Water for Health at the UN Water Conference

By Tina Lines, Advocacy and Policy Officer

The Canadian Network for NTDs had the privilege of attending the UN Water Conference in March of 2023 at the UN Headquarters in New York. It’s the first conference on water in 46 years. It brought together a diverse group of actors: governments, public and private sector actors, scientists, civil society, activists, and experts across many sectors. For the Canadian Network, the Water for Health: Access to Water, Sanitation and Hygiene (WASH) and the right to Safe Drinking Water and Sanitation thematic area was the focus of our attention. The reason is simple: NTD prevention, treatment and management are dependent on the gains made to ensure the right to clean water and sanitation for communities the most burdened by NTDs.

The Network went to the UN Water Conference ‘armed’ with this Joint Statement on water and backed by two previous joint statements: On Women and Water during COP27, and a World Water Week Joint Statement by Water Aid Canada and the Canadian Network for NTDs – highlighting the need to invest in WASH in communities affected by NTDs, and to encourage Canadian engagement towards ensuring the right to clean water and sanitation for all.

Engagement & Representation at the UN Water Conference

Although this historic conference was happening so close to our own Canadian borders, Canadian representation was minimal. Only a small number of Canadian civil society members were present, including the Canadian Network for NTDs, WaterAid Canada, a handful of conservation-focused non-profits, and key Indigenous leaders, some participating universities, among others. Canadian government representation included the Honourable Terry Duguid, M.P Parliamentary Secretary to the Minister of Environment and Climate Change, the Honourable Bob Rae, Ambassador and Permanent representative of Canada to the UN, as well as Chief Cindy Woodhouse and proxy Chief Judy Wilson from the Assembly of First Nations. Out of this conference, Canada committed domestically to establish and fund the Canada Water Agency, but has not made any new commitments towards ensuring the right to access clean water and sanitation for all as part of its development agenda.

If Canadian representation was minimal, many highlighted the lack of representation of people and organizations from the Global South. Youth engagement at the conference was meaningful and overall inspiring. Indigenous representatives from multiple countries including Canada spoke of similar challenges to water access – boil water advisories, polluted fresh water sources, critical infrastructure gaps, forced displacement.  The experience of water is intersectional, and there is still a long way to go in achieving equity in water access across gender, age and other identities.

One group was vastly underrepresented. While people living with disabilities where present at the UN Water Conference, there is a need for more inclusive, meaningful engagement by more actors with lived experience of disabilities, including people living with the long-term sequalae of repeated and untreated NTDs. People living with disabilities will never benefit from improved water management, sanitation facilities and water technologies that support access to clean water and sanitation if their specific barriers to access are not addressed.

The global disability community is as diverse as it is vast, and requires more than a handful of representatives present in a conference where approximately 2,000 people were in attendance. A lack of access to clean water and sanitation can itself lead to disability, and we see this with NTDs. Trachoma – the leading cause of infectious blindness – is a good example. Guinea Worm is another – an NTD nearly eradicated through strict management using the One Health approach. A third example is schistosomiasis, an infection that can be acquired through contact with contaminated water – you don’t even have to drink the water to become infected. This deep relationship between WASH & NTDs guided the focus of the conference for the Canadian Network for NTDs – clean water and sanitation for health.

Water for Health

Water for health is one of four themes of the Water Action Agenda, and it is critical to NTD elimination strategies. The plenary on the first day was insightful. Ms. Maria Neira, Assistant Director General, WHO, emphasized the need to invest in water and sanitation, particularly in health care settings. In another session, she reminded us that investing in WASH reduces downstream expenditure in the health of populations.  It’s amazing to me that 1.8 billion people still access health care facilities that lack basic water service to support patient care (WHO, 2021).

Access to improved sanitation is lagging, with 2 billion people still living without basic sanitation facilities. WASH in schools continues to be a challenge that should be achievable and would result in high impact for WASH, health and learning. Other sessions honed in on the relationship between nutrition and water. Climate change continues to be the main challenger to progress made in WASH (and of course, on the development agenda overall), increasing water scarcity and access to clean water and sanitation in climate-induced disasters, as well as increasing the disease burden of many NTDs and other climate-sensitive infectious diseases.

At the UN Water Conference, the UN Group of Friends in support of WASH in health care facilities convened a side event: the Water, Sanitation and Hygiene in Healthcare Facilities:  Lessons Learned and the Way Forward. This group plans to table a UN resolution on WASH in HCFs to UNGA in September 2023.  This new resolution is timely as tracking of the WHO resolution on WASH in HCF, passed at the World Health Assembly in 2019, will transition at the end of this year.  It is anticipated the new UN Resolution will advance the human right to water and sanitation that is embedded in health systems strengthening, quality of care, infection prevention and control (IPC), the protection of health care workers, along with the health for all agenda.

Water Data

Better indicators are needed to measure who’s being left behind. However, most of all there is a need to measure the costs of inaction. Data should inform policy and are a global public good. Data need to be shared, first and foremost, with communities affected by a lack of water and sanitation, to benefit local initiatives that seek to address these challenges. For any in doubt of the potential of the data-sharing agenda, there were meaningful examples of how effective data sharing can be achieved.

Water Action Financing and a New Water Culture

One barrier to water, sanitation and hygiene for all that was highlighted was the need to change our normative engagement with water. Chief Cindy Woodhouse advocated for the right to clean water and sanitation for Indigenous communities in Canada, emphasizing the need to protect water as a living part of the world, not simply as a resource.

The Conference resulted in more than 700 Water Action commitments, including a commitment from the Canadian Network for NTDs that you can view here in full, or on the SDG Webpage. Although non-binding, this will help generate more momentum towards achieving SDG6. These commitments however, need to be supported by investments to be meaningful.

The United Nations Secretary-General Antonio Guterres closed the UN Water Conference beautifully. He advocated for what we all hope: a “sustainable, equitable, inclusive and water secure future for both people and planet.”  He also spoke about the need to center the water agenda in development, rather than sideline it. “Without water, there can be no sustainable development…let’s take the next steps in our journey to a water-secure future for all.”

Outdoor Exhibit at the UN Water Conference, March 24th, 2023