| Table 1.
Growing Water Shortages Population Size and Growth and Renewable Freshwater Availability in Water-Short Countries, 1995 and 2025 | ||||||
| Country | Population 1995 (millions) |
Water Per Capita 1995a | Population 2025 (millions) |
Water Per Capita 2025a | TFR 1998 | % Growth Rate 1998 |
|---|---|---|---|---|---|---|
| Water Scarcity in 1995 and/or 2025 | ||||||
| Algeria | 28.1 | 527 | 47.3 | 313 | 4.4 | 2.4 |
| Bahrain | 0.6 | 161 | 0.9 | 104 | 3.2 | 2.0 |
| Barbados | 0.3 | 192 | 0.3 | 169 | 1.7 | 0.5 |
| Burundi | 6.1 | 594 | 12.3 | 292 | 6.6 | 2.5 |
| Cape Verde | 0.4 | 777 | 0.7 | 442 | 5.3 | 2.9 |
| Comoros | 0.6 | 1,667 | 1.3 | 760 | 5.1 | 2.7 |
| Cyprus | 0.7 | 1,208 | 1.0 | 947 | 2.1 | 0.7 |
| Egypt | 62.1 | 936 | 95.8 | 607 | 3.6 | 2.2 |
| Ethiopia | 56.4 | 1,950 | 136.3 | 807 | 7.0 | 2.5 |
| Haiti | 7.1 | 1,544 | 12.5 | 879 | 4.8 | 2.1 |
| Iran | 68.4 | 1,719 | 128.3 | 916 | 3.0 | 1.8 |
| Israel | 5.5 | 389 | 8.0 | 270 | 2.9 | 1.5 |
| Jordan | 5.4 | 318 | 11.9 | 144 | 4.4 | 2.5 |
| Kenya | 27.2 | 1,112 | 50.2 | 602 | 4.5 | 2.0 |
| Kuwait | 1.7 | 95 | 2.9 | 55 | 3.2 | 2.3 |
| Libya | 5.4 | 111 | 12.9 | 47 | 6.3 | 3.7 |
| Malawi | 9.7 | 1,933 | 20.4 | 917 | 5.9 | 1.7 |
| Malta | 0.4 | 82 | 0.4 | 71 | 2.1 | 0.6 |
| Morocco | 26.5 | 1,131 | 39.9 | 751 | 3.3 | 1.8 |
| Oman | 2.2 | 874 | 6.5 | 295 | 7.1 | 3.9 |
| Qatar | 0.5 | 91 | 0.8 | 64 | 4.1 | 1.7 |
| Rwanda | 5.2 | 1,215 | 13.0 | 485 | 6.0 | 2.1 |
| Saudi Arabia | 18.3 | 249 | 42.4 | 107 | 6.4 | 3.1 |
| Singapore | 3.3 | 180 | 4.2 | 142 | 1.7 | 1.1 |
| Somalia | 9.5 | 1,422 | 23.7 | 570 | 7.0 | 3.2 |
| South Africa | 41.5 | 1,206 | 71.6 | 698 | 3.3 | 1.6 |
| Tunisia | 9.0 | 434 | 13.5 | 288 | 3.2 | 1.9 |
| United Arab Emirates | 2.2 | 902 | 3.3 | 604 | 4.9 | 2.2 |
| Yemen | 15.0 | 346 | 39.6 | 131 | 7.3 | 3.3 |
| Water Stress in 1995 and/or 2025 | ||||||
| Afghanistan | 19.7 | 2,543 | 45.3 | 1,105 | 6.1 | 2.5 |
| Belgium | 10.1 | 1,234 | 10.3 | 1,217 | 1.6 | 0.1 |
| Burkina Faso | 10.5 | 2,672 | 23.5 | 1,194 | 6.9 | 2.9 |
| Eritrea | 3.2 | 2,775 | 6.5 | 1,353 | 6.1 | 3.0 |
| Ghana | 17.3 | 3,068 | 36.3 | 1,464 | 5.5 | 2.9 |
| India | 929.0 | 2,244 | 1,330.2 | 1,567 | 3.4 | 1.9 |
| Lebanon | 3.0 | 1,854 | 4.4 | 1,261 | 2.3 | 1.6 |
| Lesotho | 2.0 | 2,565 | 4.0 | 1,290 | 4.3 | 2.1 |
| Mauritius | 1.1 | 1,970 | 1.5 | 1,485 | 2.0 | 1.0 |
| Niger | 9.2 | 3,552 | 22.4 | 1,452 | 7.4 | 3.4 |
| Nigeria | 111.7 | 2,506 | 238.4 | 1,175 | 6.5 | 3.0 |
| Peru | 23.5 | 1,700 | 35.5 | 1,126 | 3.5 | 2.2 |
| Poland | 38.6 | 1,458 | 40.0 | 1,406 | 1.6 | 0.1 |
| South Korea | 44.9 | 1,472 | 52.5 | 1,258 | 1.7 | 1.0 |
| Tanzania | 30.7 | 2,964 | 62.4 | 1,425 | 5.7 | 2.5 |
| Togo | 4.1 | 2,938 | 8.8 | 1,370 | 6.8 | 3.6 |
| Uganda | 19.7 | 3,352 | 45.0 | 1,467 | 6.9 | 2.7 |
| United Kingdom | 58.1 | 1,222 | 59.5 | 1,193 | 1.7 | 0.2 |
| Zimbabwe | 11.2 | 1,787 | 19.3 | 1,034 | 4.4 | 1.5 |
| Water-stressed countries are those with annual water resources of between 1,000 and 1,700 cubic meters per person, shown in italic. Countries suffering from water scarcity are those with annual supplies of less than 1,000 cubic meters per person, shown in dark type. TFR = Total Fertility Rate aIn cubic meters per year Source: Gardner-Outlaw & Engelman, Sustaining water, easing scarcity: A second update, Washington, D.C., Population Action International, 1997 (69). Gardner-Outlaw and Engelman base their calculations on UN Population Division population estimates. The growth rate and TFR data come from: Populatoin Reference Bureau, World Population Data Sheet, 1998, Wahsington, D.C., 1998. | ||||||
