What is the progress in access to improved sanitation systems?

Improved sanitation concerns the management of human faeces at household level, and includes connection to a public sewer, connection to a septic system, a pour-flush latrine, and access to a pit latrine and a ventilated, improved pit latrine (WHO and Unicef). Only those facilities which are not shared or public, and which separate human excreta from human contact are considered improved. Sanitation solutions considered non-improved include public or shared latrines, open pit latrines and bucket latrines.

Inadequate sanitation poses health risks, from contaminated drinking water to life-threatening forms of diarrhoea to infants, particularly for poorer segments of the population who are most exposed to inadequate human waste disposal. Globally, almost 2 000 children die every day from preventable

diarrheal diseases, some 1 800 of which are linked to water, sanitation and hygiene (Unicef, 2013) (see http://www.unicef.org/media/media_68359.html). Among the eight Millennium Development Goals (MDGs) adopted at the Millennium Summit in September 2000 at the United Nations Headquarters in New York, Goal 7 focuses on ensuring

environmental sustainability, partly through improved access to water and sanitation. The set global target is to halve the proportion of people without sustainable access to safe drinking water and basic sanitation by 2015 (Target 10) (Table 4.2). This target was also adopted by the contacting parties to the Barcelona Convention in 2005 as part of the Mediterranean Strategy for Sustainable Development (MSSD).

The economic losses associated with poor sanitation and water supply amount to USD 260 billion annually in developing countries. However, it is estimated that the benefits from improved sanitation account for 90 % of the total annual economic benefits of meeting the MDG target (USD 54 billion of the USD 60 billion) (WHO, 2012). According to the most recent MDG report (2013), as many as 1.9 billion people worldwide have gained access to improved sanitation facilities since 1990. Despite this remarkable progress, further efforts and investments are needed to increase the relatively low coverage in rural areas, and to reach the set targets by 2015. As part of the H2020 programme on assessing progress made in depolluting the Mediterranean, the indicator on access to improved sanitation systems has been selected as a way to monitor progress towards more adequate sanitation services, both in urban and rural areas. Sanitation services are the basis of the 'wastewater management chain', which considers the link between sanitation, municipal wastewater collection, treatment and disposal in a holistic way. Although sanitation services strongly determine the quantity and quality of municipal wastes that are produced, the availability of adequate sanitation facilities on its

Table 4.2 Share of total population (%) with access to improved sanitation systems in ENP-South countries in 2011, compared to targets set for 2015, based on values for 1990

Algeria Egypt Israel Jordan Lebanon Morocco Palestine Tunisia

1990 89.0 72.0 100.0 97.0 53.0 73.0

2011 95.1 95.0 100.0 98.1 69.7 94.3 89.8

Target 2015 94.5 86.0 100.0 98.5 76.5 86.5

own does not guarantee the 'downstream' protection of coastal and marine environment from discharge of untreated wastewater. In other words, in areas where adequate sanitation services are currently being provided, typically quantified by a high share of the population with access to improved sanitation systems, these should be coupled to adequate collection and treatment of wastewater, in order to safeguard the receiving waterbodies in line with the objectives of H2020 (see Section 3.3). Targets and compliance objectives need to be defined throughout the wastewater management chain, since even where reasonable treatment facilities exist, poor maintenance and operation often result in failure to meet design effluent levels and thus to protect the receiving environment.

In 2011, around 92 % of the population in the ENP-South region (7_{) had access to improved}

Box 4.1 Access to improved sanitation systems: methodological issues

The calculation of 'Indicator 3: Share of total, urban and rural population with access to improved sanitation systems' relies on statistics for urban and rural populations. This presents a source of uncertainty,

since the characteristics of urban and rural areas vary from country to country. Statistics on urban and rural populations come directly from population censuses, but the distinction between urban and rural populations is not amenable to a single definition applicable to all countries. Moreover, some countries distinguish between communal and non-communal areas, while others consider refugees a separate population group, and others still do not make a distinction between rural and urban at all.

Administrative records and household surveys are the two main sources for this indicator. The combination of different methodologies may result in discrepancies between different data sets.

