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Costs, Climate and Contamination: Three Drivers for Citywide Sanitation Investment Decisions

机译:成本,气候和污染:全市卫生投资决策三个司机

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Significant progress is needed, in both large cities and small towns, to meet the ambitious targets set at international and national levels relating to universal access to safely managed sanitation. There has been increased recognition in the urban sanitation sector that in rapidly growing cities, there is unlikely to be a single centralised sanitation solution which can effectively deliver services to all demographics, and that heterogeneous approaches to urban sanitation are required. At the same time, due to competing investment priorities, there is a greater focus on the need for sanitation investments to address multiple objectives. However, calls for more informed sanitation planning and a more dynamic and disaggregated approach to the delivery and management of sanitation services have had limited impacts. This is in part due to the complexity of the drivers for sanitation investment, and the difficulties involved in identifying and addressing these multiple, often conflicting, goals. This paper examines three potential drivers of citywide sanitation decision-making – public health, sustainability and economic performance – via the three proxies of contamination, climate change and costs. It examines the importance of each driver and proxies, how they are considered in investment decisions, the current state of knowledge about them, and priority aspects to be included in decisions. At present, while public health is a common driver for improving sanitation, there are significant gaps in our understanding of faecal contamination spread and exposure, and how to select sanitation solutions which can best address them. Climate change is sometimes seen as a low priority for the sanitation sector given the immediacy and scale of existing challenges and the uncertainty of future climate predictions. However, potential risks are significant, and uninformed decisions may result in greater costs and increased inequalities. Cost data are sparse and unreliable, and it is challenging to build robust cost-effectiveness analyses. Yet these are needed to compare citywide options based on least-cost over their full life cycle. This paper provides insights into how existing evidence on contamination, climate change and costs can inform decisions on sanitation investments and help chart a sustainable way forward for achieving citywide services.
机译:在大城市和小城镇都需要取得重大进展,以满足与普遍获得安全管理卫生设施的国际和国家一级的雄心勃勃的目标。城市卫生部门的认可越来越高,在迅速增长的城市中,不太可能成为一个集中卫生解决方案,可以有效地为所有人口统计提供服务,并且需要对城市卫生设施的异质方法。与此同时,由于竞争投资优先事项,更加注重卫生投资来解决多项目标的需求。但是,呼吁更明智的卫生规划和更具活力和分类的卫生服务的交付和管理的方法产生了有限的影响。这部分是由于卫生投资驱动程序的复杂性,以及识别和解决这些多个,通常相互冲突的目标所涉及的困难。本文审查了全国卫生决策 - 公共卫生,可持续性和经济绩效的三个潜在驱动因素 - 通过三个污染,气候变化和成本。它探讨了每个驾驶员和代理的重要性,如何在投资决策中考虑,目前关于它们的知识状态,以及在决策中包含的优先方面。目前,虽然公共卫生是改善卫生设施的共同司机,但我们对粪便污染蔓延和曝光的理解有显着差距,以及如何选择最佳地址的卫生解决方案。气候变化有时被视为卫生部门的低优先事项,因为存在的挑战和未来气候预测的不确定性的立即和规模。但是,潜在的风险是重要的,并且不合理的决定可能导致更大的成本和增加的不平等。成本数据稀疏和不可靠,构建强大的成本效益分析是挑战性的。然而,需要这些来基于完整生命周期的最低成本比较全市各种选择。本文介绍了现有污染证据,气候变化和成本如何提供有关卫生投资的决策,并帮助绘制可持续方式以实现全市服务。

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