World Toilet Day: the urgent need to accelerate progress towards sanitation

World Toilet Day is an opportunity to celebrate the power of toilets. But there is a global sanitation crisis – 1.5 billion people in the world don't have a decent toilet of their own. In this blog, Andrés Hueso discusses the urgency of accelerating progress towards universal access to safely managed sanitation, and how countries and donors can overcome the barriers that hold progress back.

Most people I wish a ‘Happy World Toilet Day’ to think I am joking and that the day does not exist. They are also often unaware of how serious and deadly the global sanitation crisis is; 1.5 billion people in the world – almost one in five – don't have a basic sanitation service. This costs people their dignity, health, prosperity and sometimes even lives, with inadequate sanitation accounting for 564,000 deaths from diarrhoeal disease globally every year.

Toilets are powerful. They keep people safe from things like diseases and harassment, and are vital for gender equality and climate change mitigation and adaptation. And when people have a decent toilet, they have more opportunities to get an education, earn a living, and build a better future because they don't have to stop going to school or work because they are unwell or on their period.

The international community recognised sanitation as a human right at the beginning of the century. In 2015, when 193 countries signed on to the Sustainable Development Goals (SDGs), they committed to ensuring everybody would have access to safely managed sanitation services by 2030. That is, improved facilities that are not shared with other households, and where human waste is safely disposed of there or removed and treated offsite. So how far are we from achieving this?

What progress has been made?

It is encouraging that countries have made real commitments to sanitation – only that it is 2023, halfway to the SDG deadline, and very few are matching their commitment with effective action.

But let’s talk about the good news first. Since 2015, the global population with access to safely managed sanitation services increased from 49% to 57%; rising from 36% to 46% in rural areas and 60% to 65% in urban areas. Countries like India and Nepal have made significant progress, including drastically reducing the number of people who defecate in the open. 

The bad news is that 3.5 billion people in the world – almost one in two – don't have a safely managed sanitation service. And to achieve universal coverage of safely managed sanitation services by 2030, current rates of progress need to increase by five times. In the least developed countries, progress needs to increase by 21 times.

Countries need to be faster at ensuring everybody has access to a decent toilet in order to prevent millions of deaths. At the same time, they must better manage faecal waste to stop it from polluting the environment and water bodies, otherwise they risk seeing only modest disease reductions.

What is holding progress back?

Here are some of the challenges we see holding countries back from providing safely managed sanitation services:

• Political and financial investment. We rarely see enough political leadership and prioritisation to tackle the sanitation crisis, or clearly-defined roles and responsibilities to ensure coordinated action. And when money is allocated to sanitation – be it from government budgets or donors – its targeting, timeliness and equity is often sub-optimal.
• Narrow definition of sanitation. Many policies and programmes have not caught up with the idea that sanitation is a service of interconnected components that includes the capture, containment, treatment and disposal of human waste. Instead, we still see short-term initiatives that only focus on infrastructure, lack capacity development activities, and fail to incorporate gender and equity considerations, which are necessary to achieve universal access.
• Talking about sanitation is taboo. Politicians and donors typically favour photo opportunities of road openings, rather than ones for toilet blocks, and prefer talking about clean water rather than what is contaminating it. Even the families of sanitation sector professionals avoid work-related conversations. In fact, World Toilet Day was established over a decade ago to challenge this taboo.

How do we accelerate progress?

The first thing we need is leadership. In countries and regions that have made significant progress, such as East Asia in the 20th century or India more recently, political champions have played a critical role. Leaders can make a tremendous difference by making sanitation a national priority, and by championing collaboration and chasing progress.

This needs to be followed by a substantial and sustained increase in investment in sanitation systems. The allocations need to put equity and service sustainability at the centre, and barriers to using these funds must be addressed. At the end of the day, it is interested and competent people and efficient institutional systems that make it possible to turn money into actual sanitation service delivery outcomes.

Then, we need a shift towards an inclusive approach. This means offering quality sanitation services that are accessible for all people, including women and girls, people with a disability, marginalised groups, and those living in extreme poverty. Countries must recognise that this requires specific efforts, such as policy reform, new programmes and a substantial capacity boost, but it is encouraging that many have already started moving in this direction.

As we celebrate World Toilet Day, let’s remember the urgency of accelerating progress, but also reflect on how we can all contribute to tackling the challenges countries face and take this agenda forward. While many of these changes need to happen at a national level, the donor community can provide support, including by putting sanitation back on the global agenda – particularly as we approach COP28 later this month – and increasing aid budgets and climate funding for climate-resilient sanitation.

This blog builds on the analysis and reflections captured in WaterAid’s policy paper 'Ending the water, sanitation and hygiene crisis together: policy priorities for accelerating progress', which analyses the blockages to progress for water, sanitation and hygiene and sets out policy recommendations for national governments, donors and decision makers to accelerate progress.

Andrés Hueso is a Senior Policy Analyst – Sanitation at WaterAid.

Top image: Afsana outside the new WASH facilities in Satkhira, Bangladesh. December 2022.