The original version of this article, by Eric Zuehlke, appeared on the Population Reference Bureau’s Behind the Numbers blog.

Recent media reports have focused on the stalled progress for women in Afghanistan and the shift in the international community’s focus as they take steps towards an eventual military withdrawl. Although there’s much work to be done, it’s important to note that there has been tangible improvement for women in Afghanistan. A decade ago, women weren’t allowed to go out in public alone. Girls weren’t allowed to attend school – now 57 percent of girls are in school. And gender issues are now being integrated into government policy.

To reach the village of Grar Gaber from Addis Ababa, you drive up over the Entoto Mountains overlooking the capital then motor down two hours of new Japanese-built highway to the town of Fiche. From there it’s 20 minutes on a broken dirt road across rocky hills. I was joined there by about 20 others from the PHE Ethiopia Consortium’s general assembly (see day one and day two coverage here) and Population Action International, to visit an integrated population, health, and environment (PHE) development program run by LEM Ethiopia.

The Middle East/North Africa region is experiencing a “youth surge,” said Jack Goldstone, director of the George Mason University’s Center for Global Policy, at a recent GMU event. “In the last two decades the number of people in their late teens and twenties has increased… It’s doubled in Egypt; it’s grown by half in Tunisia; and nearly doubled in Libya,” he told Warren Olney on KCRW’s To the Point.

Demographers today are largely concerned with two trends: aging in the developed world, and rapid urbanization in the developing world. The majority of people in the world now live in cities, “but this tiny fraction of people that live in rural areas – concealed by the data because it’s a small fraction – still have very high fertility rates, precisely where protected areas are,” said David Lopez-Carr, associate professor of geography at the University of California, Santa Barbara in this ECSP interview.

“How are we going to feed all these mouths?” asked Bekele Hambissa, director of the Environmental Protection and Development Organization in Addis, on day two of the PHE Ethiopia Consortium general assembly (read about day one here). Environmental resources are directly tied to Ethiopia’s population growth, said Hambissa, during a discussion of balancing efforts to address population growth, environment, and livelihoods. While poverty alleviation is an important goal of population, health, and environment integration (PHE), it must be environmentally sustainable, he said.

Hello from Addis Ababa, where I am blogging from the 5th annual general assembly of the Population, Health, and Environment (PHE) Consortium of Ethiopia (see further coverage here). Along with the Philippines, Ethiopia is the largest PHE programmer in the world, both in terms of number of programs and people affected, and for good reason: The country combines dire need, willing donors, and a great deal of local capacity and will.

The original version of this article, by the USAID Global Health Bureau, appeared on the USAID Impact blog.

Bangladesh is on track to meet the 2015 deadline for UN Millennium Development Goal 5 (50 percent reduction in maternal deaths). The Bangladesh Maternal Mortality and Health Service Survey, jointly funded by the Government of Bangladesh, USAID, Australian Aid (AusAID) and the United Nations Population Fund (UNFPA), found that maternal deaths in Bangladesh fell from 322 per 100,000 in 2001 to 194 in 2010, a 40 percent decline in 9 years.

Unsafe drinking water causes nearly 1.8 million deaths each year from diarrhea, “a number that dwarfs the casualties associated with violent conflict,” said U.S. Representative James McGovern at a congressional human rights commission hearing earlier this month on water as a basic right. Nearly all of these deaths are children under the age of five, he said. “This is a war against families, children, and women on an ongoing basis,” said Representative Earl Blumenauer, also speaking at the hearing, titled “Realizing the Right to Safe Water and Sanitation.”

There are currently 884 million people in the world without access to safe drinking water, according to UNICEF, and 2.6 billion without improved sanitation. As population growth and climate change place added stress on fresh-water systems, by 2025, two thirds of the world’s population will live in water-stressed conditions, according to the Food and Agriculture Organization. “This is a severe global crisis,” said McGovern.

“A Human Right”

With 2011 World Water Day only weeks away, the hearing harkened back to Secretary Clinton’s widely quoted statement from World Water Day 2010, marking a commitment by the Obama administration to address global water issues:

It’s not every day you find an issue where effective diplomacy and development will allow you to save millions of lives, feed the hungry, empower women, advance our national security interests, protect the environment, and demonstrate to billions of people that the United States cares. Water is that issue.

