On World Toilet Day, 19 November, the World Health Organization (WHO) and UNICEF launched a report on global sanitation conditions and provided an assessment of investment required in order to achieve Sustainable Development Goal (SDG) 6.2 in the next 10 years.
In 2015, Member States committed to achieve access to adequate and equitable sanitation and hygiene for all and end open defecation, paying special attention to the needs of women and girls and those in vulnerable situations, by 2030.
"State of the World's Sanitation" describes a world "alarmingly off-track" to deliver sanitation for all by 2030.
"Despite progress, over half the world’s population, 4.2 billion people, use sanitation services that leave human waste untreated, threatening human and environmental health. Of those, 673 million people have no toilets at all and practise open defecation. An estimated 367 million school-age children attend schools without toilets. More than 10
per cent of health care facilities have no sanitation service whatsoever. Only 32 per cent of forcibly displaced people have basic sanitation".
The agencies present expectations with respect to childhood survival, health issues and nutrition in affected populations under “business as usual” and “significant investment“ scenarios, also assessing societal impacts such as food safety, climate change, work and recreation using similar assumptions.
The World Health Organization acknowledges that achievement of universal access to safe sanitation will be expensive but that inaction is even more costly. “Lack of sanitation results in greater recurrent and preventable healthcare costs, lost income and educational opportunities, loss of productivity, and environmental pollution. Investments in sanitation – particularly safely-managed sanitation services – avert these costs and generate positive externalities across society.”
The benefit of investment is estimated to be about 5 times the cost. Estimates indicate that between 2017 and 2030, the annual cost to achieve universal sanitation would be approximately $105 Billion USD. The total global average capital cost per beneficiary to gain access to safely managed sanitation is $24 USD.
Sanitation services suffer from chronic under-prioritization, lack of political will, under-investment and a lack of capacity. Although many countries have national policies and plans for sanitation, few have adequate human and financial resources to support them.
The report points to countries where the investment has paid off and underscores the necessity of political will. “In the 1960s and 1970s, Malaysia, the Republic of Korea, Singapore and Thailand produced rapid and remarkable results to achieve total sanitation coverage. More recently, countries such as Ethiopia, India and Nepal have dramatically reduced open defecation and made progress towards universal access to basic sanitation. In each case, the common factor has been strong political leadership, with government playing an important role in setting policies and plans, mobilizing investment, regulating services, galvanizing widespread participation and continuously learning and adapting.”
WHO calls for Investment in five key “accelerators” positing that governance, finance, capacity development, development of data and information, and innovation can pave the way for universal access.
Separately, advisory and taskforce members, Yvonne Magawa of the Eastern and Southern Africa Water and Sanitation Regulators Association (ESAWAS), Diego Polania of Comisión de Regulación de Agua Potable y Saneamiento Básico(CRA), and Gustavo Saltiel (World Bank), have set up a blog that focuses on urban sanitation and related public health issues.
“For too long sanitation, specifically on-site sanitation systems such as septic tanks and pit latrines, have been left in the realm of household responsibility".
“The very nature of safe sanitation, however, means that the decisions and priorities of individuals are largely decoupled from what would be required to protect public health, the environment, and reach the poorest. Services for safely containing, emptying, transporting and treating human waste, and preventing pits and septic tanks from contaminating groundwater and open drains are needed, but without regulation, investments will not prioritize public health outcomes.”
These advisors suggest that “Investments in sanitation need to be planned, regulated and financed to align the priorities of individual households with those of service providers. This alignment is required to address the broader social goals of public health protection, cleaner environments, and stronger economies.
“Among the countries that have made extraordinary gains in a generation, a common factor among them has been strong political leadership that clarified public goals, gave clear mandates to the responsible authorities to achieve those goals, regulated authorities’ delivery of services, and mobilized the corresponding investments needed.”