A literature review evaluating new approaches to resolving the sanitation challenge in developing Asia

Kelkar, Vedanti; Seetharam, K. E. Working Paper A literature review evaluating new approaches to resolving the sanitation challenge in developing Asia ADBI Working Paper Series, No. 976 Provided in Cooperation with: Asian Development Bank Institute (ADBI), Tokyo Suggested Citation: Kelkar, Vedanti; Seetharam, K. E. (2019) : A literature review evaluating new approaches to resolving the sanitation challenge in developing Asia, ADBI Working Paper Series, No. 976, Asian Development Bank Institute (ADBI), Tokyo This Version is available at: https://hdl.handle.net/10419/222743 Standard-Nutzungsbedingungen: Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden. Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen. 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If the documents have been made available under an Open Content Licence (especially Creative Commons Licences), you may exercise further usage rights as specified in the indicated licence. https://creativecommons.org/licenses/by-nc-nd/3.0/igo/ ADBI Working Paper Series A LITERATURE REVIEW EVALUATING NEW APPROACHES TO RESOLVING THE SANITATION CHALLENGE IN DEVELOPING ASIA Vedanti Kelkar and KE Seetha Ram No. 976 July 2019 Asian Development Bank Institute The Working Paper series is a continuation of the formerly named Discussion Paper series; the numbering of the papers continued without interruption or change. ADBI’s working papers reflect initial ideas on a topic and are posted online for discussion. Some working papers may develop into other forms of publication. In this report, “$” refers to United States dollars. Suggested citation: Kelkar, V. and KE Seetha Ram. 2019. A Literature Review Evaluating New Approaches to Resolving the Sanitation Challenge in Developing Asia. ADBI Working Paper 976. Tokyo: Asian Development Bank Institute. Available: https://www.adb.org/publications/evaluatingnew-approaches-resolving-sanitation-challenge-developing-asia. Please contact the authors for information about this paper. Email: [email protected], [email protected] Vedanti Kelkar is a research associate at the Asian Development Bank Institute (ADBI). KE Seetha Ram is senior consulting specialist for capacity building and training projects at ADBI. The views expressed in this paper are the views of the author and do not necessarily reflect the views or policies of ADBI, ADB, its Board of Directors, or the governments they represent. ADBI does not guarantee the accuracy of the data included in this paper and accepts no responsibility for any consequences of their use. Terminology used may not necessarily be consistent with ADB official terms. Working papers are subject to formal revision and correction before they are finalized and considered published. Asian Development Bank Institute Kasumigaseki Building, 8th Floor 3-2-5 Kasumigaseki, Chiyoda-ku Tokyo 100-6008, Japan Tel: +81-3-3593-5500 Fax: +81-3-3593-5571 URL: www.adbi.org E-mail: [email protected] © 2019 Asian Development Bank Institute ADBI Working Paper 976 Kelkar and Seetha Ram Abstract Evidence shows that there are numerous socioeconomic and environmental benefits from improved sanitation; conversely, numerous studies have explored the lack of access to basic sanitation and its negative impact on gross domestic product (GDP). This paper establishes the positive impacts on GDP from investment in sanitation and emphasizes how it can regenerate countries. As the backdrop of this idea, this paper combines and analyzes supporting evidence through an extensive literature review to show that a new way of thinking informed by a comprehensive understanding of the historical issues faced must be adopted to address the sanitation challenge. This paper emphasizes decentralization, technological standardization, innovative financing, cost-recovery mechanisms and the potential of socioeconomic spillover effects as tools to revitalize the sanitation sector. It further elaborates on the significance of hybrid governance and institutional mechanisms, including state and non-state actors, to collectively contribute toward achieving total sanitation coverage in developing Asian countries. The paper shares the message that the benefits of wastewater management are far-reaching and conveys the importance of decision makers prioritizing this sector. The paper concludes that achieving replicability and scalability requires dedicated political will and visionary leadership. Keywords: Sanitation, Asia, GDP, FSM, leadership, governance, innovative solutions, scalability, replicability JEL Classification: A13, Q53, L3, O18 ADBI Working Paper 976 Kelkar and Seetha Ram Contents 1. INTRODUCTION ......................................................................................................... 