Sanitation is not sexy. But World Toilet Day is an annual reminder of just how vital it is for health, human rights and even economic development.
“One of the historical reasons as to why people don’t focus on sanitation, and it is still true today, is that it is not sexy,” Rosie Wheen, chief executive for WaterAid Australia, told Devex. “People will often prioritize and talk about water, but sanitation not so much. It is seen more as a household issue.”
In fact, safe sanitation is far more. It not only provides people with the most basic rights but can also drive growth. South Korea, Thailand and Singapore are examples of countries that saw their economies boom as sanitation access improved.
“It is time to get behind sanitation as key political issues,” Wheen said. “To bring it into the spotlight highlights the seriousness of the issue.”
Sanitation in numbers
Accessing a toilet is most difficult in Africa, home to the 10 countries with poorest access. In South Sudan, less than 7 percent of the population has access to improved sanitation facilities, the WHO says. This number drops to just 4.5 percent for rural areas. Only Togo is worse, with just 3 percent of the rural population having access to a toilet.
Despite the persistent gaps, the world has seen a significant improvement in sanitation over the last 15 years. In 2000, 180 countries did not have universal access toilets, and in 59 countries, less than half the population had access. By 2015, that number had been reduced to 46.
Political will is an important part of sanitation progress, Wheen said. Creating change requires support across political lines, as well as from players in government, health care, education and housing.
“For sanitation to be achieved, it does require different actors to be working on it,” Wheen explained. “It has to be universally supported.”
Wheen hopes the Sustainable Development Goals’ focus on safe sanitation, including looking at the entire chain of waste management, will help push progress over the next decade. Under the Millennium Development Goals, sanitation had been an afterthought.
“Looking back at the history of the MDGs, sanitation was completely forgotten when the first goals and targets were in,” Wheen said. “It was slotted in under the water goal.”
The SDGs prioritize targeting open defecation, behavioral change and safely managed toilets to provide greater and safer access by 2030.
Cambodia offers an example of how change can happen. In 1990, the country had the second lowest level of access to sanitation facilities in the world, only ahead of Ethiopia. Less than 3 percent of the population able to use a toilet. But strong political drivers meant that by 2015, 42 percent of the population had access. Universal access is the goal.
“They’ve got a really exciting approach called ‘sanitation marketing’ which has seen huge successes,” Wheen told Devex. “There are a number of organizations that WaterAid partners with in Cambodia that are working on marketing toilets and investing in small scale enterprises to sell toilets out into communities.”
An important aspect of Cambodia’s policies has been to consider those who traditionally get left behind — women and girls, elderly populations and people with disabilities. Cambodia has implemented disability-inclusive WASH guidelines to ensure no one is an afterthought, for example.
“The government in Cambodia has really thought about this, particularly people with disabilities,” Wheen explained. “Often people with disabilities can miss out on access because they are not consulted or because their particular access needs are not taken into account in the design of facilities.”
The SDGs have modified the way improved sanitation is measured, but initial figures from the WHO should show progress for countries where there is political will in driving change.
One of the greatest challenges ahead will be urbanization. Papua New Guinea, for example, is one of the few countries to see access to sanitation facilities decline. Between 2000 and 2015, population with access to toilets dropped from 19.2 percent to 18.9 percent. The fall came from urban areas.
“PNG almost feels like it is going backwards in health outcomes,” Wheen said. “We now have 54 percent of the population living in urban areas worldwide and the people being left out are the poorest. They are more often than not moving into or being born into unplanned settlements. Here they are either open defecating or using unsafe toilets.”
The SDG’s call to leave no one behind will challenge advocates to seek progress across the board. “Water Aid is calling for there to be money allocated to sanitation goals in the SDGs to make sure it is reaching everyone in both rural and urban areas,” Wheen said.
Organizations including WaterAid aim to make universal access to toilets a basic human right.