A/HRC/22/61 24. Urban poverty is intertwined with the problem of environmental degradation, where poor air and water quality are particularly hazardous and pervasive. The urban poor are often exposed to high degrees of outdoor air pollution from traffic and industry. Airborne particulates and pollutants have been linked to respiratory illness, particularly in cities in Latin America and Asia.53 Indoor air pollution caused by the intensive use of solid fuels, cooking stoves and open fires among the urban poor, combined with inadequate ventilation in poorly constructed shelters, are also believed to substantially raise the incidence of acute respiratory infections and chronic obstructive pulmonary disorders among the urban poor. 54 Poor families in cities are more likely to rely on these forms of fuel for their lighting and cooking needs than those with higher incomes. 25. Settlements of the urban poor often lack access to water and sanitation infrastructure. These communities exist off the grid and rely on private, small-scale distributors of water. As a result, most urban slum dwellers pay several times more than their higher income counterparts, not just in absolute terms but also as a share of household expenditure. In Nairobi, residents of informal settlements pay five to seven more times per unit than the official tariff levied on households with a connection to the water network. 55 In Argentina, poor urban households spend 16 per cent of all expenditure on utilities, compared with only 11 per cent of the wealthiest 25 per cent. 56 For residents of Kibera in Kenya, waiting times for access to communal taps exceed one hour on average, and are much longer during the dry seasons.57 According to a study conducted in 47 different countries, average water prices ranged from 1.5 to 12 times higher than in the formal network.58 Furthermore, these sources are often not monitored for quality. 26. Even when urban-dwellers have access to adequate sanitation facilities, most of these facilities are shared, increasing the chance of a rapid spread of diseases. For example, a 2012 UNICEF study found that 52 per cent of urban-dwellers in Accra shared a public facility, 12 per cent shared facilities with five or more other households and 11 per cent used a facility shared by up to five households. In fact, only 11 per cent of the population had access to a private, improved sanitation facility.59 27. Children are particularly vulnerable to an increased risk of illness, undernutrition and health due to inadequate access to safe drinking water and sanitation services. Children who live in poor urban settings face significant health risks even where services are nearby. In many countries, children living in urban poverty fare similar or worse health risks as children living in rural poverty in terms of height-for-weight and under-5 mortality.60 28. The painful irony is that, while urban areas may enjoy better access to health services compared to rural areas, such services are prohibitively expensive for the urban poor. For much of the developing world, health services in urban areas are largely fee-forservice, making reliable access cost-prohibitive for the urban poor. However, even when subsidies are implemented to remove the cost barrier, often the system is inaccessible to the 53 54 55 56 57 58 59 60 10 Ibid. UN-Habitat. United Nations Development Programme (UNDP), Human Development Report 2006: Beyond scarcity: Power, poverty and the global water crisis (Basingstoke and New York, Palgrave Macmillan, 2006), pp. 7, 52 and 83. Baker, “Urban poverty”, p. 8. UNDP, Human Development Report, p. 38. Mukami Kariuki and Jordan Schwartz, “Small-Scale Private Service Providers of Water and Electricity Supply: A Review of Incidence, Structure, Pricing and Operating Characteristics”, Policy Research Paper, No. 3727 (World Bank, 2005), p. 26. UNICEF, “Understanding the Specifics of Urban Poverty: A Case Study from Accra, Ghana” (2012). UNICEF, The State of the World’s Children 2012, p. 4.