LA PAZ, Bolivia -- Cholera has taken root in South America because governments have failed for decades to modernize the region's decrepit water and sewage systems, health officials say. Now, there are no cheap solutions, and the epidemic is forcing Latin American leaders to make excruciating choices.
Colombian Health Minister Camilo Gonzalez proposed during an anti-cholera summit in Sucre, Bolivia, that regional governments battle the contagion, which breeds in dirty water and sewage, with an emergency campaign to provide running water and basic sanitation to all Latin Americans -- in two years.
"The epidemic we face is not only the result of . . . bacteria, but also of poverty and the negligence of many governments," said Mr. Gonzalez, who represents the M-19 former guerrilla movement in Colombia's coalition government.
Solutions, however, are expensive.
Experts estimate the cost of piping in clean water to all Latin Americans at $11 billion and say that universal sewage treatment could cost an equal amount. With Latin nations already burdened by a $434 billion foreign debt and most governments committed to austerity programs, the question health experts ask about every anti-cholera strategy is: Who will pay?
Betraying a certain resignation to these political realities, the other health ministers at the cholera summit discarded Mr. RTC Gonzalez's proposal for a two-year emergency sanitation program, instead calling for increases in public health spending and for international solidarity.
Carlyle Guerra de Macedo, director of the Pan-American Health Organization (PaHO), told the ministers that the epidemic offered an opportunity to correct Latin America's health inequities because it "shocked the psycho-social conscience of our peoples."
About 89 million poor Latin Americans have no access to clean water, and 144 million lack toilet facilities, according to PaHO figures. Both groups are extremely vulnerable to cholera, according to GermanPerdomo, PaHO's representative in Bolivia.
Health experts are pessimistic that regional governments can invest the billions of dollars necessary for modernization.
"They don't have the money, and no one is going to lend or donate it to them, either," said Jose Fiusa, a Brazilian health official studying the crisis.
Ironically, the continent enjoys the world's most abundant water resources. Before the Spanish Conquest, the Incas built extensive aqueducts to channel fresh water throughout their empire.
But progress failed to keep pace with population growth during colonial times, and during the 20th century Latin American governments have preferred flashier investments.
"Latin politicians haven't favored water lines and sewage plants because voters can't see them. They'd rather build public plazas, footballstadiums and highways," Mr. Fiusa said.
During the 1960s, U.S. Peace Corps volunteers built hundreds of local water systems in Latin America, but they often used cheap materials. Many systems have crumbled into disrepair, according to Jose Antonio Zuleta, a water specialist with the United Nations Children's Fund.
In 1980, Latin governments made their most sweeping commitment to basic sanitation when they declared the 1980s the "Potable Water Decade," vowing to deliver clean water to all in just 10 years.
But during the decade, Latin America's population surged from 353 million to 438 million. Meanwhile, pollution levels rose in most of the continent's rivers and lakes, making clean water harder to find and costlier to distribute.