for the role of the federal government in water and sanitation that had remained undefined during the previous 20 years. léo heller, professor of sanitary and environmental engineering at the federal university of minas gerais, even called it "arguably the most important legislative innovation in basic sanitation sector in decades". in the same month, the president announced a new program for the acceleration of growth (pac) that includes major investments in highways, airports, ports, energy, as well as providing housing, water and sewage that would benefit poor brazilians. the program calls for a total of 504 billion real (235 billion u.s. dollars) through 2010, of which about 205 billion u.s. dollars would be provided by state-owned companies and the private sector, while the rest would come from the federal government. national sanitation plan in december 2013 the federal government approved a national sanitation plan (plansab) that aims to reach universal access to drinking water by 2023, and universal access to sanitation in urban areas by 2033. it also aims to reach 93% coverage in terms of wastewater treatment by 2033. the plan foresess federal subsidies to municipalities, provided they draw up local water and wastewater plans. as of december 2013 only around 30% of municipalities have drafted such plans. especially municipalities in the poorest states have failed to submit plans, thus potentially cutting themselves off from federal funding. infrastructure in brazil, countrywide, 19.1% of households are connected to septic tanks but they are not connected to the general network. approximately 9 million households (12.6%) had a ditch, rudimentary cesspit, river, lake or sea, in addition to other forms of waste disposal. the relevance of sanitation infrastructure in the health-disease process was highlighted in a study on hospitalizations due waterborne diseases. overall, in 2015, diarrhea was estimated to be one of the main causes of death in all age groups (1.31 million). in terms of coverage, around 40% of the sewage generated in brazil is treated, with an estimated number of treatment plants in the order of 2,800. national responsibility for wastewater and sewage treatment lies in the hands of the ministry of cities in brazil. the ministry of cities consists of different ministries that each contribute to water supply and sanitation including wastewater and sewage treatment. responsibility for water supply and sanitation policy and regulation at the national level the ministry of cities coordinates sector policies, which are implemented by various ministries. for example, the ministry of health has certain attributions related to sanitation, and the ministries of regional development and of agriculture and agrarian reform have attributions in rural areas. water resources management is the responsibility of the national water agency ana. headquarters of the department of water and wastewater (dae) of the municipality of santa bárbara d'oeste, são paulo. the council of cities is "a consultative and decision-making body with the purpose of 'proposing goals for the formulation and implementation of national urban development policy, as well as monitoring and assessing its execution". it includes a consultative technical committee for environmental sanitation. similar structures exist at the state and municipal levels. the national water supply and sanitation policy, approved by the council of cities, has identified six steps to improve service coverage and efficiency by encouraging a more competitive and better regulated environment: (1) the institutional separation of service providers and service regulators: (2) promotion of different decentralized alternatives for service provision; (3) promotion of social participation in service regulation and control; (4) use of low-cost technologies; (5) development of financially sustainable pricing schemes which include subsidies for low-income families where required to assure universal access to basic services; and (6) greater cooperation between federal and local authorities and civil society. regulation of service provision is a responsibility of the municipalities. nevertheless, 14 brazilian states have established regulatory agencies for public services that cover, among other sectors, water supply and sanitation. given that the legal mandate for regulation rests with the municipalities, however, the role of these regulatory agencies in water and sanitation is minimal. service provision according to the brazilian constitution the provision of water and sanitation services is the responsibility of the country's 5,560 municipalities (see list of major cities in brazil). however, state water and sewer companies 25 of brazil's 27 states (see states of brazil) are in charge of water services in about 3,887 municipalities with a population of 103 million, corresponding to about 75% of brazil's urban population with water connections. they are also in charge of sewer services in 893 municipalities with a population of 45 million, corresponding to about 55% of the population. the two only states that have no water and sanitation company are amazonas state and mato grosso the state water and sanitation companies are as follows: atlanticocean pacificocean north northeast central-west southeast south acre amazonas pará roraima amapá rondônia tocantins maranhão bahia piauí ceará rio grandedo norte paraíba pernambuco alagoas sergipe mato grosso mato grossodo sul federaldistrict goiás minas gerais são paulo rio de janeiro espírito santo paraná santa catarina rio grandedo sul argentina bolivia chile colombia french guiana guyana paraguay peru suriname uruguay venezuela agespisa águas e esgotos do piauí s.a. caema companhia de saneamento ambiental do maranhão caer companhia de águas e esgotos de roraima caerd companhia de águas e esgotos de rondônia caern companhia de águas e esgotos do rio grande do norte caesa companhia de água e esgotos do amapá caesb companhia de saneamento ambiental do distrito federal cagece companhia de água e esgoto do ceará cagepa companhia de água e esgoto da paraíba casal companhia de saneamento de alagoas casan companhia catarinense de águas e saneamento cedae companhia estadual de águas e esgotos (of the rio de janeiro state) cesan companhia espírito santense de saneamento compesa companhia pernambucana de saneamento copasa companhia de saneamento de minas gerais corsan companhia riograndense de saneamento (of rio grande do sul state) cosanpa companhia de saneamento do pará depasa departamento estadual de pavimentação e saneamento (of acre state) deso companhia de saneamento de sergipe embasa empresa baiana de águas e saneamento s.a. sabesp companhia de saneamento básico do estado