Deputy Director and Senior Fellow, Global Health Policy Center and Senior Fellow, Americas Program
Last week I wrote about the persistent challenge of sanitation, noting that the world is not on track to reduce by half the proportion of the population without sustainable access to sanitation, one of the targets of MDG 7 focused on ensuring environmental sustainability. At least 2.6 billion people worldwide lack access to basic facilities. Even if current efforts to put in new systems remain constant, that number is projected to rise, thanks to population growth and the need to maintain existing infrastructure.
Beyond its deleterious effects on the environment, the lack of sanitation has negative implications for health. Diarrheal diseases are the second leading cause of childhood mortality in the developing world; nearly two million people, 90% of whom are children, die from diarrhea each year. But safe disposal of feces is estimated to reduce diarrheal disease by up to 40% in some areas, while drinking water interventions alone have been shown to reduce diarrhea by 25%. And the economic benefits of sanitation are impressive. The Geneva-based World Water Supply and Sanitation Collaborative Council (WSSCC) reports that every dollar spent on sanitation in developing countries leads to a nine dollar economic return over time.
Both at the September MDG Summit -- and since then -- there have been positive signs that the international community intends to accelerate efforts to improve access to sanitation over the next five years. Sanitation activities were mentioned several times in the Summit’s outcomes document, and high-level side events raised high-level awareness of the challenges that remain.
Last month the Sanitation and Water For All process formalized its partnership and steering committee “to increase political prioritization, promote evidence-based decision-making and support strong national processes” in bolstering cooperation and support for sanitation projects. Members include a range of developing and donor countries, multilateral organizations and development banks, civil society organizations and professional associations that have agreed to work together to raise awareness and support the implementation of sanitation activities at the household and community levels.
The WSSCC is also making progress with its Global Sanitation Fund. Launched in 2008, the Fund pools money from donor countries and organizations and makes it available to countries that meet its application criteria, allowing governments and sub-grantees to carry out sanitation projects. Earlier this year the Fund announced its first program, a $5 million investment in Madagascar. Six other countries, Burkina Faso, India, Nepal, Pakistan, Senegal and Uganda, have received support in the first round, and a second round to focus on Bangladesh, Benin, Cambodia, Ethiopia, Kenya, Malawi, Mali, Nigeria, Tanzania and Togo is underway.
More recently, a group of water and sanitation advocacy groups and implementing organizations launched the “Raising Clean Hands” initiative to highlight the importance of including schools in water, sanitation and hygiene programs. Ensuring sanitation facilities are in place in schools not only protects children’s health and educational experience but also encourages students to advocate for water, sanitation, and hygiene programs within their communities. At the same time, evidence suggests that in some regions parents are reluctant to send girls to school if they cannot count on private latrine or toilet facilities, so providing sanitation in schools is a way of encouraging girls’ education, specifically, and gender equality, more generally.
All of these examples underscore the importance of developing and strengthening cross-sectoral sanitation partnerships involving governments, universities, NGOs, the private sector, and communities. It is especially important that governments and communities, themselves, prioritize sanitation interventions if there is to be progress on the MDG sanitation target. With scarce resources and competing priorities, putting sanitation at the top of the list can be a challenge. But with children’s health, environmental conservation, education quality, economic savings, and gender equity at stake, there is no time to waste.