Introduction
Let me begin by affirming the view of the South African government is that WSSD is foremost about development rather than purely or specifically about environment. As our Minister of Environment and Tourism has emphasized at various preparatory meetings, the three pillars of sustainable development are economic, social, and environmental. Among the key issues that he has highlighted are the:

• global partnerships to address inequality and poverty
• integration of trade, investment and finance issues with the sustainable development agenda.

If development is about the quality of economic growth, sustainable development is about the quality of that development. Sustainable development is about whether we are growing our economies and societies in a way that will enable future generations to enjoy a better - rather than worse - quality of life than we do.

Poverty at the forefront of sustainable development
This is why South Africa, with the rest of Africa, has put poverty at the forefront of the sustainable development agenda. We understand that, for development to occur and be meaningful, we must attack poverty. We must achieve a reduction in poverty that will help us to achieve our development goals, especially the goal of ensuring that development is sustainable.

The horrific events of 11 September [2001] must underline for us all that poverty reduction is the way to deal with global inequalities. It is inequality which is the cause of hopelessness, feelings of helplessness, frustrations, turmoil and tensions; this is the breeding ground for extremism and terrorism. The eradication of poverty and gross inequality must therefore be at the forefront of the sustainable development agenda.

We need to keep this perspective uppermost in our minds as we prepare - in our individual sectors - for the WSSD. I will be illustrating this point with reference to the water sector, since that is what I know best, and because it is a sector which you as health ministers have a deep interest.

Integration of sectoral issues
We have not sought to make water a 'stand-alone' issue for this conference. Rather, what we are doing is to use the example of water to show how we need to approach effective and sustainable development. In a number of preparatory meetings, most recently at the International Freshwater Conference in Bonn in December, we began with the targets set by the heads of state at the Millennium Assembly of the United Nations in the year 2000.

Regarding water, they agreed that within 15 years, the total number of people around the globe without access to potable water (1.2 billion) should be halved. At the Bonn conference, we proposed that the same target should be applied regarding the 2.5 billion people who have inadequate sanitation.

We have identified other areas in which we need to make progress regarding water. These areas include improving our management of rivers, both nationally and internationally, and getting better systems in place to deal with natural disasters like floods, droughts, cholera epidemics, and so on.

What we have been emphasizing is that the key to dealing with these issues does not lie in the water sector alone. The key to achieving our water goals is to improve the international environment in which we work. For example, farmers in developing countries cannot invest in more efficient water use, if they cannot sell their products to world markets because of trade barriers. Industries cannot invest in water purification works if they cannot access the technologies they need. The poor cannot pay for potable water if they are unemployed, especially if the likelihood of getting a job has diminished because investment and jobs have gone elsewhere in accordance with the dictates of the global market.

A new global framework
We insist that the Millennium Summit targets can be achieved in the poorer countries only if a new global framework is put in place. Clearly, as the world order stands, the poorest of the poor cannot achieve goals such as access to safe water without help. Rather, in the spirit of NEPAD, the New Partnership for African Development, we are not advocating holding out begging bowls for more aid. But we are advocating the need to create the conditions in which communities and countries are better able to provide for themselves.

Such enabling conditions require economic growth, investment, and access for poor countries to international markets. This means that processes surrounding the World Trade Organization and Finance for Development negotiations must be linked to the WSSD.

This is why we are calling for a new “global deal”. We propose that if we are to make progress in protecting the environment, we must agree to take global action to tackle poverty. Because we all know, poverty is the worst threat to the environment and sustainable development.

A unified stance for development sectors
We believe that the challenge for the health sector is to look at the sustainable development debate in the same way. We cannot have a world summit at which we all advocate our sectoral goals outside of a broad strategy.

We also need to be clear about the challenges of managing [development] in an international context. So another issue which we are putting high on the summit agenda is global environmental governance.

We are saying that we will need more effective international governance of matters such as sustainable development. We all know that it is very difficult for developing countries to participate effectively in the many detailed protocols. Simply to fund and brief the delegations required to attend to the multitude of meetings is often a major challenge and beyond the means of many countries. Yet, as we know from the POPs process (the review of so-called “persistent organic pollutants”), if we fail to participate, we may find that we cannot afford insecticides to fight malaria because the cheaper ones have been outlawed.

We need a system that is designed to facilitate our participation in international governance, in environment and sustainable development, as in other areas. That might require some reforms on our side. One requirement might well be to improve our ability to act as regions rather than as single countries. This is why today’s meeting is so important, bringing us together as Southern African partners, demonstrating that we are building our regional governance to ensure that we can, as a region, participate effectively in new systems of global governance.²

PostScript: lessons from a local sanitation crisis
Having outlined the big picture of our approach to the Summit, I would like to ask your indulgence to take advantage of my final few minutes to raise a subject which is dear to my heart, and I am sure to yours: sanitation.

Our minds are acutely focused on this issue because of the current cholera outbreak in the KwaZulu-Natal province. Effective sanitation is, as we know, a key to breaking the chain of transmission of cholera and many other diseases. Yet sanitation always seems to take second place to water supply.

We would like to change this approach at the Summit and I cannot think of better partners and advocates than you health ministers and experts. Excellencies, you know better than anyone the interconnection between the lack of clean water and inadequate sanitation to illness and disease. Over one million children a year die from water-borne diseases - that is 6 000 everyday - the equivalent of six Jumbo jets full of children crashing to their death every day. A daily death toll that is double the number that died in the New York atrocity of 11 September.

A three-pronged approach to a healthy environment
Any student of history - let alone a medical student - is aware that 19th century Europe dealt with its cholera outbreaks by the provision of clean water and sanitation. It was by this intervention (rather than through medication), that mortality rates were dramatically reduced. But the third element of that revolution in health was the widespread introduction of hygiene education, starting with schools and embracing entire populations. A programme that comprises the three essential elements of clean water, sanitation, and hygiene education is vital to ensure a better and sustainable quality of life for the world's people.

[With this goal in mind, we propose that] the first step in this project was to get the Bonn Conference to recommend that a sanitation target be added to the water supply targets of the Millennium Declaration. The second challenge is to ensure that there is a truly global campaign to promote sanitation improvement. The third challenge is to ensure that we get the message across that improved water supply and sanitation, without improved hygiene practices, will not achieve our goals.

The message we want to get across to the leaders of the world is this: in order to take advantage of the healthy environment which we aim to create, we need to focus equally on health and hygiene education as the third (but not least) element of the trinity of water supply and toilet provision. The WASH campaign of the UN mandated Water Supply and Sanitation Collaborative Council focuses on the simple act of washing hands after going to the toilet and before eating or handling food. This practice alone reduces illness and death from water borne disease by 40%. We must popularize the WASH campaign.

Conclusion
I hope I can count on you for support in that effort and, on behalf of Minister Valli Moosa, Minister of Environmental Affairs and Tourism, I wish you well for the rest of your deliberations.

Thank you and I look forward to seeing you all here in Sandton, Johannesburg in seven months time.

1. This speech has been edited slightly by SARPN to make the original 'speech style' more suitable to be read as a text. The meaning has not been altered in any way. Section titles have been added.
2. SARPN readers will note the relevance of this statement to NEPAD, and to Ravi Kanbur's initial comments on NEPAD which point to its "Africa-wide voice" as being of crucial value and importance.