In theory we have sufficient renewable freshwater resources, but this only remains true if we manage responsibly and do not pollute that which we are using.

With no water at all life cannot survive, but for many it is also access to clean water that is the problem. 2.2 billion people in the developing countries lack access to safe drinking water, and 2.7 billion people lack access to sanitation services.

Most urban centres in Africa and Asia have no sewage system at all, including many cities with populations over 1 million people. The result is a tragic rate of morbidity and mortality in the less developed parts of the world. Waterborne diseases, such as cholera, cause more than 1.5 billion episodes of diarrhoea each year resulting in 4 million deaths annually.

The United Nations program for the decade 1981-90 is still continuing with its aim to supply the most basic facilities to more than one billion people in the third world. The cost was estimated at $30-60 billion a year with one third from development agencies and the rest from third world governments. This is $80 million a day but compared with the $250 million spent on cigarettes perhaps not such a large sum. Currently Malawi is probably the only Third World country likely to achieve the objective of clean water for its entire population. Their target date is the year 2000.

The program although not achieving its aim within the time scale has spurred many third world countries to take a close look at needs and options and to draw up plans. Importantly, they have found that health programmes based on new hospitals in cities can often divert attention from the real priorities such as clean water. In effect they will gain real long-term benefits if they invest in prevention strategies.