, Food and Agriculture Organization of the UN, 2002)
17. A. Lovins, H. Lovins, P. Hawken, (Natural Capitalism, Little, Brown and Company, 1999.)
19. A. Lovins, H. Lovins, P. Hawken, (Natural Capitalism, Little, Brown and Company, 1999. p. 218)
20. Peter H. Gleick, “Global Freshwater Resources: Soft-Path Solutions for the 21st Century,” (Science, November 28, 2003, p. 1527).
21. A. Lovins, H. Lovins, P. Hawken, (Natural Capitalism, Little, Brown and Company, 1999. p. 217).
22. Empty Breadbasket; The Coming Challenge to America’s Food Supply and What We Can Do About It, (Rodale Press, 1985, p. 116).
23. National Resources Defense Council, “Alfalfa: The Thirstiest Crop” At: October 17, 2004.
24. Peter H. Gleick, “Global Freshwater Resources: Soft-Path Solutions for the 21st Century,” (Science, November 28, 2003, p. 1527).
25. A. Lovins, H. Lovins, P. Hawken, (Natural Capitalism, Little, Brown and Company, 1999. p. 223).
26. “Water Scarcity: Forecasting The Future With Spotty Data,” (Science, August 9, 2002, p. 927).
27. $35 billion was spent on bottled water in the world in 2000; (State of the World 2004, Worldwatch Institute, 2004).
28. Annual global illegal drug expenditures are approximately $200 billion.
29. U.S. spent $116 billion on alcohol in 2002; (Bureau of Economic Analysis, Department of Commerce).
30. UNDP, 2006 Human Development Report (New York, UNDP, 2006).

31. World Bank, World Development Report 1992 Development and the Environment (Oxford, Oxford University Press, 1993).
32. $1 trillion / 365 days in a year = $2.74 billion/day; $12 billion cost of Water for All /$2.74 billion = 4.38 days.
33.“Economic focus: The stuff of life,” (The Economist, May 15, 2004, p. 75).
34. ibid.

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