Initiated April 2003
Approved by the WMA General Assembly, Tokyo 2004

1. PREAMBLE
   
   
   1. An adequate supply of fresh (i.e. clean and uncontaminated) water is essential for individual and public health. Unfortunately, over half of the world's population does not have access to such a supply, and even in those places where there is an abundance of fresh water, it is threatened by pollution and other negative forces.
      
      
   2. In keeping with its mission to serve humanity by endeavoring to achieve the highest international standards in health care for all people in the world, the World Medical Association has developed this statement to encourage all those responsible for health to consider the importance of water for individual and public health.
      



2. CONSIDERATIONS
   
   
   3. Water-borne diseases account for a large proportion of mortality and morbidity, especially in developing countries. These problems are accentuated in times of disasters such as wars, earthquakes, epidemics, droughts and floods.
      
      
   4. Anthropogenic changes to ecosystems, lowered retention by the earth's surface, and the limitation of the inherent capacity of nature to filter dirt from the water are causing increasing damage to the natural environment, especially the water environment.
      
      
   5. The commodification of water, whereby it is provided for profit rather than as a public service, has implications for access to an adequate supply of drinking water.
      
      
   6. The development of sustainable infrastructure for the provision of safe water contributes greatly to sound public health and national well-being. Curtailing infectious diseases and other ailments that are caused by unsafe water alleviates the burden of health care costs and improves productivity. This creates a positive ripple effect on national economies.
      
      
   7. Water as a vital and necessary resource for life has become scarce in many parts of the world and therefore has to be used reasonably and with care.
      
      
   8. Water is an asset that is shared by humanity and the earth. Thus, water-related issues should be addressed collaboratively by the global community.
      



3. RECOMMENDATIONS
   
   
   9. Physicians, National Medical Associations and health authorities are encouraged to support the following measures related to water and health:
      
      
      1. International and national programmes to provide access to safe drinking water at low cost to every human on the planet and to prevent the pollution of water supplies.
         
         
      2. International, national and regional programmes to provide access to sanitation and to prevent the degradation of water resources.
         
         
      3. Research on the relationship between water supply systems, including waste- water treatment, and health.
         
         
      4. The development of plans for providing potable water and proper wastewater disposal during emergencies. These will vary according to the nature of the emergency, but may include on-site water disinfection, identifying sources of water, and back-up power to run pumps.
         
         
      5. Preventive measures to secure safe water for health care institutions after the occurrence of natural disasters, especially earthquakes. Such measures should include the development of infrastructure and training programs to help health care institutions cope with such crises. The implementation of continued emergency water supply programs should be done in conjunction with regional authorities and with community involvement.
         
         
      6. More efficient use of water resources by each nation. The WMA especially urges hospitals and health institutions to examine their impact on sustainable water resources.

9.10.2004