1 1.1 Socioeconomic Spillover Effects from Improved Sanitation ............................ 4 2. LITERATURE REVIEW ............................................................................................... 5 2.1 Historical References of Sanitation Provision and Its Present-Day Relevance ....................................................................... 5 2.2 Present Global Scenario: System Failures, Inability to Invest in the Sector, and Unwillingness of Decision-Makers to Make Changes ............................... 6 2.3 Decentralization, Technological Standardization, and Community Engagement .................................................................................................... 6 2.4 Transformations in Innovative Financing Mechanisms for Decentralized Approaches, Hybrid Institutional, and Governance Structures ........................ 8 2.5 Political Will as the Key Driver in Prioritizing Sanitation and the Role of Data in Evidence-Based Decision-Making .................................................. 9 3. CONCLUSION .......................................................................................................... 10 REFERENCES ..................................................................................................................... 12 ANNEX: GENERIC DATA ON URBAN SANITATION-RELATED VARIABLES IN THE GIVEN COUNTRIES ................................................................................................ 14 ADBI Working Paper 976 Kelkar and Seetha Ram 1 1. INTRODUCTION Water and sanitation are core targets of the Sustainable Development Goals (SDGs) and the UN’s 2030 agenda. SDG 6’s focus on clean water and sanitation clearly outlines the urgent need to adapt and develop innovative solutions. Sanitation has been a consistently challenging development goal, with over 1.7 million people in the Asia and the Pacific having no access to safe sanitation, 780 million still practicing open defecation, and 80% of wastewater being disposed without appropriate treatment. As Asia is witnessing rapid urbanization, provision of safe sanitation remains crucial. It is estimated that 57% of urban dwellers lack access to toilets that provide a full sanitation service chain, including containment, treatment, and end-use treatment and disposal (Asian Development Bank 2016). There are numerous socioeconomic and environmental benefits from improved sanitation including a lowered disease burden, improved nutrition, increased literacy and safety for girls and women, reduced stunting, improved quality of life, healthier living environments, increased job opportunities and wages, and improved regional competitiveness (World Bank 2007). Experts have unanimously emphasized the need to attract attention to the impacts of lack of sanitation on the nation’s gross domestic product (GDP). The idea that a dollar invested in sanitation can yield at least a fivefold return in increased productivity is representative of a larger potential economic impact in the case of countries such as Cambodia, Indonesia, the Philippines, and Viet Nam, where an estimated loss of $9 billion annually results in a 2% GDP loss (World Bank 2007). A substantial part of these setbacks also arises from the resulting health-related economic impacts such as was seen with the Ebola crisis in West Africa. Globally, poor sanitation resulted in a loss of about $222.9 billion in 2015, with Asia and the Pacific continually suffering the greatest losses at 1.1% of total GDP, typically stemming from India, with almost 5.2% of its GDP (Lixil, Oxford Economics, Water Aid 2016). Though studies of sanitation have consistently focused on regions where it is persistently lacking, resulting policy recommendations have not driven governments to prioritize improvements and investments. Globally, sanitation has consistently lagged