Water supply and sanitation in China is undergoing a massive transition while facing numerous challenges, such as rapid urbanization, increasing economic inequality, and the supply of water to rural areas. Water scarcity and pollution also impact access to water.BBC News. China to clean up polluted lake. 27 October 2007.

Progress has been made in the past decades, with increased access to services, increased municipal wastewater treatment, the creation of water and wastewater utilities that are legally and financially separated from local governments, and increasing cost recovery as part of the transformation of the Chinese economy to a more market-oriented system. The government quadrupled investments in the sector during the Eleventh Five-Year Plan (2006–10).

Nevertheless, much remains to be achieved. According to survey data analyzed by the Joint Monitoring Program for Water and Sanitation of the World Health Organization and UNICEF, about 100 million Chinese still did not have access to an improved water source in 2008, and about 460 million did not have access to improved sanitation. Progress in rural areas appears to lag behind what has been achieved in urban areas. According to data presented by the Joint Monitoring Program for Water Supply and Sanitation of WHO and UNICEF in 2015, about 36% of the rural population in China still did not have access to improved sanitation.

Access Access to water supply and sanitation has increased significantly in China over the past two decades in parallel with economic growth. The number of people lacking access to "at least basic" water in 2015 was 63 million. The term "at least basic water" is a new term since 2016, and is related to the previously used "improved water source".

Regarding sanitation, progress has been slower and there are still 329 million people without access to "at least basic sanitation", in 2015.WHO/UNICEF (2015) Progress on sanitation and drinking water - 2015 update and MDG assessment , Joint Monitoring Programme for Water Supply and Sanitation Between 1990 and 2008 alone more than 450 million Chinese gained access to an improved water source, based on estimates by the Joint Monitoring Program for Water Supply and Sanitation of the WHO and UNICEF that are based on household survey data.

In earlier years, access to an improved water source was 89%, and access to improved sanitation was 55% in 2008. Having access to an improved water source, however, is not the same as having access to safe water. Many of those who have access to adequate infrastructure suffer from poor water quality due to fecal contamination; high levels of naturally occurring fluoride, arsenic, or salts; and growing industrial and agricultural chemical pollution. Furthermore, seasonal water shortages occur.World Bank: Fourth Rural Water Supply And Sanitation Project, Project Appraisal Document, 1999, p. 3-5

Urban (56% of the population) Rural (44% of the population) Total Improved water source 98% 93% 95% Improved sanitation 87% 64% 76%

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As in many other developing countries, there is a significant gap between urban and rural areas. For example, in 2010, in urban areas of China, 95% had access to piped water supply, while the share in rural areas was only 45%.Joint Monitoring Program for Water Supply and Sanitation:Estimates for the use of Improved Sanitation Facilities, updated March 2010, China and Estimates for the use of Improved Water Facilities, updated March 2010, China Service quality

Water supply According to the World Bank about 13% of urban water users receive water at inadequate pressure. Furthermore, 60% of China's 661 cities face seasonal water shortage, and over 100 cities have severe water constraints.World Bank:Stepping up - Improving the performance of China's urban water utilities, by Greg Browder et al., 2007, p. xx Contamination of drinking water from feces is a critical health problem in China, as in other developing countries, that causes serious illnesses such as diarrhea and viral hepatitis. A 2010 survey by UNICEF in 11 provinces found that over half of all drinking water samples contained unacceptably high levels of bacteria.UNICEF:China:Child's environment & sanitation, without date. Retrieved April 17, 2010. Currently, China is facing a shortage of water due to climate and rapid development. In 2013, China "for the first time issued water quotas to every province, setting targets for annual consumption by 2015".

Wastewater treatment It has been estimated that in 2006 there was sufficient capacity to treat 52% of municipal residential wastewater. By June 2010, there were 1,519 municipal wastewater treatment plants in China and 18 plants were added each week.Global Water Intelligence:"New directions in Chinese wastewater", October 2010, p. 22, quoting the Ministry of Housing and Urban-Rural Development Many existing plants are being expanded and upgraded to include a tertiary treatment stage for nutrient removal to comply with more stringent discharge standards introduced in 2002. In terms of technologies, in 2007, the most commonly used technologies were various forms of activated sludge, including oxidation ditches (24% of all plants), sequencing batch reactors (11%), conventional activated sludge (5%) and membrane bioreactors. In small communities, plants using only primary treatment were still common (15% of all plants).Ministry of Environmental Protection:Statistical Report on the Environment in China for 2006, Beijing, 2007 An analysis in 2004 by the Ministry of Construction showed that, according to treatment plant records, most plants operated in compliance with discharge standards.World Bank:Stepping up - Improving the performance of China's urban water utilities, by Greg Browder et al., 2007, p. 20

Links to water resources

Man-made pollution, natural contamination, and water scarcity all affect the provision of drinking water.