| Table 2. Major Water-Related Diseases | ||||
| Disease | Cause and Route of Transmission | Geographic Extent | Number of Casesa | Deaths Per Year |
|---|---|---|---|---|
| Major Water-Borne Diseases | ||||
| Amoebic dysentery | Protozoa travel the fecal-oral route via contaminated water, food, person-to-person contact. | Worldwide | 500 million per year | |
| Bacillary dysentery | Bacteria travel the fecal-oral route via contaminated water, food, person-to-person contact. | Worldwide | ||
| Diarrheal disease (including amoebic and bacillary dysentery) | Various bacteria, viruses, and protozoa travel the fecal-oral route via contaminated water, food, person-to-person contact. | Worldwide | 4 billion currently | 3-4 million |
| Cholera | Bacteria travel the fecal-oral route via contaminated water, food, person-to-person contact. | South America, Africa, Asia | 384,000 per year | 20,000 |
| Hepatitis A | Virus travels the fecal-oral route via contaminated water, food, person-to-person contact. | Worldwide | 600,000 to 3 million per year | 2,400 to 12,000 |
| Paratyphoid and typhoid | Bacteria travel the fecal-oral route via contaminated water, food, person-to-person contact. | 80% in Asia; 20% in Latin America, Africa | 16 million currently | 600,000 |
| Polio | Virus travels the fecal-oral route via contaminated water, food, person-to-person contact. | 66% in India; 34% in Near East, Asia, Africa | 82,000 currently | 9,000 |
| Major Water-Based Diseases | ||||
| Ascariasis | Fertilized eggs are passed out in human feces. Larvae in eggs develop in warm soil. Human ingests soil on food. Hatched larvae penetrate intestinal wall, where they mature. | Africa, Asia, Latin America | 250 million currently | 60,000 |
| Clonorchiasis | Worms reproduce in gastropod snails, then are swallowed by freshwater fish or other snails. When humans eat raw or undercooked fish, the worms migrate to the bile ducts and lay eggs. | Southeast Asia | 28 million currently | None reported |
| Dracunculiasis (guinea worm) | Worm Dracunculus ingested by Cyclops (a crustacean). When humans digest Cyclops, worm larvae are released into the stomach. Larvae penetrate intestinal wall, then develop into worms, migrating through tissues. After a year, adult worm reaches skin surface of lower extremities. Female comes in contact with water, then discharges larvae into water. | 78% in Sudan; 22% in other sub-Saharan Africa and a few cases in India and Yemen | 153,000 per year | None reported |
| Paragonimiasis | Worms living in pulmonary cysts lay eggs in human lungs, which are coughed up and then swallowed. Worm eggs are passed out in feces and break when in fresh water. Larvae find snail host in which to replicate, then move into freshwater crab or crayfish. Humans eat uncooked seafood. Worms migrate in pairs from stomach through intestinal wall and diaphragm to lungs, where they mate. | Far East, Latin America | 5 million currently | None reported |
| Schistosomiasis (bilharzia) | Eggs of the schistosome worm are passed out in human feces. Eggs hatch on contact with water, releasing the parasite miracidium. Parasite moves into a freshwater snail, where it replicates. It is released back into water, then penetrates human skin within seconds and moves into blood vessels. Within 30 to 45 days, miracidium grows into worm, which can lay 200 to 2,000 eggs per day for an average of 5 years. | Africa, Near East, rain forest belt in Central Africa, Western Pacific, Kampuchea, Laos | 200 million currently | 20,000 |