water supply, but some Asian countries have shown remarkable progress with impressive coverage rates over the years. Specifically, in Southeast and East Asia, there has been a marginal rise in basic sanitation services. Globally, from 2000 to 2015, basic sanitation increased by an annual incremental average of 0.63% in comparison with basic drinking water services. Southeast and East Asia’s 77% coverage rate is higher than Central and South Asia’s 50% rate (WHO, JMP, UNICEF 2017), but it was not always this positive. In 1990, only 25% of Southeast Asia had access to improved sanitation, but access incrementally increased to more than 45% by 2012. This indicates that sanitation improvements gained substantial momentum in Southeast and East Asia over the years. As Asia has rapidly progressed and urbanized over the past decade, countries in Southeast and East Asia have been at the helm of economic development; as a result, the correlation between sanitation improvements and a nation’s GDP growth has begun attracting attention. While the literature has often described lack of sanitation as a cause of losses that negatively impact GDP, the reverse has also been true. Countries such as Japan, the Republic of Korea, Malaysia, and Thailand are examples of success achieved through governments prioritizing sanitation in the formative years of nation-building that contributed to GDP growth. While the authors do not intend to claim causality, they urge that a deeper understanding of the positive impact of sanitation improvements on GDP ADBI Working Paper 976 Kelkar and Seetha Ram 2 can shift points of view and perceptions of sanitation investments as an economic generation model as opposed to an economic drain. Table 1 details the comparative sanitation coverage to GDP per capita scenarios of Japan, the Republic of Korea, and Thailand. Although the understanding of sanitation coverage is not universal, the numbers in Table 1 represent components such as latrine access, sewer network coverage, and access to wastewater treatment, in the form of overall sanitation coverage in the countries. On the other hand, Table 2 describes the sanitary growth profile of only Malaysia through total latrine coverage and rural latrine coverage from 1961 to 2011. Table 1: Comparative Sanitation Coverage and GDP/Capita of Countries Japana Republic of Koreab Thailandc Year Sanitation Coverage (%) GDP/Capita ($) Sanitation Coverage (%) GDP/Capita ($) Sanitation coverage (%) GDP/Capita ($) 1961 20 563.59 Data unavailable 93.8 0 107.5 1966 48 1,058.50 133.45 5 161 1971 78 2,260.38 300.77 15 194.25 1976 89 5,171.04 830.7 34 391.48 1981 100 10,331.74 1,870.339 41 720.9 1986 100 17,079.6 2,803.37 45 813.2 1991 100 28,874.36 35.7 7,523.48 71 1,715.63 1996 100 38,436.93 52.6 13,137.9 97 3,042.9 2001 100 33,846.47 73.2 11,252.9 100 1,893.14 2006 100 35,433.99 85.5 20,888.38 100 3,368.95 2011 100 48,168 90.9 24,079.8 100 5,491.16 GDP = gross domestic product. a. Otaki, Y., M. Otaki, and O. Sakura, Water Systems and Urban Sanitation: A Historical Comparison of Tokyo and Singapore. b. Korea Water and Wastewater Works Association, Transformation of Water Sector (1960–2012). c. Punpeng, T. (Dept. of Health, Ministry of Public Health), Conference Presentation, East-Asia Ministerial Conference on Sanitation and Hygiene. Source: World Development Indicators. Table 2: Malaysia Sanitary Growth Profile 1961 1968 1971 1981 1991 2001 2011 GDP/ Capita ($) 234.92 357.66 1,774.74 2,440.59 4,045.17 9,071.36 Total Latrine Coverage (%) 4.5 63.1 Rural Latrine Coverage (%) 12 40 80 90 98 100 GDP = gross domestic product. Source: World Development Indicators, Water Aid, and UNDP Malaysia Country Team Report (2005). ADBI Working Paper 976 Kelkar and Seetha Ram 3 In Thailand, where sanitation coverage grew from 45% to 71% until 1991 and GDP grew from 1961 to 2001, the country successfully achieved total sanitation coverage similar to other developing countries at the time, such as Japan and the Republic of Korea. In the Republic of Korea and Malaysia, the governments also took strategic steps to achieve total sanitation, although the data are unavailable. In the Republic of Korea, the development of the water and sanitation sectors was consistently linked to economic growth (Korea Water and WasteWater Works Association n.d.), leading to the effective utilization