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02 de julho de 2014
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Basic Sanitation: There are money and technology, but no projects and political will

In 2013, the diseases caused by the lack of sanitation have generated expenses to the health national system of R$ 121 million, a value which, if invested in the sanitation universalization would result in R$ 27.3 million annual savings

A recent survey carried out by ONG Instituto Trata Brasil, which was published in March this year, places Brazil, the seventh economy in the world in the 112th position in the basic sanitation international ranking. Based on the Sanitation Development Index, calculated by the Human Development Index, of the United Nations Program for the Development (IDH), the Country reached the level 0.581, what places us below the rich nations of North America and Europe, but also below some Latin American nations, such as Ecuador, the economic performance of which is inferior to the Brazilian one, and even below Arabian countries, such as Oman, and African nations, such and Egypt.

The worst scenario is found in the North Region of Brazil, where 14.4 million houses do not have collection service and sewage treatment. The Northeast has 13.5 million houses without the service, and more than six million do not have treated water. Bahia is the state with more houses with no collection service and sewage treatment in the region, with 3.3 million of units that lack the service. Ceará ranks on the second position, with 1.9 million. The best coverage record is in the South Region, which has 6.4 million of houses without the service, followed by the Southeast Region, with 8.2 million of houses without collection service and sewage treatment.

As a result of several decades of postponed investments in sanitation infrastructure, Brazil accumulated a historic deficit in the segment. There is an estimative that more than 36 million people do not have access to potable water, less than half of Brazilians have access to collection service and only 38% of sewages in the Country are treated. This has generated, in 2011, about 400 thousand hospitalizations for diarrhea all over Brazil, according to a study published by Instituto Trata Brasil, in 2013. Out of the total recorded cases, 53% involved 0 to 5 year old children.

Data of Associação Brasileira das Concessionárias Privadas de Serviços Públicos de Água e Esgoto (Abcon) show that at every passing day, seven children die in Brazil, victims of diseases caused by the lack of basic sanitation.

In 2013, according to Ministério da Saúde (DataSus), more than 340 thousand hospitalizations were notified due to gastrointestinal infections all over Brazil. About 173 thousand were classified by the doctors as “gastrointestinal diarrhea of presumable infectious origin”. Not less than 170.7 thousand hospitalizations involved children and young people with up to 14 year of age.

The sanitation precarious situation is also reflecting on the population’s longevity. The life expectation in Brazil, of 73.3 years in 2011, is lower than the average in Latin America (74.4 years). As compared to closer countries, Brazil is behind Argentina (with 75.8 years) or Chile (79.3 years).

The deficit cost

The cost of a hospitalization due to gastrointestinal infection in Sistema Único de Saúde (SUS), in 2013, was of about R$ 355.71 per patient in the national average. This resulted in public expenses of R$ 121 million/year. The sanitation universalization would result in R$ 27.3 million annual savings, distributed 52.3% in the Northeast and 27.2 in the North; the balance of the reduction would occur in Southeast, South and Mid-West regions of the country.

In the same year, 2135 persons died in hospitals, because of gastrointestinal infections. It is calculated that this number could drop to 1806 cases, in a reduction of 329 deaths (15.5% if we had a universal access to sanitation. According to the World Health Organization (WHO), each and every dollar invested in sanitation generates a four dollars savings in waterborne diseases treatment.

For Abcon, there is no lack of resources for investments, but lack of political will and the definition of efficient short, medium and long term projects. In 2007, after 20 years of discussions in the National Congress, they approved Law number 11 445 which brought new national guidelines and defined the services planning as a fundamental instrument to have the universal access to basic sanitation services. According to the Law, all municipalities should formulate their public policies aiming at the universalization, and Plano Municipal de Saneamento Básico (PMSB) is the instrument to define strategies and guidelines.

The law determines that the basic sanitation components are the water supply, sewage, urban cleaning and solid waste management and draining and urban pluvial waters management, which should be the object of PMSB.

Nevertheless, due to the lack of technical teams, that are ab le to prepare the municipalities projects, Decree Law number 7207/2010, which regulated Law 11 445/2007, postponed the PMSBs submission term from 2010 to December 2013, by determining that from 2014 on the existence of the plan would be condition to have access to the Union budgetary resources (§2, art. 26). This term, however, was postponed again to 2016 (Federal Decree 82ll of March 21st, 2014), and the deadline to submit the plans is now December 31st 2015. The Decree linked the access to the Union resources to the existence of social control entities until December 2014.

For Édison Carlos, executive president of Instituto Trata Brasil, the new extension did not create any incentive for those municipalities which strove to meet the previous deadline, and did not determine punishments to those which did not do anything, even after six years that the Law is in force. “The plans that have not been submitted further undermine the agility and planning of basic sanitation in the cities, which need to link the advancements to the soil occupation rules, the housing boom and the preserved areas protection”, he says.

Also according to the ONG president, a Country as Brazil, with aspirations to be an important player in important international discussions, cannot remain among the countries that have no basic sanitation. “Despite the fact that we host the World Cup in 2014 and the Olympic Games in 2016, we could not guarantee treated water, collection and treatment of sewage to all citizens”, says the executive president of Instituto Trata Brasil.

 

 

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