The paper presents the guiding principles and options for wastewater management in small communities in the Middle East and North Africa (MENA) which were adopted by the expert group consultation convened by WHO Regional Centre for Environmental Health Activities in November 2000. The paper also proposes promotional pathways for action.

In the water stressed countries of MENA, every drop of water including wastewater, must count. The water resources and wastewater management policies must come together in addressing the water cycle in a holistic manner. Water must be used efficiently to reduce the consumptive use of water and wastewater flows. Wastewater flows must be managed effectively to safeguard public health, and protect the freshwaters from pollution. They must be reintegrated safely in the water cycle and accounted for in the water budget of the household, community, industry, and the agriculture.

The costly and water intensive large centralized wastewater systems are currently the preferred choice of planners and decision makers. In many situations in MENA, centralized systems have actually aggravated the problem they were set to solve. Money is often not available to build centralized systems. Wastewater management needs remain unmet and pollution continues to consume the scarce freshwater resources.

The guiding principles call for a shift from centralized to decentralized wastewater systems to facilitate accelerated and environmentally responsible extension of wastewater services to small communities. Decentralized small wastewater systems at the scale of the household or neighborhood offer robust, efficient, and equally convenient solutions at much lower cost. They accommodate the necessary domestic water conservation efforts, reduce freshwater inputs in wastewater transportation thus eliminate unnecessary demand on freshwater, reduce associated environmental risks and increase reuse opportunities.

The enabling technologies and tools are well tested and established. Water conservation tools can reduce wastewater generation. Onsite systems must be improved to control pollution and to recover water. Greywater can be separated and used in non-potable applications. If total onsite management is not possible because of the site conditions, modular wastewater systems can be built using the lower cost and less water dependent settled sewers to collect the partially treated septic tanks effluent to a simplified neighborhood or community treatment facility after which the effluent is brought back into the community for beneficial use.

Decentralized systems are often met with resistance from conventional engineering practices often due to the lack of knowledge. Institutional reform must be introduced to recognize the decentralized systems. Rational planning processes are needed in order to analyze the spectrum of available development alternatives and to tailor the solutions to the social, environmental and economic circumstances in the target areas. Knowledge of the decentralized wastewater management options must be introduced to the policy makers, project planners and designers, project implementers, operators, and the community members through: college education; training of technical service providers; advocacy with planners and decision makers; networking to develop an informed community of agents of change; information exchange services; and research and demonstration interventions.