of official development assistance (ODA). Additionally, when some of these countries prioritized investments in sanitation, their GDPs were lower than those of subSaharan African countries, as shown in Table 3, though a vision enabled financial investments from various sources. Table 3: Progress of GDP to Sanitation Coverage Country GDP/Capita ($) in 1960 Sanitation Coverage Rate (%) in 2015 Republic of Korea 158.23 100 Ghana 182.97 14.28 Liberia 170.03 16.89 Senegal 247.23 48 Zambia 234.166 31.11 Zimbabwe 280.99 38.59 GDP = gross domestic product. Source: WHO-JMP/World Bank Data, Water Aid (January 2018). Developing Asian countries today resemble the GDP per capita of countries like the Republic of Korea and Malaysia from the 1960s, yet they have not been able to achieve comparative levels of sanitation coverage. For example, India’s GDP per capita in 2018 was $1,977.29, but sanitation coverage was low. Following the implementation of the Swachh Bharat Campaign, safe sanitation coverage in rural India has reached above 90%. In 1991, when Thailand’s GDP per capita was $1,715.63, its total sanitation coverage was 71%, indicating that higher GDP per capita may not directly correlate and that countries that invested in sanitation improvements and succeeded in greater coverage were not as wealthy when they started. It is important to understand that today’s developing countries face increasing challenges and complexities with regard to urban sprawl, rapid urbanization, and formation of informal settlements. It may be significant for sector experts to explore the idea that sanitation coverage may be linked to GDP growth and a myriad of policy reforms are needed to engender a new way of thinking about sanitation improvements and economic prosperity. Another dimension to sanitation implementation involves donor aid, ODA, and their effective allocations. “Asian countries have been able to receive substantial donor aid to develop the Water, Sanitation and Hygiene (WASH) sector. ODA to countries like the People’s Republic of China, India, and Turkey consists of loans that have financial grants of at least 25%. Yet, sanitation and water consisted of only 1% of the GDP for the countries in 2008-2009” (OECD 2011). In the case of Indonesia, “2.3% of GDP was lost due to lack of sanitation which is 20 times higher than the required investments” (Water and Sanitation Program – East Asia and the Pacific (WSP-EAP) 2007). ADBI Working Paper 976 Kelkar and Seetha Ram 4 1.1 Socioeconomic Spillover Effects from Improved Sanitation Understanding the wider impact of aid disbursements is essential to cultivating the socioeconomic spillover effects from improved sanitation. Until now, the emphasis has been on direct impacts from sanitation interventions; very few studies have documented the larger benefits that can be seen over a longer period in terms of higher literacy, better job opportunities, increased health and business opportunities, and all-round well-being. With development aid projects, negative outcomes related to community benefits and socioeconomic profits have resulted in a pessimistic atmosphere within donor agencies toward the continued success of investment in sanitation sector development and its impact on the end-use consumer. A study by Clarke, Feeny, and Donnelly (2014) argued that aid projects in the WASH sector should not only be assessed by their immediate benefit to their targeted community, but also their lasting impact, that is, their sustainability. Through an appreciative inquiry, their study found that although one in 27 water and sanitation projects in Pacific countries could be considered sustainable through direct impact, while benefits persisted by way of enhanced community health in 22 projects. This reframing of the term sustainability to include persistent benefits can provide an accurate assessment of an aid’s project value. Public investment portfolios assess projects based on their immediate impacts and full-cost recovery; traditional measures are unable to capture the wider impact of many projects, which adds to the perception of failure. But, the above findings support our argument that while immediate impacts from sanitation must be assessed, the greater value of investment in the projects is through the long-term spillovers, resulting in greater sustainability and returns