4 Water and sanitation policy in 19th century Great Britain ‘Parliament was all but compelled to legislate upon the great London nuisance by the

Box 12.4 Water and sanitation policy in 19th century Great Britain ‘Parliament was all but compelled to legislate upon the great London nuisance by the

force of sheer stench.’ Thus commented the London Times on an episode known as the ‘Great Stink’. So severe was the stench of sewage emanating from the Thames River in the long hot summer of 1858 that parliament was forced to close temporarily. Beyond parliament, the problems were more serious.

As industrialization and urbanization accelerated in the 19th century, fast-growing cities like Birmingham, London and Manchester became centres of infectious disease. Sewage overflowed and leaked from the limited number of cesspools into neighbour- hoods of the poor and ultimately into rivers like the Thames, the source of drinking water.

Parliamentary nostrils were offended – while poor people died. In the late 1890s, the infant mortality rate in Great Britain was 160 deaths for every 1000 live births – roughly the same as Nigeria today. Children died mainly from diarrhoea and dysentery. They died for the same reason that so many children still die in developing countries: sewage was not separated from drinking water. Between 1840 and the mid-1890s, average income doubled while child mortality increased slightly – a powerful demonstration of the gap between wealth generation and human development.

Growing awareness of the human costs of urban industrial life forced water onto the political agenda. In 1834, the Office of the Registrar General was formed, producing a steady stream of mortality figures that generated public concern. Social investigation became another powerful tool for reform. Edwin Chadwick’s Report on the Sanitary Condition of the Labouring Population of Great Britain provided an account of a crisis on

a grand scale, documenting in graphic detail the consequences of the water and sanitation problem: ‘The annual loss of life from filth and bad ventilation is greater than the loss from death or wounds from any war in which the country has been engaged in modern times’ (p369). Chadwick’s recommendations: a private tap and a latrine connected to a sewer for every household and municipal responsibility for providing clean water.

Reform came in two great waves. The first focused on water and began in the 1840s with the Public Health Act (1848) and the Metropolitan Water Act (1852), which expanded public provision of clean water. The discovery by John Snow in 1854 that cholera was a waterborne infection and that its spread could be halted by access to uncontaminated water supplies added to the impetus. By 1880, municipalities had displaced private water operators as the main providers of water in towns and cities.

The second great wave of reform shifted the locus of the public action from water to sanitation. This wave gathered momentum after 1880 and was reflected in a surge of public investment. Between the mid-1880s and mid-1890s, capital spending per capita on sanitation more than doubled in constant prices. It then doubled again over the next decade.

After 1840, life expectancy began to increase partly because of the first wave of reforms in water. It then came to a standstill, to resume after the great sanitation reforms came into play in the 1880s. In the space of little more than a decade (since) 1900, the infant mortality rate fell from 160 deaths per 1000 live births to 100 – one of the steepest declines in history. Public investment in sanitation, not rising private income, was the catalyst. Average incomes rose by only 6 per cent between 1900 and 1912.

HUMAN DEVELOPMENT POLICY ANALYSIS

New approaches to financing played a critical role in the second wave of reform. Mounting political pressure for public action generated an active search for new fiscal mechanisms to address a dilemma familiar in developing countries today: how to finance large upfront payments from a limited revenue base without raising taxes or charges to politically-unfeasible levels. Cities supplemented low-interest loans from the central government with municipal borrowing on bond markets. Water and sanitation accounted for about a quarter of local government debt at the end of the 19th century.

This huge mobilization of public finances reflected the changing place of water and sanitation in political priorities. Sanitation reform became a rallying point for social reformers, municipal leaders and public health bodies, who increasingly viewed inade- quate sanitation as a constraint not just on human progress but on economic prosperity. The public voice of civil society played a key role in driving the sanitation reform that made advances in public health possible.

But why the lag between the two great waves of reform? One of the major reform coalition partners in the first wave were the industrialists, who wanted water for factories but who were reluctant to pay higher taxes for extending sanitation to the poor. Politically powerful segments of society remained more interested in insulating themselves from the effects of poor sanitation among the poor than in universal provision. It was not until the electoral reform that extended voting rights beyond propertied classes that the voice of the poor became a more telling factor.

Edited extract from Box 1.1 of the Human Development Report, 2006, pp29–30.

This analysis of sanitation policy in Victorian Britain illustrates how analysis of policy is intertwined with analysis for policy. First, there is analysis of the content of the sanitation policy, and how it originated – Parliament could not function because of the smell from the Thames. The ‘policy-making’ stage is described in terms of its output, the mobilization of public finances to provide sanitation facilities. This policy content is however not alien from ‘analysis for policy’ in the form of evaluation. Chadwick’s study on the sanitary condition of the British labouring population had a lot to do with the passing of acts expanding the provision of clean water in the 1840s. And the discovery that cholera thrived in dirty water provided a final impetus to raise public awareness of the importance of water and sanitation. These conditions – the earlier advances in water provision, the scientific evidence, the evaluation of the health consequences of a lack of sanitation, and the Great Stink of 1858 which affected Parliamentarians themselves – led to public provisions for sanitation. The policy did not struggle against powerful interests because the Great Stink affected both rich and poor Londoners. Another significant factor in the policy process is that workers had acquired voting rights and were able to challenge the power of the rich to block taxation reform that would enable the financing of sanitation. Last but not least, the policy of sanitation provision in Victorian Britain discussed above is at the same time an ‘analysis for policy’. It contains a strong evaluative component: it reports the substantial impact

POLICY

that the introduction of the sanitation policy had on public health. It further demonstrates that providing public health is not necessarily rocket science. A well-functioning sanitation system is all that is needed, and this does not always have to cost huge amounts of money. And, finally, the policy analysis is not done for its own sake but for the sake of advocacy. It presses others to develop similar policies.

Analysis of policy and for policy, whether ex-ante or ex-post, is extremely complex. There are no precise guidelines on how to do it. In an influential book entitled A Practical Guide for Policy Analysis, Eugene Bardach (2005) proposes eights steps in policy analysis: 6

1 Describe the problem (without diagnosing its causes or proposing a solution).

2 Assemble the evidence: gather information in the form of factual data which has meaning.

3 Construct the alternatives: each alternative must address not only the basic intervention strategy, but also indicate how the strategy will be financed and implemented.

4 Select the criteria: evaluative criteria are used to judge the best outcomes.

5 Project the outcomes: determine as far as possible the benefits and costs of the policy options. Indicate the values and dimensions of the indicator to assess the outcomes.

6 Confront the trade-offs: measure trade-offs across outcomes rather than alternatives.

7 Decide: select the best alternatives given the analysis.

8 Tell your story. Other basic questions arise when doing policy analysis, depending in part on

who is doing the analysis – the organization(s) that will implement it, other stakeholders, other interested parties, etc. These questions include: what is the policy environment, international as well as national? Who are the political actors? How do the political actors interact with one other? What power do they command? How do they influence the policy process?