| Major Water-Related Vector Diseases | ||||
| Denque | Virus is picked up by a mosquito from an infected human or animal. The virus incubates for 8 to 12 days and replicates. The next time the mosquito takes a blood meal, the virus is injected into a human's blood. | All tropical environments; concentrated in Asia, Central and South America | 50-100 million per year | 24,000 |
| Filariasis (includes elephantiasis) | Worm larvae are ingested by a mosquito and develop. When the infected mosquito bites a human, the larvae penetrate the puncture and reach the lymphatics, where they reproduce. | Africa, Eastern Mediterranean, Asia, South America | 120 million currently | None reported |
| Malaria | Protozoa develop in gut of a mosquito and are passed on in its saliva each time it takes a new blood meal. Parasites are then carried by the blood to the human's liver, where they invade the cells and multiply. | Africa, Southeast Asia, India, South America | 300-500 million per year (clinical) | 2 million |
| Onchocerciasis | Worm embryos are ingested by black flies. Embryos then develop into larvae within the black flies, and the flies inject the larvae into humans when they bite. | Sub-Saharan Africa, Latin America | 18 million currently | None reported** |
| Rift Valley fever (RVF) | Virus usually exists in animal hosts. Virus is picked up by mosquitos and other blood-sucking insects and injected into the blood of humans. Humans also are infected while working with body fluids of dead animals. | Sub-Saharan Africa | NA | 1% of cases |
| aNumber of cases are reported as incidence ("per year")—the number of new cases occurring in a year—or as prevalence ("currently")—the number of cases existing at a point in time. * Included in diarrheal disease ** No deaths but causes 270,000 reported cases of blindness annually. NA = not available Source: WHO 1996 (205) except amoebic dysentery, bacillary dysentery, dracunculiasis, dengue, and RVF from WHO 1998 (200); and clonorchiasis and paragonimiasis from Muller & Morera 1994 (119). | ||||
| Table 3.
Reducing Water-Related Disease Impact of Improved Water Infrastructure, Selected Studies | ||||
| Place | Type of Facilities or Improvement | Type of Study | Diseases | Difference in Incidence After Improvement |
|---|---|---|---|---|
| Teknaf, Bangladesh | Hand pumps and health education | Case-control | Diarrheal diseases | 17% difference between groups |
| Northeast Brazil | Latrines, communal taps, laundry facilities, showers, and hand pumps | Case-control | Schistosomiasis | 77% difference between groups |
| Khuzestan, Iran | Courtyard latrine and public standpipes | Case-control | Ascariasis | 16% difference between groups |
| Uttar Pradesh, India | Piped water | Before and after | Dysentery | 76% reduction |
| Peninsular Malaysia | Toilets and running water | Case-control | Diarrheal diseases | 82% difference in infant mortality between groups |
| Kwara State, Nigeria | Boreholes, hand pumps, and health education | Before and after | Dracunculosis | 81% reduction |
| Cebu, Philippines | Private, sanitary latrines | Before and after | Diarrheal diseases | 42% reduction |
| St. Lucia | Household water and latrines | Case-control | Ascariasis | 31% difference between groups |
| Lusaka, Zambia | Extension of piped water supply | Before and after | Typhoid | 37% reduction |