Social justice, public health and the water wars in developing countries

Water is essential to human life, health and development. Inadequate water and sanitation is associated with 10% of the global disease burden resulting in the deaths of approximately 1.8 million children each year. Driven by large multinational companies, prepaid water metres are a popular yet controversial approach to extending water services to the poor in developing countries. They operate on an upfront payment system that automatically disconnects water if households do not have enough money to replenish supplies. Despite global health concerns over prepaid water metres, the City of Johannesburg's (South Africa) water utility company launched an unprecedented prepaid water metre installation campaign – dubbed Operation Save Water - in two large poor (predominantly black) townships. Prior to the campaign, poor households received unlimited water access at an affordable monthly fixed rate. Amidst outrage, violent community protest and legal action; the City continued to forcibly install pre-paid water metres in poor people's homes. Based on a qualitative analysis of campaign materials, interviews and policy documents; this paper describes resistance to the campaign through coalitions between community groups, non-governmental organizations and legal practitioners. In particular, the paper highlights how the campaign's problematic notions of ‘sustainable development' were countered by a human rights discourse that reflected the need for sufficient water for the health and development of the poor. It concludes by highlighting opportunities for a multi-disciplinary public health response to the growing resistance to pre-paid water metres in developing countries.