Water privatization and public health in Latin America.
OBJECTIVE
This study had two objectives: (1) to determine what the public health and development literature has found regarding the public health outcomes of water privatization in Latin America and (2) to evaluate whether the benefits of water privatization, if any, outweigh the equity and justice concerns that privatization raises.


METHODS
Using a standard set of terms to search several databases, the authors identified and reviewed articles and other materials from public health and development sources that were published between 1995 and 2005 and that evaluated the public health effects of water privatizations in Latin America from 1989 to 2000, based on (1) access to water by the poor and/or (2) improvements in public health. Next, the authors examined the experiences of three cities in Bolivia (Cochabamba, El Alto, and La Paz) in order to illuminate further the challenges of water privatization. Finally, the authors considered the equity and justice issues raised by the privatization of water.


RESULTS
The literature review raised persistent concerns regarding access to water by the poor under privatization. The review also suggested that the public sector could deliver public health outcomes comparable to those of the private sector, as measured by access rates and decreasing child mortality rates. In terms of social equity and justice, privatization marked a troubling shift away from the conception of water as a "social good" and toward the conception of water--and water management services--as commodities.


CONCLUSIONS
Our results indicated there is no compelling case for privatizing existing public water utilities based on public health grounds. From the perspective of equity and justice, water privatization may encourage a minimalist conception of social responsibility for public health that may hinder the development of public health capacities in the long run.
Religion Department, Xavier High School, New York City, New York, USA.
John P
JP
Mulreany
Sule
S
Calikoglu
Sonia
S
Ruiz
Jason W
JW
Sapsin
D000328:Adult; D001118:Argentina; D001838:Bolivia; D001938:Brazil; D046688:Child Mortality / Q000639:trends; D002675:Child, Preschool; D002677:Chile; D003105:Colombia; D019992:Databases as Topic; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007843:Latin America; D008800:Mexico; D009527:Nicaragua; D010568:Peru; D011203:Poverty; D011332:Privatization; D011634:Public Health; D011640:Public Policy; D017150:Public Sector; D012935:Social Justice; D014881:Water Supply / Q000592:standards