A/HRC/10/6 page 8 IV. SUBSTANTIVE PRIORITIES FOR THE FIRST YEAR: SANITATION 21. Given the multitude of tasks, the broad mandate, the fact that it is newly created, and also since it covers more than one issue - namely both water and sanitation - the independent expert decided to take a thematic approach to the tasks ahead. This means that she will not address all subjects simultaneously, but rather intends to focus on a different subject each year. The conclusions of the OHCHR study provide an initial basis for identifying themes that need further study under the mandate. During the first year of her mandate the independent expert plans to pay special attention to sanitation, namely to the normative content of human rights obligations in relation to access to sanitation. 22. Sanitation has been identified in a poll of over 11,000 participants, organized by the British Medical Journal (BMJ), as the most important medical breakthrough since 1840 (the year the first issue of the journal appeared) - beating antibiotics, vaccines, anaesthesia and the discovery of the DNA structure. However, according to United Nations agencies, access to improved sanitation remains a promise unfulfilled for nearly 40 per cent of the world’s population (c. 2.5 billion).17 Globally, it is estimated that 1.6 million people die each year from water and sanitation-related causes18 - the vast majority of those affected being children under 5. Tragically, as of 2006, 23 per cent of the world’s population still had no access to any sanitation and practised open defecation.19 23. Improved sanitation which ensures separation of waste from human contact is important as open defecation jeopardizes the health of the whole community, resulting in increased diarrhoeal diseases, including cholera, as well as worm infestations and hepatitis. Almost 50 per cent of all people in developing countries are suffering at any given time from a health problem caused by a lack of water and sanitation.20 According to the World Health Organization (WHO), access to improved sanitation results in a 32 per cent reduction of diarrhoeal diseases.21 17 Estimates vary between 2.4 and 2.6 billion as to the number of people without access to basic sanitation. See United Nations Children’s Fund (UNICEF) and World Health Organization (WHO) Joint Monitoring Programme (JMP) for Water Supply and Sanitation, 2008 report, p. 7, available at http://www.wssinfo.org/en/40_MDG2008.html. See also p. 6 for a definition of improved sanitation. 18 R. Lenton, A.M. Wright, and K. Lewis, Health, Dignity and Development: what will it take? UN Millennium Project Task Force on Water and Sanitation, p. 18, available at http://www.unmillenniumproject.org/documents/WaterComplete-lowres.pdf. 19 See footnote 17 above, p. 18. 20 See footnote 18 above, p. 20. 21 Water, Sanitation and Hygiene Links to Health, Facts and Figures, 2004, WHO, available at http://www.who.int/water_sanitation_health/factsfigures2005.pdf.