from the investment through diverse avenues that, while not exactly associated with full-cost recovery, provide larger benefits to governing bodies. Therefore, the question remains why, despite receiving high ODA, countries in South Asia are unable to effectively prioritize and allocate financial resources toward improved sanitation. Box 1: Philippines Case, Dumaguete Fecal Sludge Management Plant In early 2000, the city of Dumaguete in the Philippines faced tremendous contamination from uncollected and untreated wastewater leading to pollution of the city’s bay and groundwater. A fecal sludge management (FSM) program was established in 2006 through which the city invested in a $500,000 on-site sewage treatment facility. Following deployment of the facility, the city witnessed improvements in health, the environment, and the economy. The investment was fully recovered in 8 years through a sewage tariff that consisted of each household paying $1 per month for the local government to empty the septic tanks every 5 years. Now that the initial investment has been recovered, the plant has been generating revenue for the city’s employment program, infrastructure, health services, and education. The implementation of this project also leads to the overall economic growth of the city through growth in industries, tourism, livelihood, productivity and property values. The success of the Dumaguete city FSM program has been documented extensively by the Asian Development Bank Institute (ADBInstitute 2018). ADBI Working Paper 976 Kelkar and Seetha Ram 11 tariffs have consistently focused on full-cost recovery and, thus, on large-scale technological solutions, while not entirely considering the potential from tax revenues stemming from the “user pays” principle. This paper has combined and analyzed available literature and presented a new way to think about the sanitation challenge. Using decentralized and distributed options, tailor-made solutions must be devised according to local contexts using innovative financing mechanisms. Standardization of available technologies with adequate community participation is critical to resolving issues on a region-by-region basis. With growing demands from urbanization and migration, it is imperative that a hybrid governance model be adopted, including state and non-state actors, to collectively contribute toward implementation of sanitation projects at various scales. Consequently, it is significant to understand that access to improved sanitation and wastewater management has benefits that greatly counter the negative effects of a lack thereof on gender, education, and GDP. The spillover effects from sanitation lie beyond the periphery of its immediate impacts and concurrently result in greater economic prosperity and social well-being over a long period of time, resulting in a sustainable environment. Ultimately, this paper emphasizes that countries need to immediately prioritize and invest in sanitation through dedicated political will, evidence-based decision making and government support, driven by the understanding of the far-reaching spillovers from decentralized and community-driven projects required to replicate and scale. ADBI Working Paper 976 Kelkar and Seetha Ram 12 REFERENCES Abesuriya, K., C. Mitchell, and J. Willets. 2008. Expanding Economic Perspectives for Sustainability in Urban Water and Sanitation. Development 51(1): 23–29. Anderson, K., S. Dickin, and A. Rosemarin. 2016. Towards ‘Sustainable’ Sanitation: Challenges and Opportunities in Urban Areas. Sustainability 8(12): 1289. Araral, E. 2009. The failure of water utilities privatization: Synthesis of evidence, analysis and implications. Policy and Society 27(3): 221–228. ———. 2010. Reform of water institutions: review of evidences and international experiences. Water Policy 12(S1): 8–22. Araral, E., and D. J. Yu. 2013. Comparative water law, policies, and administration in Asia: Evidence from 17 countries. Water Resources Research 49: 5307–5316. Asian Development Bank. 2016. Asian Water Development Outlook 2016: Strengthening Water Security in Asia and the Pacific. Manila: Asian Development Bank. ———. 2018. Spillover Effects from Fecal Sludge Management: Dumaguete City. Directed by Asian Development Bank Institute. Produced by Asian Development Bank Institute, Bill & Melinda Gates Foundation. https://www.adb.org/news/videos/spillover-effects-fecal-sludge-managementdumaguete-city. (accessed 27 May 2019). ———. 