"There continues to be a critical situation with regard to water and sanitation. Although there has been progress in terms of coverage, there still are large areas with inequalities, especially in urban fringe areas and rural areas. This is a reflection of the lack of adequate investments in the sector", said Dr. Mauricio Pardón, director of the Division of Health and Environment of PAHO, said. He spoke on World Environment Day, celebrated every year to deepen public awareness of the need to preserve and enhance the environment.

Not only coverage but also quality of water services concerns PAHO. The problems with water quality are reflected in the booming bottled water industry, a result of public perception of the quality of water they get from domestic water taps, added Dr. Pardon.

PAHO's Basic Sanitation program supports country efforts to provide infrastructure and services required by the population to meet their basic environmental health needs. It seeks to reduce environmental risks associated with diarrheal diseases by increasing access to water and sanitation services, improving drinking water quality, and strengthening the institutions of the sector

PAHO is rethinking its technical cooperation for the next ten years, including new strategies for water and sanitation. A joint PAHO-UNICEF evaluation on the situation at the end of the 1990s, revealed that of the 459 million inhabitants in Latin America in 1998, 70 million lacked drinking water, 95 million-lack sanitation, and 194 million were connected to sewerage systems where effluents do not receive treatment.

"With this up-to-date information in hand, we are preparing new strategies for cooperation in water and sanitation centered where inequalities are greatest and where there are those enormous lags in terms of water quality and coverage. The strategy focuses on rural areas, medium-sized municipalities and urban fringe areas, and it includes broad participation by the communities themselves", Dr. Pardón said.

One of the greatest puzzles is the problem of wastewater. "I am concerned that this problem will continue. Wastewater and refuse continue to be dumped in watercourses and to the environment, without treatment", said Dr. Pardón. "And we do not see investment proposals that suggest that this is going to change."

The Basic Sanitation Program also works to strengthen the capacity of national institutions to administer health aspects related to water supply for human consumption, disposal of excreta and solid waste, and housing and urban sanitation.

Less than 15 percent of wastewater currently receives some type of treatment and this could worsen, according to Dr. Pardón. The situation already has a strong impact on watercourses, and contamination of surface water and groundwater of coastal areas.

If serious action is not taken in the next ten years, we could face more serious crises than the reappearance of cholera, according to Dr. Pardón.

PAHO has responded to this situation with the Regional Plan for Investment in the Environment and Health (PIAS). This plan indicates the type of investments required for the region of the Americas to have adequate sanitation. One of its strategies is the preparation of sectoral analyses that identify priorities for countries and regions.

The priorities cited in these multiple sectoral analyses point out the need for significant investments in treatment and sanitary disposal of wastewater. Concrete projects are needed in the countries, on the part of the governments, and municipalities.

"It is encouraging to see that the Inter-American Development Bank (IDB), in its urban infrastructure and sewage projects by definition already includes treatment of wastewater", said Dr. Pardón.

Another aspect of PAHO's work is 30 years of experience in promotion of useful and viable technologies for treatment of wastewater, such as stabilization ponds.

PAHO calculates that major investments in basic sanitation re needed to overcome cumulative deficits in the sanitary infrastructure of the region.