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What are the public health impacts of prepayment meters?

In many developing countries the lack of access to clean and affordable water contributes to the spread of water-borne diseases. More than two million people, mostly children, die each year from water-borne diseases.

Research on the source of the cholera outbreak in the Madlebe Tribal Authority areas in South Africa uncovered startling effects of the meters. Read the full study here. The conversion of nine, previously free communal standpipes to pre-payment meters resulted in many households being denied clean water supply due to their inability to afford the water. Instead women and children went back to collecting water from polluted sources. 113,966 people were infected with cholera, of which 259 died, between August 2000 and February 2002. In contrast, during the previous two decades, from 1980 to 2000, 78 people died of cholera.

With increased use of prepaid water meters we are likely to see a directly correlated increased spread of easily preventable diseases, such as diarrhea and cholera.

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