however, including water, remain underpriced, leading to inefficient use and wastage. Because access to groundwater is free and water is made available to industries at a low price, industries have very little incentive to conserve water. As a result, water usage levels are ten times higher in some industries in Pakistan than they are in industrial countries.

Targeted policies aimed at addressing industrial waste water have focused on the NEQS. To date, however, these have not been enforced. A new system, based on the 'polluter pays" principle used in some industrial countries, is being discussed by the government and NGOs. Under the policy effluent charges would be imposed based on pollutant loads and the quantity of water wasted. Other potentially effective targeted policies, such as economic incentives for industries to acquire environment-friendly technology, have not been introduced.

# _Domestic Waste Water Pollution_

Waste water in Pakistan is often dumped into open drains, streams or ponds, shallow pits, or septic tanks connected to open drains (many leading out directly to agricultural land); less often it is dumped into sewers. Household refuse is also dumped into streams and drains, which over time have become overloaded. Direct disposal of municipal waste water into streams not only reduces groundwater quality, but also disturbs the aquatic ecosystems, depletes aquatic resources, and affects agricultural uses of the surface water. Another problem is the practice of municipal waste water for farm use prior to treatment. Besides serious health dangers when consumed, soils irrigated by untreated municipal waste water become enriched in salts and quickly become unproductive for cultivation.

Only 80 percent of the urban and 45 percent of the rural population is estimated to have access to clean water in Pakistan, and migration to the cities is putting pressure on inadequate urban water and sanitation facilities. Pollution has led to the spread of water-related infections: more than 40 percent of the hospital beds in Pakistan are occupied by patients with water-related diseases, such as cholera, typhoid, hepatitis, diarrhea, dysentery, yellow fever, and malaria, and about 60 percent of infant mortality is associated with water-related infectious and parasitic diseases.

A recent World Health Organization (WHO) study found that improved water supply and sanitation produced a median reduction in illness and a median reduction in death of 65 percent. Because high income groups are more likely to have access to clean water supplies or to be able to purify their water or to purchase bottled water, the incidence of water-related illness falls with income.

Problems of domestic water disposal tend to stem from distortions due to economywide policies, failure of targeted environmental policies, and institutional failures. Uneconomic water pricing exacerbates the problem in urban areas, where a flat rate is charged or water is provided free of charge, a policy that both encourages the wasteful use of water and eliminates incentives for suppliers of water services to upgrade their water supply, treatment, and disposal facilities. In rural areas, waste water is used as a cheap, nutrient-rich source of supplemental irrigation, so that the need to invest in treatment facilities is not recognized. Targeted policies to control domestic waste water have not developed.

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