2016. Sanitation and Sustainable Development in Japan. Manila: Asian Development Bank. Brdjanovic, D., F. Zakaria, P. M. Mawioo, H. A. Garcia, and C. M. Hoojimans. 2015. eS0S - Emergency Sanitation Operation System. Journal of Water, Sanitation and Hygiene for Development 5: 156–164. Clarke, M., S. Feeny, J. Donnelly. 2014. Water, Sanitation and Hygiene Interventions in the Pacific: Defining, Assessing and Improving ‘Sustainability’. European Journal of Development Research 26(5): 692–706. Cooper, P. F. 2001. Historical Aspects of Wastewater Treatment. In Decentralised Sanitation and Reuse: Concepts, Systems and Implementation, edited by G. Zeeman, G. Lettinga, and P. Lens, 11–54. London: IWA Publishing. Domenech, L. 2011. Rethinking Water Management: From Centralised to Decentralised Water Supply and Sanitation Models. Documents d'Analisi Geografica 57(2): 293–310. Fane, S., and C. Mitchell. 2006. Appropriate Cost Analysis for Decentralised Water Systems. Paper presented at Enviro 06 Conference and Exhibition, May 9–11, Melbourne, Australia. Geels, F. W. 2005. Co-evolution of Technology and Society: The Transition in Water Supply and Personal Hygiene in the Netherlands (1850-1930): A Case-Study in Multi-Level Perspective. Technology in Society 27(3): 363–397. Kallis, G. and H. Cocossis. 2003. Managing Water for Athens: From the Hydraulic to the Rational Growth Paradigm. European Planning Studies 11: 245–261. Korea Water and WasteWater Works Association. n.d. Transformation of Water Sector (1960–2012). Lixil, Oxford Economics, Water Aid. 2016. The True Cost of Poor Sanitation. ADBI Working Paper 976 Kelkar and Seetha Ram 13 Lofrano, G., and J. Brown. 2010. Wastewater Management through Ages: A History of Mankind. Science of the Total Environment 408: 5254–5264. McGranahan, G., and D. Mitlin. 2016. Learning from Sustained Success: How Community-Driven Initiatives to Improve Urban Sanitation Can Meet the Challenges. World Development 87: 307–317. Organisation for Economic Co-operation and Development (OECD). 2011. Benefits of Investing in Water and Sanitation: An OECD Perspective. Paris: OECD. Otaki, Y, M. Otaki and O. Sakura. 2007. Water Systems and Urban Sanitation: A Historical Comparison of Tokyo and Singapore. Journal of Water and Health (IWA Publishing). Pories, L. 2015. Income-enabling, not Consumptive: Association of Household SocioEconomic Conditions with Safe Water And Sanitation. Acquatic Procedia: World Water Week 6: 74–86. Post, A. E., V. Bronsoler, L. Salman. 2017. Hybrid Regimes for Local Public Goods Provision: A Framework for Analysis. Perspectives on Politics 15(4): 952–966. Punpeng, T. (Dept. of Health, Ministry of Public Health). 2007. Universal Sanitation – Thailand. East-Asia Ministerial Conference on Sanitation and Hygiene. Sim, J. 2018. Lecture Seminar on a Vision for Accelerating Access to Sanitation. Internal Seminar. Tokyo: Asian Development Bank Institute. Starkl, M., N. Brunner, M. Feil, A. Hauser. 2015. Ensuring Sustainability of NonNetworked Sanitation Technologies: An Approach to Standardization. Environmental Science & Technology 49: 6411–6418. United Nations Country Team, Malaysia. 2005. Malaysia Achieving the Millenium Development Goals: Successes and Challenges. UNDP. Water Aid. n.d. Universal Access to Improved Sanitation in Malaysia’s rural areas: Detailed Study on the Role of Institutions and their Political Drivers. Water and Sanitation Program – East Asia and the Pacific (WSP-EAP). 2007. Economic Impacts of Sanitation in South-East Asia Summary. A four-country study conducted in Cambodia, Indonesia, the Philippines and Vietnam under the Economics of Sanitation Initiative (ESI), World Bank – East Asia and the Pacific Region. ———. 2008. Economic Impacts of Sanitation in Southeast Asia. World Bank – East Asia and the Pacific Region. WHO, JMP, UNICEF. 2017. Progress on Drinking Water, Sanitation and Hygiene. 2017 Updates and SDG Baselines. WHO, JMP, UNICEF. WHO, Water Supply and Sanitation Collaborative Council, UNICEF. 