Four months after that statement, the UN passed a resolution to make access to water and sanitation a human right, not just a development priority. Said Catarina de Albuquerque, a UN independent expert who testified at this month’s congressional hearing, the resolution stipulates that water must be “available, accessible, affordable, acceptable and safe.” A “right to water” is an important “sign of political will,” that will place increased obligations on governments to improve access to water and sanitation, she said. But in the meantime, for the millions without access to safe water, “there is no change.”

According to the UN, the world is on track to meet the Millennium Development Goal target of halving the number of people without access to an improved water source by 2015. But de Albuquerque noted that the reality is not quite so optimistic. On a UN fact-finding mission, she encountered at least one family who by UN definitions had access to an “improved drinking water source,” yet their tap water was literally black. “Water quality is not being monitored” and for many of the people who do have access, it is simply “undrinkable,” she said.

In developed countries as well, there are significant barriers to access, especially for marginalized communities. On a recent mission to the United States, de Albuquerque found that America’s “voiceless” – people of color, Native Americans, and the homeless – face significant discrimination in access to water. “Society closes its eyes to them,” she said. Thirteen percent of Native Americans lack access to safe water, in comparison to 0.6 percent of non-native Americans, she said in a statement to the press releasing her findings. And in Boston, “for every one percent increase in the city ward’s percentage of people of color, the number of threatened cut-offs increases by four percent.” To make the necessary improvements to fill these gaps in America’s aging water infrastructure would cost $4 to $6 billion annually, she said.

A National Security Issue

Water “is a security issue as well as a human development issue,” said Blumenauer. Since, according to UNEP, 40 percent of the world relies on river basins that share two or more political boundaries, water management has enormous potential for both conflict and cooperation. Echoing Clinton’s World Water Day statement, McGovern championed the cross-cutting nature of water:

The right to water is inextricably linked with other basic rights…including the right to food, the right to health, and the right to education.

The burden of collecting water in underdeveloped countries often creates a gender gap and exposes women and girls to violence and rape, he said. And it “has been the basis for many territorial and violent disputes between various peoples and even nations.”

Last month, a staff report by the Senate Foreign Relations Committee expressed a similar sentiment with the publication of their report, Avoiding Water Wars: Water Scarcity and Central Asia’s Growing Importance for Stability in Afghanistan and Pakistan. The report commends the Obama administration for recognizing the importance of water: “For the first time, senior government officials are recognizing the critical role that sound water management must play in achieving our foreign policy goals and in protecting our national security.” However, by exclusively focusing on Pakistan and Afghanistan’s water issues and “neglecting the interconnectivity of water issues between Central and South Asia, the U.S. approach could exacerbate regional tensions,” the report says.

To be more strategic about water assistance, the report recommends the United States: (1) provide technical support in data collection to better manage water; (2) help increase water efficiency and reduce demand for water; (3) recognize the transboundary nature of water issues and “provide holistic solutions;” and (4) “safeguard institutions against shocks to water supply and demand.”

Moving Forward

The Obama administration’s commitment to water issues, the UN’s recognition of water as a human right, and the 2005 Water for the Poor Act have all been important steps towards fulfilling the pledge of making access to safe water a human right. “We’ve come a long way,” Blumenauer (who authored the Water for the Poor Act) said at the hearing, but there is still significant work ahead.

“We’re going to have to be more strategic moving forward” in order to meet global water shortages, said Aaron Salzberg, special coordinator for water resources for the U.S. Department of State who testified at the hearing. Salzberg recommended that the U.S. government take steps to integrate water management with the food and health sectors; build political will; mobilize financial support; promote science and technology; and form partnerships with other governments and aid organizations. The United States must also “be smarter” about allocating funds based on the dual criteria of “need” and “opportunity.” Balancing efforts with partners to find out which countries have the greatest need and the least resources will allow limited U.S. funds to make the deepest impact, he said.

John Oldfield, managing director of the WASH Advocacy Initiative, urged Congress to increase funding for foreign assistance, continue appropriations for the Water for the Poor Act, and improve the effectiveness of existing water, sanitation, and hygiene (WASH) assistance. “Each dollar invested in water and sanitation leads to an 8:1 return from reduced healthcare costs and time savings,” he said. “The world does not need to bury millions more of its children in the coming years when we know how to prevent waterborne disease today.”

Sources: FAO, UNEP, UNICEF, United Nations, WHO.

Image Credit: Adapted from “School girl drinks water from new handpump,” courtesy of flickr user waterdotorg.