de são paulo saneago saneamento de goiás s.a. saneatins companhia de saneamento do tocantins sanepar companhia de saneamento do paraná sanesul empresa de saneamento do mato grosso do sul s.a. water treatment plant of the copasa (companhia de saneamento de minas gerais) in coronel fabriciano, minas gerais. most state water and sewer companies are mixed public-private companies with the majority of shares owned by the respective state government. three companies - sabesp in são paulo, copasa in minas gerais and sanepar in paraná - have floated shares in the brazilian stock market and one of them - sabesp - also at the new york stock exchange. one state company, saneatins in tocantins, is majority-owned by the private sector with the state government owning only a minority of shares. some state companies operate under concession contracts with municipalities, while others operate under the authority of state governments. in some cases municipalities have challenged the legality of service provision by state companies that do not have concession contracts with municipalities. since 1996 65 municipalities in 10 states (rio de janeiro, são paulo, paraná, espírito santo, mato grosso and pará among others) that serve 7 million customers signed concession contracts with private service providers either to provide only water services, only sewer services or both. according to the world bank's private participation in infrastructure database, investment commitments by the private sector in brazil's water and sanitation sector reached us$3 bn in 1994-2004 through 52 projects. 3 projects were divestitures, 39 were concessions and 10 were greenfield projects in wastewater treatment plants. some public service providers, both at the state and the municipal level, perform very well, while other perform poorly. likewise, some private concessions are quite successful, while others have not lived up to expectations and their obligations. utility associations about 2,000 municipal utilities and municipalities are associated in the national association of municipal water and sanitation service providers assemae, created in 1984. also in 1984, state water and sanitation companies have formed the association of state companies for water supply and basic sanitation aesbe. in 1996 private service providers have formed the brazilian association of private water and sanitation concessionnaire (abcon). all three associations promote the interests of their member by influencing national policy. efficiency two common indicators of the operating efficiency of water and sanitation utilities are the level of non-revenue water (nrw) and labor productivity. non-revenue water in brazil varies between 21% and a staggering 81%, reflecting huge differences in efficiency between service providers. the average level of nrw in brazil in 2006 was 40%, roughly the same for state and municipal public water companies. the level has remained unchanged since 2000. the average nrw for private utilities, however, was only 30% in 2000. labor productivity. many public utilities in brazil are overstaffed. in 2000 the staff ratio was lowest for state utilities (3.7), much higher for municipal utilities (5.8) and - surprisingly - highest for privately operated utilities (6.4). average labor productivity has since then increased from 4.4 to 3.7 employees/1000 water connections. financial aspects tariffs tariff level.in 2020, water and sanitation tariffs in many brazilian cities are relatively high compared to other latin american cities. according to the urban water and sanitation information system snis the average water tariff of utilities participating in the system (which provide water services to 95% of the urban population) was the equivalent of us$0.68/m3 and the average sanitation tariff was us$0.67/m3, also, the sewage tariffs for brazilians was us$1.35/m3 for those connected to the sewer network. this compares to us$0.81/m3 in chilean cities, us$0.79/m3 in argentine cities and us$0.51/m3 in peruvian cities. the ratio of sanitation to water tariffs of almost 1:1 is very high for latin america and close to the ratio of the actual cost of the two services, while in most other latin american countries sewer tariffs remain much lower than water tariffs. water and sewer tariffs vary substantially between cities. according to a 2005 study by the latin american association of water and sanitation regulators aderasa the typical monthly residential water bill for a consumption of 20 cubic meters per month was equivalent to us$17 in são paulo, us$15 in espírito santo and us$10 in pernambuco, compared to an average of us$11 among the 21 latin american cities covered. tariff structure and subsidies. in most parts of brazil a low social tariff applies to the first block of consumption. in some cases a minimum consumption fee applies to all residential connections, and sometimes to commercial and institutional connections. such subsidies benefit many who are not poor. however, some state water companies have improved the targeting of their social tariffs by using the cadastres established for the bolsa familia conditional cash transfer program. this is the case in paraná (sanepar), pernambuco (compesa) and bahia (embasa). in these cases the social tariff is limited to about 10% of the company's customers. other utilities have introduced direct cash payments to needy families to help them pay their water bills. for example, the city of brasilia has introduced such a scheme. the federal district pays the water utility an amount equivalent to the water and sewerage bills of poor families consuming less than 10 cubic meters per month. the state water company in goiais has introduced a similar program. in each case, about 20,000 families benefit from the program. however, not many municipalities in brazil have the institutional capacity to administer such a targeted subsidy scheme. change in tariffs over time. tariffs in most cities increased moderately in the 2002-2005 period net of inflation. according to the snis the average urban water tariff increased by 57% and the average sanitation tariff increased by 54% in nominal value prices, while inflation stood at 40%, thus resulting in a moderate increase in real prices. affordability. according to data collected by the pan-american health organization based on multi-purpose household surveys, the share of water expenditures in household expenditures in urban areas was the second-highest among 10 countries in latin america and the caribbean in the late 1990s. the share was on average 2.3% and 3.4% for households in the poorest income decile. revenue collection overall revenue collection losses for state utilities in brazil were about 12% in 2000, but this masks