1992. Water Supply and Sanitation Sector Monitoring Report 1990 (Baseline Year). WHO/UNICEF Joint Monitoring Programme, WHO/ UNICEF. World Bank. 2007. Economic Impacts of Sanitation in Southeast Asia-Summary. Water and Sanitation Program – East Asia and Pacific ( WSP-EAP), East Asia and the Pacific Region: World Bank. ———. n.d. World Development Indicators. https://datacatalog.worldbank.org/dataset/ world-development-indicators. (accessed 27 May 2019). ADBI Working Paper 976 Kelkar and Seetha Ram 14 ANNEX: GENERIC DATA ON URBAN SANITATIONRELATED VARIABLES IN THE GIVEN COUNTRIES GDP per capita (current US$) Country 1960 1965 1970 1975 1980 1985 Bangladesh 88.69 105.79 138.25 272.75 222.63 239.04 Bhutan .. .. .. .. 331.53 368.63 Cambodia 111.34 134.30 102.70 .. .. .. PRC 89.52 98.49 113.16 178.34 194.80 294.46 India 81.28 118.06 111.26 156.38 263.84 293.49 Indonesia .. .. 84.84 248.12 523.25 550.32 Japan 479.00 919.78 2,027.07 4,635.12 9,416.63 11,599.74 Korea, Rep. of 158.24 108.70 279.13 615.20 1,704.47 2,457.33 Malaysia 234.92 310.33 357.66 764.56 1,774.74 2,000.15 Nepal 50.52 67.37 72.18 118.25 130.58 156.66 Sri Lanka 142.78 152.85 183.93 275.63 267.67 369.50 Singapore 427.88 516.29 925.29 2,489.78 4,926.96 6,995.10 Thailand 100.77 137.92 192.13 351.55 682.77 747.49 Viet Nam .. .. .. .. .. 230.87 Country 1990 1995 2000 2005 2010 2015 Bangladesh 297.57 319.61 405.60 484.16 757.67 1,210.16 Bhutan 557.97 588.59 765.86 1,247.06 2,178.92 2,615.31 Cambodia .. 323.01 300.69 474.22 785.69 1,163.19 PRC 317.88 609.66 959.37 1,753.42 4,560.51 8,069.21 India 363.96 370.10 438.86 707.01 1,345.77 1,596.47 Indonesia 622.87 1,092.70 830.58 1,342.54 3,113.48 3,336.11 Japan 25,417.28 43,440.37 38,532.04 37,217.65 44,507.68 34,474.14 Korea, Rep. of 6,516.31 12,332.98 11,947.58 18,639.52 22,086.95 27,105.08 Malaysia 2,440.59 4,328.00 4,045.17 5,593.82 9,071.36 9,648.55 Nepal 193.48 205.69 231.43 317.09 592.18 747.16 Sri Lanka 463.51 714.07 869.50 1,250.03 2,808.43 3,891.66 Singapore 11,864.28 24,936.83 23,792.61 29,869.85 46,569.68 53,629.74 Thailand 1,508.29 2,845.41 2,007.56 2,893.65 5,075.30 5,814.86 Viet Nam 94.88 275.75 388.27 683.60 1,310.37 2,065.17 continued on next page ADBI Working Paper 976 Kelkar and Seetha Ram 15 Annex table continued People using at least basic sanitation services (% of population) Country 1960 1965 1970 1975 1980 1985 Bangladesh .. .. .. .. .. .. Bhutan .. .. .. .. .. .. Cambodia .. .. .. .. .. .. PRC .. .. .. .. .. .. India .. .. .. .. .. .. Indonesia .. .. .. .. .. .. Japan .. .. .. .. .. .. Korea, Rep. of .. .. .. .. .. .. Malaysia .. .. .. .. .. .. Nepal .. .. .. .. .. .. Sri Lanka .. .. .. .. .. .. Singapore .. .. .. .. .. .. Thailand .. .. .. .. .. .. Viet Nam .. .. .. .. .. .. Country 1990 1995 2000 2005 2010 2015 Bangladesh .. .. 25.35 32.72 39.93 46.92 Bhutan .. .. 53.19 56.76 60.00 62.87 Cambodia .. .. 12.26 24.37 36.52 48.83 PRC .. .. 60.58 65.15 70.14 75.04 India .. .. 21.68 29.22 36.72 44.15 Indonesia .. .. 44.24 52.59 60.49 67.89 Japan .. .. 99.98 99.99 99.99 100.00 Korea, Rep. of .. .. 100.00 100.00 100.00 99.89 Malaysia .. .. 96.78 97.88 98.87 99.57 Nepal .. .. 19.19 28.38 37.35 46.13 Sri Lanka .. .. 85.38 88.56 91.75 94.21 Singapore .. .. 100.00 100.00 100.00 100.00 Thailand .. .. 94.87 94.96 95.00 95.01 Viet Nam .. .. 53.40 62.01 70.31 78.24 continued on next page ADBI Working Paper 976 Kelkar and Seetha Ram 16 Annex table continued People using safely managed sanitation services (% of population) Country 1960 1965 1970 1975 1980 1985 Bangladesh .. .. .. .. .. .. Bhutan .. .. .. .. .. .. Cambodia .. .. .. .. .. .. PRC .. .. .. .. .. .. India .. .. .. .. .. .. Indonesia .. .. .. .. .. .. Japan .. .. .. .. .. .. Korea, Rep. of .. .. .. .. .. .. Malaysia .. .. .. .. .. .. Nepal .. .. .. .. .. .. Sri Lanka .. .. .. .. .. .. Singapore .. .. .. .. .. .. Thailand .. .. .. .. .. .. Viet Nam .. .. .. .. .. .. Country 1990 1995 2000 2005 2010 2015 Bangladesh .. .. .. .. .. .. Bhutan .. .. .. .. .. .. Cambodia .. .. .. .. .. .. PRC .. .. 29.06 35.35 46.63 59.69 India .. .. .. .. .. .. Indonesia .. .. .. .. .. .. Japan .. .. 98.21 99.01 99.60 99.80 Korea, Rep. of .. .. 85.64 89.95 94.38 98.46 Malaysia .. .. 78.06 79.50 80.84 81.93 Nepal .. .. .. .. .. .. Sri Lanka .. .. .. .. .. .. Singapore .. .. 