Access to Water and Sanitation Services in Brazilian Vulnerable Areas: The Role of Regulation and Recent Institutional Reform

Policies, institutions, and regulations: PIRs of a stormwater management system

Urban services, like stormwater management, are complex tasks that depend on many actors and involve activities that fall within several fields of knowledge, but infrastructure solutions have been known for a long time. Recently, the view that urban water should be treated in an integrated way has become more pronounced, breaking the pathway dependency that treated it in isolation. Since the last decade, the perception that policies, institutions, and regulations (PIRs) condition good results has become more pronounced. The key question lies in incentives capable of mobilizing actors to produce aligned PIRs in a governance system. Better results can come from transformations in the incentives that currently exist for PIRs. The compatibility between incentives, which are not always identical for all involved, aligning them toward results, is the main objective. Based on these premises, aspects related to the necessary ideological change are analyzed here, that is, at the level of ideas and conceptions, which reflect the perception of objective, involving all actors, public and private, attracting them to solve the challenges posed, for example, the delivery of services according to sustainable development goals (SDGs). Examples of this in-progress transformation, a paradigm shift, are presented as support for reflection and experimentation.

Aedes Aegypti-Insights on the Impact of Water Services

Epidemics in general and dengue in particular surcharge the health services and the economy. However, the fighting actions are circumscribed to the health sector despite the known positive economic impacts that the investments in water supply and sanitation services (WSS) may cause on society and public health. Besides the fact that urban WSS infrastructure is closely linked to disease prevention, in Brazil, the user's perception and demand are very few and many institutional aspects, like the integration between local WSS, health, environment, and development of city councils, need to be improved and better aligned. In this way, disease control and vector density reduction remain challenges to be overcome. This article addresses the need for greater institutionalization of urban WSS relating them to health aspects from official data. It concludes that the negative impacts of lacking universal access to WSS on dengue and other mosquito diseases are dispersed in all cities, regions, and populations regardless of their degree of development. Furthermore, contrary to what is normally emphasized, the analysis carried out shows that the lack of urban stormwater management systems may be an important component of WSS in preventing the proliferation of dengue disease.

The Use of Fluorides in Public Health: 65 Years of History and Challenges from Brazil

Untreated dental caries is the most common disease globally and fluoride use at the population level is crucial for its control. To investigate the economic and political conditions under which the trajectory of population-based fluoride use has occurred is key for a more comprehensive view on its current and future challenges. The objective was to give a brief history and summarize the information on the use of fluorides at the population level in Brazil from 1952 to 2017 and to point to current and future challenges. A critical overview was undertaken based on country-level analyses comprising political and economic conditions. The analytical approach adopted a set of premises applicable to the study of capitalist democracies. Fluoride methods of systemic and topic use began to be employed in Brazilian public health programs in the 1950s and in a combined way from 1974. Differences in political and economic contexts were highlighted for four periods: the first interventions from 1952 to 1974, when the fluoridated water law was approved; the expansion after 1974 until 1988, when a new constitution was enacted; the following time until 2010; and the final period. From the 1980s to 2008, water fluoridation coverage increased progressively, consolidating as a major strategy of systemic use in spite of inequalities among territories. Activities aimed to promote access to topical fluoride use increased and maintained stability until 2014, when they dropped sharply. Regulation of fluoride dentifrice's quality remained insufficient. It was hypothesized that the strengthening of conservative liberalism and the increase in fiscal austerity observed in recent years might produce serious constraints on public investment and limit access to fluorides. To reduce inequities and promote benefits for all, including the most vulnerable groups, policies based on egalitarian and social justice theoretical perspectives are needed more than ever.

Attracting the Private Sector to Urban Stormwater: A Feasible Task or Just a Pipe Dream?

Private sector participation (PSP) in stormwater drainage and management systems is desirable for two reasons: firstly, for its capacity to contribute resources, allowing existing public budgets to be used for other purposes, and secondly for its capacity to introduce management efficiency. Despite the apparent simplicity of this conceptualization, in practice, such participation does not occur simply out of a desire to improve service delivery. Private and public partners have their interests, which are, on the private side, the profit margins and deadlines for return on investments, and on the public side, representing society, the obligations of equity, universality, continuity, and the sustainability of service provision and infrastructure. Reconciling these often-contradictory aspects requires complex and sophisticated political, institutional, organizational and regulatory structures aligned to provide incentives, resources, and involves everyone. Without exhausting the subject, this article addresses several aspects related to the attractiveness and participation of private initiatives in urban stormwater management and discusses some international examples with a special focus on Brazil.

The Potential to Address Disease Vectors in Favelas in Brazil Using Sustainable Drainage Systems: Zika, Drainage and Greywater Management

Residents of informal settlements, the world over, suffer consequences due to the lack of drainage and greywater management, impacting human and environmental health. In Brazil, the presence of the Aedes aegypti mosquito in urban areas promotes infections of the Zika virus as well as companion viruses, such as dengue, chikungunya and yellow fever. By using observation and interviews with the community, this paper shows how a simple sustainable drainage system approach could prevent the accumulation of on-street standing water, and thus reduce opportunities for the mosquito to breed and reduce infection rates. During the interview phase, it became apparent that underlying misinformation and misunderstandings prevail related to existing environmental conditions in favelas and the role of the mosquito in infecting residents. This inhibits recommendations made by professionals to reduce breeding opportunities for the disease vector. Whilst unrest is an issue in favelas, it is not the only issue preventing the human right to reliable, safe sanitation, including drainage. In "pacified" favelas which may be considered safe(r), the infrastructure is still poor and is not connected to the city-wide sanitation/treatment networks.

Perspectives on Sustainable Integrated Clean Environment for Human and Nature

The term “sustainability” is generally used to describe an ideal condition in which the Earth’s biosphere and human civilization can safely interact and coexist [...]