Source: EMWIS Mediterranean Water Information Mechanism, 2011 (http://www.emwis.net/medwip/topics/WSS/donnees- chiffrees/analyse-de-la-disponibilite-des-donnees/wat-p05-part-de-la-population-ayant-acces-un).

sanitation. Most countries reached connection rates as high as 95 % of the total population (Figure 4.2), as compared to an overall coverage of 87.5 % in 2003. This implies that steady progress has been achieved since 2003 in all the ENP-South countries, in particular in Egypt and Tunisia, where coverage increased by more than 5 % of the total population over the time period from 2003 to 2011. Since 2003, more than 3 million people have gained access to improved sanitation in the region, in large part made possible by investments from regional and international cooperation.

Although the indicator data show general progress in access to sanitation services, they do not fully take into account the current population growth and (especially the informal) urban sprawl, which are amongst the major drivers as well as pressures in the region. These figures should therefore be

(7_{) Including Jordan, Libya and Syria.}

Figure 4.1 Example of analysis of data sets availibility to complete H2020 indicator number 3

WAT-P05 Share of population with

access to an improved sanitation system 5b/Total population 5a/Population with access to an improved sanitation system 5a1/Urban population with access to an improved sanitation system 5a2/Rural population with access to an improved sanitation system 5b1/Urban

Figure 4.2 Percentage of total population having access to improved sanitation systems in ENP-South countries, for the time period 2003–2011

Note: Data for Israel, Jordan, Palestine, Tunisia and

(Lebanon) is provided by countries under the ENPI-SEIS South project. The source of data for Algeria, Egypt, Libya, Morocco and Syria is the UN database. Morocco did provide data for Indicator 3 in the context of the ENPI-SEIS South project. However, these data were at the level of the coastal hydrological basins, and could not be integrated with national data from other countries.

60 65 70 75 80 85 90 95 100 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 % total population Algeria Egypt Israel Jordan Lebanon Libya Morocco Palestine Syria Tunisia

interpreted with caution, accounting for a possible bias that depicts a more favourable situation than exists in reality. Although most countries have already reached the target set for 2015 (Table 4.2), data for 2011 show that an estimated 17.6 million people continued to rely on unimproved sanitation solutions, calling for more localised efforts. It should be noted that the UN data presented in Table 4.2 vary slightly from those provided by the countries in the context of the ENPI-SEIS project (see Figure 4.2 and its notes). This is because the national data sources may not be the same and the methodologies used may differ (see Box 4.1).

As explained in Part 1, the geographical focus of H2020 for the Water priority theme is established as the coastal watershed draining into the

Mediterranean Sea. Indicator data on access to sanitation systems provided by ENP-South countries in the context of the ENPI-SEIS project, as well as supplementary data retrieved from international sources, namely the UN database, refer to the national level. With the exception of Morocco (see Box 4.2), reliable data at the desired geographical level are not readily available. Assuming that ~ 65 % of the population in the ENP-South countries reside in the coastal watershed (8_{) (see Table I.1),}

it is estimated that 11.5 out of the 17.6 million inhabitants without access to sanitation systems are concentrated in this coastal watershed. Although this is a highly approximate calculation, it is a strong indication that the inhabitants and environment in coastal watersheds draining into the marine waters are the most severely impacted by inadequate sanitation systems.

According to the WHO and Unicef definition, 'improved sanitation systems' include connection to public sewage network, as well as to septic systems, pour-flush latrines, access to a pit latrine, a ventilated improved pit latrine and other not shared facilities that separate human excreta from human contact. In some countries, Palestine for instance, the fraction of households connected to a sewage network varied between 43.6 % in 2003 and 55 % in 2011. In 2010, ~ 39 % of Palestinian households, particularly those residing in the West Bank, still relied on other improved facilities such as porous cesspits. Cesspits or cesspools are also the most common disposal method for wastewater in rural areas in Jordan. These cesspits, which are purposely designed and constructed without a concrete lining to allow seepage into the ground, occasion a number of environmental concerns. With time, cesspits get filled with wastewater, which require periodical emptying by vacuum tankers. The collected wastewater in the tankers is often released into the oueds (dry riverbeds, which may at times form intermittent streams), contaminating the environment and creating a nuisance odour, particularly during the summer months. During times of heavy rain, the untreated wastewater turns into a 'sewage flood', causing the degradation of the environmental quality of the surrounding agricultural land, and putting public health at risk.