100.00 100.00 100.00 100.00 Thailand .. .. .. .. .. .. Viet Nam .. .. .. .. .. .. continued on next page ADBI Working Paper 976 Kelkar and Seetha Ram 17 Annex table continued Tuberculosis case detection rate (%, all forms) Country 1960 1965 1970 1975 1980 1985 Bangladesh .. .. .. .. .. .. Bhutan .. .. .. .. .. .. Cambodia .. .. .. .. .. .. PRC .. .. .. .. .. .. India .. .. .. .. .. .. Indonesia .. .. .. .. .. .. Japan .. .. .. .. .. .. Korea, Rep. of .. .. .. .. .. .. Malaysia .. .. .. .. .. .. Nepal .. .. .. .. .. .. Sri Lanka .. .. .. .. .. .. Singapore .. .. .. .. .. .. Thailand .. .. .. .. .. .. Viet Nam .. .. .. .. .. .. Country 1990 1995 2000 2005 2010 2015 Bangladesh .. .. 26 39 46 58 Bhutan .. .. 80 80 80 80 Cambodia .. .. 27 52 65 62 PRC .. .. 33 74 87 87 India .. .. 37 36 44 59 Indonesia .. .. 8.9 26 30 32 Japan .. .. 87 87 87 87 Korea, Rep. of .. .. 94 94 94 94 Malaysia .. .. 87 87 87 87 Nepal .. .. 76 80 80 74 Sri Lanka .. .. 68 73 74 69 Singapore .. .. 87 87 87 87 Thailand .. .. 22 40 55 53 Viet Nam .. .. 57 64 71 79 continued on next page ADBI Working Paper 976 Kelkar and Seetha Ram 18 Annex table continued Incidence of malaria (per 1,000 population at risk) Country 1960 1965 1970 1975 1980 1985 Bangladesh .. .. .. .. .. .. Bhutan .. .. .. .. .. .. Cambodia .. .. .. .. .. .. PRC .. .. .. .. .. .. India .. .. .. .. .. .. Indonesia .. .. .. .. .. .. Japan .. .. .. .. .. .. Korea, Rep. of .. .. .. .. .. .. Malaysia .. .. .. .. .. .. Nepal .. .. .. .. .. .. Sri Lanka .. .. .. .. .. .. Singapore .. .. .. .. .. .. Thailand .. .. .. .. .. .. Viet Nam .. .. .. .. .. .. Country 1990 1995 2000 2005 2010 2015 Bangladesh .. .. 12.50 12.60 8.60 0.80 Bhutan .. .. 26.40 7.00 1.50 0.10 Cambodia .. .. 207.00 48.70 20.50 13.00 PRC .. .. 0.10 0.10 0.02 0.00 India .. .. 42.70 48.10 33.10 18.60 Indonesia .. .. 99.00 119.10 129.20 26.10 Japan .. .. .. .. .. .. Korea, Rep. of .. .. 2.80 0.90 0.80 0.80 Malaysia .. .. 16.30 6.20 6.50 1.90 Nepal .. .. 18.30 12.50 5.40 3.30 Sri Lanka .. .. 107.00 0.80 0.30 0.00 Singapore .. .. .. .. .. .. Thailand .. .. 11.90 6.40 6.30 2.70 Viet Nam .. .. 6.30 1.20 0.70 0.30 continued on next page ADBI Working Paper 976 Kelkar and Seetha Ram 19 Annex table continued Improved sanitation facilities (% of population with access) Country 1960 1965 1970 1975 1980 1985 Bangladesh .. .. .. .. .. .. Bhutan .. .. .. .. .. .. Cambodia .. .. .. .. .. .. PRC .. .. .. .. .. .. India .. .. .. .. .. .. Indonesia .. .. .. .. .. .. Japan .. .. .. .. .. .. Korea, Rep. of .. .. .. .. .. .. Malaysia .. .. .. .. .. .. Nepal .. .. .. .. .. .. Sri Lanka .. .. .. .. .. .. Singapore .. .. .. .. .. .. Thailand .. .. .. .. .. .. Viet Nam .. .. .. .. .. .. Country 1990 1995 2000 2005 2010 2015 Bangladesh 34.40 40.00 45.40 50.70 55.80 60.60 Bhutan 18.90 23.60 31.00 39.00 46.80 50.40 Cambodia 2.90 7.70 16.30 24.90 33.60 42.40 PRC 47.50 53.20 58.80 64.90 70.80 76.50 India 16.80 20.80 25.60 30.60 35.50 39.60 Indonesia 35.20 41.00 47.10 52.10 57.00 60.80 Japan 100.00 100.00 100.00 100.00 100.00 100.00 Korea, Rep. of 100.00 100.00 100.00 100.00 100.00 100.00 Malaysia 86.20 88.80 91.20 93.40 95.40 96.00 Nepal 4.50 13.10 21.70 29.90 37.90 45.80 Sri Lanka 70.70 76.00 81.20 86.40 91.70 95.10 Singapore 99.20 99.40 99.70 100.00 100.00 100.00 Thailand 86.90 89.10 91.30 93.20 93.30 93.00 Viet Nam 36.20 44.60 52.90 61.40 69.70 78.00 continued on next page ADBI Working Paper 976 Kelkar and Seetha Ram 20 Annex table continued Public-Private partnerships investment in water and sanitation (current US$) Country 1960 1965 1970 1975 Bangladesh .. .. .. .. Bhutan .. .. .. .. Cambodia .. .. .. .. PRC .. .. .. .. India .. .. .. .. Indonesia .. .. .. .. Japan .. .. .. .. Korea, Rep. of .. .. .. .. Malaysia .. .. .. .. Nepal .. .. .. .. Sri Lanka .. .. .. .. Singapore .. .. .. .. Thailand .. .. .. .. Viet Nam .. .. .. .. Country 1980 1985 1990 1995 Bangladesh .. .. .. .. Bhutan .. .. .. .. Cambodia .. .. .. .. PRC .. .. .. 150,000,000.00 India .. .. .. .. Indonesia .. .. .. 200,000,000.00 Japan .. .. .. .. Korea, Rep. of .. .. .. .. Malaysia .. .. .. 10,000,000.00 Nepal .. .. .. .. Sri Lanka .. .. .. .. Singapore .. .. .. .. Thailand .. .. .. 160,000,000.00 Viet Nam .. .. .. .. Country 2000 2005 2010 2015 Bangladesh .. .. .. .. Bhutan .. .. .. .. Cambodia .. .. .. .. PRC 72,400,000.00 1,007,319,000.00 123,700,000.00 774,050,000.00 India .. .. .. 18,500,000.00 Indonesia .. .. .. .. Japan .. .. .. .. Korea, Rep. of .. .. .. .. Malaysia 3,964,800,000.00 .. .. .. Nepal .. .. .. .. Sri Lanka .. .. .. .. Singapore .. .. .. .. Thailand 8,800,000.00 241,600,000.00 .. .. Viet Nam 20,000,000.00 92,000,000.00 .. .. continued on next page