WMA Statement on Water and Health
Approved by the 55thWMA General Assembly, Tokyo, Japan, October 2004
and revised by the 65th WMA General Assembly, Durban, South Africa 2014
and by the 68th WMA General Assembly, Chicago, United States, October 2017
PREAMBLE
1. An adequate supply of fresh (i.e. clean potable and uncontaminated) water is essential for individual and public health, as well as being a social determinant of health. It is central to living a life in dignity and health and upholding human rights. Many individuals, families and communities do not have access to such a supply, and even in those places where there is an abundance of fresh water, it is threatened by pollution, activities such as industry and waste, inadequate or ineffective sanitation and other negative forces.
2. A recent review of the evidence demonstrates that inadequate access to clean water, sanitation and soap for hand washing is the norm in many healthcare facilities worldwide, even in normal operating conditions. Natural and manmade major events, including war, reduce access to clean water still further.
3. In keeping with its mission to serve humanity by endeavouring to achieve the highest international standards in health care for all people in the world, the World Medical Association has developed this statement to encourage all those responsible for health to consider the importance and work towards achieving universal access to of water, sanitation and hygiene for individual and public health
4. Hygiene, sanitation and water (HSW) are important determinants of health. And key intervention strategies for reducing preventable morbidity, mortality and health care costs. The health sector, and physicians in particular, play a key role in ensuring such determinants are properly managed.
CONSIDERATIONS
5. Water-borne diseases account for a large proportion of mortality and morbidity, especially in developing countries. These problems are accentuated in times of disasters such as conflicts nuclear and man-made accidents with oil and/or chemicals, earthquakes, epidemics, droughts and floods.
6. Anthropogenic changes to ecosystems, lowered retention by the earth’s surface, and the limitation of the inherent capacity of nature to filter dirt from the water are causing increasing damage to the natural environment, especially the water environment. Fracking for fossil fuels may have a significant effect on ground water as does the accumulation of micropollutant substances including pharmaceuticals and pesticides.
7. The commodification of water, whereby it is provided for profit rather than as a public service, has potentially significant negative implications for access to an adequate supply of drinking water.
8. The development of sustainable infrastructure for the provision of safe water and adequate sanitation contributes greatly to sound public health and national well-being. Curtailing infectious diseases and other ailments that are caused by unsafe water lowers the burden of health care costs and improves productivity. This creates a positive ripple effect on national economies
9. Water as a vital and necessary resource for life has become scarce in many parts of the world and therefore must be used reasonably and with care.
10. Water and effective sanitation are assets that are shared by humanity and the earth. Thus, water-related issues should be addressed collaboratively by the global community.
11. Water, sanitation and hygiene are essential to the safe and effective provision of health care services, and are fundamental to public health.
RECOMMENDATIONS
13. The WMA encourages National Medical Associations, health authorities and physicians to support all measures related to improving access to adequate, safe water and health including:
13.1. International and national programmes to provide ready access to safe drinking water at low cost, or free, to every human on the planet and to prevent the pollution of water supplies.
13.2. International, national, local and regional programmes to provide access to sanitation and to prevent the degradation of water resources.
13.3. Research on the relationship between water pollution, water supply systems, including wastewater treatment, and health.
13.4. The development of plans for providing potable water and proper wastewater disposal during emergencies. These will vary according to the nature of the emergency, but may include on-site water disinfection, identifying sources of water, and back-up power to run pumps.
13.5. Preventive measures to secure safe water, sanitation and good hygiene for all health care institutions, including after the occurrence of natural disasters, especially earthquakes. Such measures should include the development of infrastructure and training programs to help health care institutions cope with such crises. The implementation of continued emergency water supply programs should be done in conjunction with regional authorities and with community involvement.
13.6. More efficient use of water resources by each nation. The WMA especially urges hospitals and health institutions to examine their impact on sustainable water resources and to adhere to the highest safety standards for drug and medical waste disposal from healthcare settings.
13.7. Preventive measures and emergency preparedness to save water from pollution.
13.8. The promotion of the universal access to clean and affordable water and sanitation as a human right[1] and as a common good of humanity.
13.9. Instruction on the link between hygiene supported by hand washing, and ill health prevention are health promotion and health education measures and requires work by government and health agencies, especially where access to water has previously been too limited for persons to exploit it for hygiene purposes.
13.10. The establishment of a real-time alert system accessible to both the local population and to tourists providing information about the risks of contamination of water in a particular area.
[1] In 2010, the United Nations General Assembly and the Human Rights Council explicitly recognized the human right to water and sanitation, derived from the right to an adequate standard of living as stipulated in article 11 of the International Covenant on Economic, Social and Cultural Rights and other international human rights treaties. Hence, it is part of international human rights law.