Prioritising safely managed sanitation through better policy, regulation and resourcing

In the least developed countries, progress must increase fifteen times over for everyone to have a safely managed toilet by the goal year of 2030. Here, experts from WaterAid and UNICEF discuss some of the often neglected areas of sanitation service delivery, and the developments needed to achieve SDG6.2.

Almost half of the world’s population, around 3.6 billion people, don’t have access to safe sanitation. This includes the more than 1.7 billion people without a clean, private toilet (basic sanitation), and the almost 2 billion people who use toilets that are either connected to leaky sewers or not connected at all. In both cases, human waste is not emptied, transported or treated properly and can, instead, leak into the waterbodies and environments near where people live.

The global community is working towards a target – SDG6.2 – for everyone to have access to a safely managed toilet by 2030. And yet, progress is so off-track that in the least developed countries, it is estimated that rates of progress must increase fifteen times over to reach this goal on time.

If all the evidence that highlights the health, environmental and economic benefits of safe sanitation was not enough, recent cholera outbreaks in countries such as Malawi and Mozambique should beg the question: “Why is sanitation NOT being prioritised?”

In February 2023, representatives from government agencies, utilities and private companies, as well as researchers and development partners, gathered in Abidjan, Côte d’Ivoire, to highlight this slow progress and the need for greater prioritisation of sanitation. Gathered at the 7th International Faecal Sludge Management Conference (which was combined with the 21st African Water Association International Congress), they discussed the many facets that underpin sanitation service delivery, with a particular focus on the on-site systems required in areas sewers don’t reach. Based on the conference sessions – some organised by UNICEF, WaterAid and other partners – we have highlighted a number of issues that don’t always get the attention they deserve: the two-fold benefits of policy reform; the nexus between regulation, data and accountability; and the need for adequate financial and human resourcing.

The benefits of policy reform

Well-rounded policies are vital to guide and expand sanitation service delivery and clarify the roles and responsibilities around it. However, policy reform is often solely focused on the outputs and is outsourced to external consultants, which risks any new policies ending up on a shelf gathering dust.

But the policy reform process is as important as the outputs themselves and, when well-managed, can create ownership and build commitment from different levels of government. This is highlighted in AMCOW’s African Sanitation Policy Guidelines, which are currently being rolled out across many African countries, and was illustrated by Dr Doris Bah from the Directorate of Environmental Health in Sierra Leone’s Ministry of Health and Sanitation. There, the consultative process of creating sanitation policy guidelines helped to build productive relationships between the ministries involved and led to the establishment of a technical working group to take forward sanitation improvements in the country.

The experience was similar in Ghana, where parliamentarian involvement in policy reform built commitments that will make it easier to address the usual delays and reticence involved with approving policies, and put in place what is needed to implement them. Several presentations also highlighted the need for the policy reform process to be inclusive by mainstreaming gender and other vulnerable groups in the development process.

The regulation-data-accountability nexus

New policies need then to be translated into regulation. Yvonne Magawa, from the Eastern and Southern African Water and Sanitation Regulators Association, likened regulation to the rules of the road for traffic. Regulation tells us how actors and services should behave when it comes to sanitation service delivery, but it is only possible with data; you need data to know what systems and service provisions exist to set a good regulatory framework. You also need data to know the extent to which service providers are abiding by regulation, once it is established. However, few countries have well-resourced data collection and management.

The need for financial and human resourcing

Resourcing constraints do not only affect data, but sanitation services as a whole. In 2020, few countries reported that they had sufficient human and financial resources to implement their sanitation policies and plans: just 7% of countries had the necessary financial resources for urban sanitation policies, 3% of countries had the required resources for rural policies, according to the most recent GLAAS report. Current investment levels need to at least triple for countries to have the financial resources needed to deliver SDG6.2 in the next seven years.

It is more difficult to say how much human resourcing needs to increase, but the shortage is monumental. This was also highlighted by Shaka Bakabulindi, Secretary-General of the Pan-African Association of Sanitation Actors, who stressed the importance of a competent sanitation sector where all actors have the skills and capacity needed. An exhibition at the conference highlighted the most glaring gap in adequate human resourcing for sanitation: the unsafe and undignified working conditions faced by informal manual pit emptiers.

The slow progress in sanitation requires a monumental shift in ambition and approach, and these three areas are just a few pieces of the holistic puzzle to turn the tables and confine poor sanitation to the history books.

NICEF and WaterAid are trying to play their part. UNICEF's Game Plan to Reach Safely Managed Sanitation 2022-2030 and WaterAid's Global Strategy 2022-2032 both aim to transform the lives of billions of people through better sanitation services. The two organisations are also collaborating closely in several countries to convene government and other key actors to assess existing sanitation policies and strategies to inform policy reform, protocol development for safely managed sanitation, and advocacy for high level political buy-in to support the acceleration towards safely managed sanitation.

We hope these and other similar efforts will help catalyse change. To accelerate progress towards safely managed sanitation, we need governments and donors to seriously prioritise sanitation, reform policies and regulations, and increase many-fold the financial and human resources for sanitation.

• Laura Kohler is a Programme Adviser for Sanitation at WaterAid
• Andrés Hueso González is a Senior Policy Analyst for Sanitation at WaterAid
• Ann Thomas is Team Leader for Sanitation and Hygiene in the WASH Programme Division at UNICEF
• Andrew Narracott is WASH Specialist – Sanitation at UNICEF

Top image: Rose Isa, 42, a trader, hopes her children will have access to water and good toilet facilities. Guzape, Nigeria. September 2020