Inadequate sanitation costs Pakistan $5.3 billion: World Bank report

A World Bank (WB) revealed that only inadequate sanitation causes Pakistan economic loss of $5.7 billion (PKR 343.7 billion) per year, equivalent to 3.9 percent of the country's GDP.
The report, 'The Economic Impacts of Inadequate Sanitation in Pakistan, by Water and Sanitation Programme (WSP), a multi-donor partnership administered by the WB, was launched here.
Muhammad Javed Malik, Secretary Ministry of Disaster Management, during the launching ceremony said that deterioration of environment continues to affect the livelihoods and health, increasing the vulnerability of the poor. Rachid Benmessaoud, Country Director Pakistan of World Bank, Christopher Juan Costain, Regional Team Leader of Water and Sanitation Programme, Farhan Sami from Water and Sanitation Program were among the participants.
"Various studies have reported that lack of access to clean water and sanitation facilities has a wide variety of impacts; however, the data and evidence needs to empirically verify the significant burden this imposes on the people of Pakistan. As a result, investment in the sector is well below what is required to ensure a basic minimum of services to the entire population," Malik said.
He added that the current status of sanitation and poor hygiene practices has led to huge public costs, such as premature deaths, economic and financial costs due to diseases attributable to poor sanitation, environmental and other welfare costs.
The report shows that the largest share of losses is due to premature mortality and other health-related impacts of poor sanitation being PKR 299.6 billion (US $4.9 billion) amounting to 87.2 percent of the total economic cost. This includes costs related to premature mortality, productivity loss due to illness and cost of treatment. The water-related economic cost is estimated at PKR16 billion (US $262.7 million), which includes costs related to bottled water, household treatment and pipe-water cost due to sanitation. The report also estimates welfare costs at PKR 22.8 billion (US $374.4 million) which includes time loss for defecating in the open. The economic cost for loss of tourism is estimated at PKR 5.4 billion (US $84 million).
In Pakistan, diarrhea is the largest contributor to health-related economic impacts resulting from poor sanitation, amounting to almost two-thirds of the total health-related impacts. 63 percent of the premature mortality-related economic losses out of the total economic impact are due to deaths and diseases among children under five. Diarrhea among children under five accounts for PKR 121.5 billion (US $2 billion) amounting to 40.5 percent of all health-related economic impacts. This is followed by acute lower respiratory infections, which account for about PKR 25.2 billion (US $414.9 million) amounting to 8.4 percent of all health-related impacts.
"The total amount of the losses caused by poor sanitation in Pakistan is 7 times higher than the national health budget and 3.5 times higher than the national education budget, said Rachid Benmessaoud, World Bank Country Director for Pakistan. "These figures have caught the attention of policy-makers and Pakistan has already started the development of federal and provincial policies," Rachid added.
Pakistan is the world's 6th most populous country and South Asia's 2nd most populous state. The current population is estimated to be 177 million, reflecting a nearly fivefold growth over the past six decades. Despite several challenges Pakistan's economy has grown somewhat over the last few years, but this economic performance has not been reflected in its social indicators. The UNDP Human Development Index (HDI) still ranks Pakistan at 145 out of 187 countries.
Rachid said that Pakistan's environment has been deteriorating severely in a way that continues to damage livelihoods & health and increases its marginalized population's vulnerability to disasters. A large majority of its people rely on groundwater for drinking purposes.
The key challenge to achieving adequate water supply and sanitation in Pakistan is the low priority given to water and sanitation in the public sector. According to the Pakistan Poverty Reduction Strategy Paper, budgetary expenditures for water and sanitation ranged from 0.09 percent to 0.13 percent of GDP during 2002-03 and 2008-09.
"After 18th amendment, sanitation has become the responsibility of provinces but unfortunately, the provinces do not have sufficient financial resources to invest in the projects of water and sanitation," Rashid said while responding to a query.
The report, The Economic Impacts of Inadequate Sanitation in Pakistan, is based on evidence on the adverse economic impacts of inadequate sanitation, which include costs associated with death and disease, accessing and treating water, and losses in education, productivity and time due to sanitation issues.
"Similar studies carried out in East Asia, Africa and elsewhere in South Asia indicated annual per capita losses of $28.6 in Indonesia, $ 29.6 in Bangladesh and $ 20.0 in Nigeria," said Christopher Juan Costain. He added that Pakistan's loss per capita is PKR 2,160 (US $35.5). For decades we have been aware of the significant health impacts of poor sanitation, this report not only puts a number on health losses, but also identifies and quantifies areas where sanitation takes a toll.
Christopher added the report underlines that substantial investment is needed to improve sanitation. Poor sanitation needs to be given priority treatment at all administrative levels-local, provincial, and national-and investments should be made to build moderately improved and hygienic latrines in both urban and rural areas.
These investments could include increased sanitation coverage, as already targeted in various government policies. This rising trend in the Government's budgetary allocation to sanitation indicates a strong commitment to improve sanitation outcomes.
He said that the report shows that sanitation and hygiene-related improvements will reduce premature deaths and related morbidity, limit domestic water-related costs, reduce absenteeism at schools and workplaces, and improve welfare and productivity.
Christopher said that as per the report, the potential gain for Pakistan of about R 140 billion (US $2.3 billion) is expected as a result of comprehensive efforts to improve the level of sanitation.