The discussion on water and sanitation is entwined with environmental and ecological choices. At the heart of the problem is the lack of balance between the availability and supply of freshwater and the many demands for its use. It is predicted that half the world's poorest countries will be facing moderate to severe water shortages by the year 2025. There is the geographical imbalance with some countries blessed with abundant sources of water or straddling the headwaters of river or canal systems, and others, perhaps downstream, in desperate need of water, unable for one reason or another to use these supplies. This can lead to inter country and sometimes inter province disputes over the allocation of river waters.

There is tension between different sectors for the use of water, with agriculture, industry; energy and supplies of domestic water all making competing demands. These are all problems of a size and scale that engage the attention of the politicians, planners, Governments and international bodies.

But the biggest imbalance of all, which should be of concern to all of us and which should demand our greatest attention, is the shocking fact that over 1.1 billion people lack access to even the minimum quantity of safe water for their health and dignity. Even worse, over 2.4 billion people are without access to adequate sanitation.

The freshwater challenges encompass and underpin poverty reduction and sustainable development, and so are rightly highlighted as one of the major issues to be addressed in the Summit. WaterAid is specifically calling for commitments to resourced national plans of action to achieve the Millennium Development Goal in water and to adopt and achieve a similar target in sanitation.

In sub-Saharan Africa more than half the total population do not have access to safe drinking water, causing around two million Africans to die each year from preventable, water-related diseases. In nine African countries, people are trying to live on an average of less than 10 litres a day - the same as one flush of a UK toilet.

In comparison the UK water industry supplies 18,000 million litres of water each day to 58 million people, an average of 310 litres per person per day. This alone is enough to provide everyone on earth with twice the recommended intake.

It is calculated that an additional £6 billion is needed each year to halve the proportion of people without safe drinking water. An additional £11 billion each year would be needed halve the proportion of people without sanitation by 2015.

Although these are considerable sums, they are lower than the costs currently incurred by not having safe water and sanitation i.e. the combined costs of working days lost to water related disease and medical treatment of water related disease. In order to generate the will to mobilise these resources, the linkages between poverty and the lack of safe water must be understood. There are enough studies and examples to show that the provision of safe water and sanitation is a fundamental step out of poverty. When families gain access to water and sanitation they cite increased opportunities for education, increased income and improvements in health and general well being. You cannot escape the stranglehold of poverty when you're living in unsanitary conditions and without clean drinking water close to home. This recognition, by itself, should alert Governments, opinion makers, donors and international organisations to the importance of safe water and the need to ensure that their planning priorities and allocation of resources reflect this recognition. However, the allocation of resources is just the beginning of the solution; the greatest challenge is to use them on a scale that will make a significant impact on the problem.

The most successful examples of poor people gaining access to safe water and sanitation are often, but not always, small scale projects designed and implemented by local community groups, supported by non Government organisations. The principle of community participation, the use of appropriate and affordable technology and linkages to local government structures are factors in the success of these schemes, and are likely to ensure that these facilities and services do not fall into disrepair. It is when such facilities and services have to be provided on a much bigger scale at district, province and national levels that the problems begin and the debates become polarised and acrimonious. Two issues that are currently causing controversy have far reaching complications. One is the debate about the scale of projects, for example, big dams versus small local projects or centralised water and sewage treatment facilities versus local, small-scale low technology solutions based on handpumps and protected wells. The other is whether the private sector could provide the necessary investment in the water and sanitation sector, and deliver these services equitably.

Both these issues have the tendency to lock protagonists into promoting standardised solutions for all situations, a "one size fits all" approach. Governments, donors and international organisations are often under political and time pressure to complete projects, disburse or formulate policy recommendations. A single model solution, which can be repeated everywhere, may seem an attractive option in such circumstances. Often such models are based on a few examples, which have worked in specific circumstances or environments. When applied to other situations, with differing political systems, administration arrangements, cultural compulsions, levels and characteristics of poverty it is unlikely the models will meet with the same success.

Surely there is need for dialogue and partnerships on appropriate solutions for delivering water and sanitation to the poor. If Governments, donors and international organisations are genuinely committed to achieving the millennium goals for the provision of water and sanitation services to poor people, they should ensure they have a thorough understanding of poor people's circumstances. The multi-stakeholder teams that work towards involving local people in the development of policies would benefit from the participation of civil society organisations that are well placed to understand and articulate poor people's view.

It is important that Governments determine solutions in consultation with their citizens and in light of local circumstances. They should not be subject to pressure from external donors or organisations that might wish to promote their own particular pre-determined solutions. It is also essential that partnerships are genuine. Often civil society organisations are called upon to "organise" people to implement solutions which have been decided without consultation. Without open dialogue, transparency in decision making processes and a genuine commitment to including local communities in the process, government policies will remain inappropriate, expensive and ultimately unsustainable. Full consultation may seem messy and time-consuming, but is there any other way? If funds are to be committed to achieving the Millennium goals, it is essential they are spent wisely in order to ensure the water and sanitation facilities established are sustainable.

I can think of no better way than to sum up in the words of Lucy Akanboguure, a teacher I met in Kandiga, northern Ghana. She tells how water and sanitation have revolutionised her life and how community involvement can make a lasting difference. Seven years later she is still reaping the benefits and looking forward to a brighter future.

''A decade ago, I had to get up at 3am every day to collect water from a river 5km walk away. The earliest I returned was 10am, which meant I was late for work. In my community women were expected to provide water every morning for their husbands. The lack of water often resulted in quarrels, wife beating or even divorce ... my husband divorced me. ''Girls were also expected to carry water and so very few enrolled in schools. In many deprived communities today only one woman is educated for every 30 men.

''In Kandiga communities suffered most from water shortages during the long dry season. Women injured one another in the 'mad' rush for water. We were forced to collect dirty water which posed severe health hazards. Sanitary facilities were generally non-existent. Diarrhoea, dysentery, guinea worm and cholera were rife and often resulted in death because we didn't have health facilities. ''

''In 1994 our community applied for assistance from a charity. In 1995, after several meetings, the project was agreed and the first two hand-dug wells were constructed. As part of the project requirements the community provided labour, contributed funds and bought the handpumps. The charity provided skilled labour and materials and monitored the project.

''The community maintains and manages the handpumps, using funds that they themselves contribute monthly to pay for repairs.

''Since the pumps fighting, quarrels, snakebites, tiredness and water borne diseases are things of the past. There is a remarkable increase in school enrolment for both boys and girls. Our primary school is now fully staffed because teachers accept jobs as there is water nearby.

'' Because of the charity's approach women's lives in particular have been greatly enhanced. They have time to look after their families and earn money by weaving or farming. Previously women were seen as unintelligent. Now they are seen as equals. They are involved in decision-making and can take up leadership roles - something that was unthinkable before. I have been elected to represent my community in the District Assembly, the highest political authority at the district level. Before clean water I didn't think I was capable of anything. Now I am so surprised by what I can do.''

(NOTE: Ravi Narayanan is Director of WaterAid in London. WaterAid is the UK's only major charity which is dedicated exclusively to providing safe water, sanitation and hygiene education to the world's poorest people. He will form part of the EC delegation at The Summit. This is particularly relevant as they will be launching a major water initiative. This delegation will act as advisors to the official Ministerial Delegation and will be a conduit of information to the many groups at the Summit. Most of WaterAid's work will be focused at the side-event, The Water Dome. They will be holding discussion forums for issues like private sector participation in water supply and financing. They will also be campaigning for a sanitation target to be set to tackle the half of the world's population who are suffering from a lack of basic sanitation facilities.)