Box 4.2 Access to sanitation systems in the coastal hydrological basins of Morocco

Since the 1960s, Morocco has focused significantly on the development of the water sector, in particular on the implementation of hydraulic structures enabling safe access to drinking water. However, the upgrading of sanitation systems, including sewage networks and wastewater treatment, was a low priority, resulting in insufficient coverage and significant delays. Lack of adequate sanitation services led to the deterioration of the quality of water resources and natural environments, posing a threat to public health and to the social and economic development of the region. To counteract the situation, in 2005 the Moroccan government approved the National Sanitation Programme (Programme National d'Assainissement liquide et d'épuration des eaux usées (PNA)) which aims to achieve an 80 % connection rate to the sanitation network in urban areas and a 60 % wastewater treatment rate by 2020. By improving the sanitation connection network, this programme also contributes towards lowering the pollution load into receiving waters.

In the context of the ENPI-SEIS South project, Morocco lay down the geographical focus: the 16 provinces and prefectures in the coastal hydrological basins of Oued Moulouya and Tangier in the Mediterranean region. These two regions cover an area of 74 000 km² and 9 000 km2_{,respectively, and have a total}

population of 2.5 million, ~ 8 % of the total population.

In general, a steady increase was observed during the time period from 2003 to 2011 in the 16 provinces (see Figure 4.3 below). Based on the available data, the rate of access to sanitation systems in 2011 has exceeded 90 % in the following 6 provinces: Berkane, Taourirt, Chefchaouen, M'Diq Fnidq, Tetouan and Al Hoceima. In the ENPI-SEIS focus area, coverage increased from ~ 63 % in 2003 to 88 % in 2011, denoting a significant progress in sanitation services. This estimation, however, does not include the provinces of Jerada, Ouja Augad, Midelt Tanjer-Assilah, Guercif, Taza, one commune in Berkane, one commune in Driouch, five communes in Nador and two communes in Taourirt, with a collective population of 1.9 million inhabitants in 2003 and 1.3 million inhabitants in 2011, for which no data are available. At national level, the rate of access to sanitation systems is around 70 % (see Table 4.2).

According to the WHO and Unicef definition, 'improved sanitation systems' include connection to public sewage network, as well as to septic systems, pour-flush latrines, access to a pit latrine, a ventilated improved pit latrine and other not shared facilities that separate human excreta from human contact. In some countries, Palestine for instance, the fraction of households connected to a sewage network varied between 43.6 % in 2003 and 55 % in 2011. In 2010, ~ 39 % of Palestinian households, particularly those residing in the West Bank, still relied on other improved facilities such as porous cesspits. Cesspits or cesspools are also the most common disposal method for wastewater in rural areas in Jordan. These cesspits, which are purposely designed and constructed without a concrete lining to allow seepage into the ground, occasion a number of environmental concerns. With time, cesspits get filled with wastewater, which require periodical emptying by vacuum tankers. The collected wastewater in the tankers is often released into the oueds (dry riverbeds, which may at times form intermittent streams), contaminating the environment and creating a nuisance odour, particularly during the summer months. During times of heavy rain, the untreated wastewater turns into a 'sewage flood', causing the degradation of the environmental quality of the surrounding agricultural land, and putting public health at risk.

Box 4.2 Access to sanitation systems in the coastal hydrological basins of Morocco (cont.) 0 10 20 30 40 50 60 70 80 90 100 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

% access to sanitation system

Boulemane Berkane Driouch Jerada Nador Oujda Angad Taourirt Midelt Chefchaouen Fahs-anjra M'diq Fnidq Tanger-Assilah Tetouan Al Hoceima Guercif Taza Sum of provinces

Figure 4.3 Percentage access to sanitation systems in 16 Moroccan provinces based on available data

Note: The sum of provinces does not include Jerada, Ouja Augad, Midelt Tanjer-Assilah, Guercif, Taza, one commune in

Berkane, one commune in Driouch, five communes in Nador and two communes in Taourirt, for which no data are available.

4.2 What is the difference between