Links to poverty, health, and hygiene Health problems caused by the lack of safe water are exacerbated by poor sanitary conditions, especially in rural China. Traditionally, Chinese households collect human waste and transport it to the fields for use as fertilizer, often without further treatment. Latrines are common in rural areas. Some are rudimentary, being unprotected from flies and other disease vectors, while others are odorless and insect-free. Composting toilets that promise high rates of pathogen destruction are common. The availability of public and school latrines in rural areas that met sanitary standards was low in the late 1990s. The government has made a concerted effort to promote good health-related behaviors. In most rural areas, a network of National Patriotic Health Campaign Committee (NPHCC) workers, the All-China Women's Federation representatives, the Communist Youth League of China, local epidemic prevention stations, and schools have led health education campaigns encouraging a wide array of hygienic behaviors. That work, combined with a high literacy rate (even in poor areas), has led to widespread knowledge of many basic health behaviors, such as the importance of drinking boiled water. However, actual behavioral change has been slow to follow, especially in poor areas where fuel may be scarce and understanding of the link between raw water or unwashed hands and diarrhea is tenuous. Thus, the problem is more one of the effectiveness of health messages than of their dissemination: In the late 1990s, health education in most rural areas provided little concrete information to link hygienic behavior to improved health, and most provinces still lacked specialized health education training. As a result, significant disparities exist between poorer and wealthier rural counties, both among and within provinces in China. While a number of wealthier and middle-income rural counties have experienced tremendous health-related benefits as a result of improvements in water supply and sanitation, poorer counties with more limited resources have yet to receive similar benefits. In Minqin county, Inner Mongolia, "10,000 people have left the area and have become shengtai yimin, "ecological migrants".

Responsibility for water supply and sanitation Responsibility for water supply and sanitation policies at the national level is shared between five Ministries. Provincial governments play a relatively limited role in the water sector, providing some limited financing for rural water supply. Local government plays a major role, providing a substantial share of financing and owning water supply and sanitation companies that are the main service providers in urban areas. In smaller towns, local government sometimes provides services directly. Village committees operate water systems in rural areas.

To a large extent, the institutional structure of the sector has been inherited from the period of the planned economy before 1978. There are overlaps in responsibilities between public institutions at the central and local level, as well as between various Ministries. There are also no clear definitions of what terms like "supervision" and "management" that are mentioned in the legislation mean, so that "often the departments in charge cannot tell the differences themselves".Jiane Zuo and Lili Gan:Water and Sanitation Services in China:Current Problems and Potential Solutions, in: José Estaban Castro and Léo Heller (Editors):Water and Sanitation Services. Public Policy and Management, Earthscan, London, 2009, p. 311

Policy and legal framework The national government does not have a single policy document for water supply and sanitation. The two major laws in the water sector relate to water resources management: the Water Law of 2002Government of China:Water Law of the People's Republic of China (Order of the President No.74) . Retrieved April 17, 2010. and the Water Pollution Prevention and Control Law of 1984.

The legal framework for water supply and sanitation at the national level is constituted by secondary legislation, of which the 1994 regulation of urban water supply, the 1996 administrative measures for the sanitary supervision of drinking water and the 2006 sanitary standards for drinking water are among the most important ones. It is complemented by numerous local regulations and administrative measures.

Water supply and sanitation

It is the government's policy to fully recover costs for water supply and sanitation through user fees, and that water tariffs should be volumetric.World Bank Country Water Resources Assistance Strategy 2002, p. 13 The Ministry of Housing and Urban-Rural Development (until 2008 the Ministry of Construction) oversees financing for urban water and sanitation infrastructure as well as policies concerning the regulation of water and sanitation utilities. Some important policy papers it has issued are "Accelerating the Marketization of Public Utilities" (No.272 Policy Paper of the MOC, 2002), the "Measure on Public Utilities Concession Management" (No.126 Policy Paper of the MOC, 2004), and the "Opinions on Strengthening Regulation of Public Utilities" (No.154 Policy Paper of the MOC, 2005). However, there is no law concerning the regulation of public utilities or private sector participation in the sector.Asian Development Bank:Country Water Action: People's Republic of China. Private Funds for Cleaner Water — BOT Applied in the Chinese Wastewater Sector , February 2007. Retrieved April 17, 2010. The Ministry of Health has attributions related to the promotion of rural water supply and sanitation.

Water resources management

The responsibility for water resources management is split between a number of entities at the national and local level. At the national level the Ministry of Water Resources is responsible for surface water management, with a focus on quantitative aspects,