Why we need strong systems to ensure progress on safely managed sanitation

5 min read
Image: WaterAid/ Sam Vox

Achieving global targets on sanitation needs a holistic approach that strengthens the systems that manage human waste. This requires a coordinated effort at national and local levels to ensure the right policies, resources, skills, willpower, and behaviours are in place. These videos, produced by WaterAid, UNICEF and WHO, reflect on the key challenges and solutions to accelerating progress towards safely managed sanitation. 

Every year, a staggering 564,000 people die due to diarrhoeal diseases (PDF) attributed to unsafe sanitation. 

With six years left to meet the Sustainable Development Goals (SDGs), progress on sanitation is alarmingly behind. According to the WHO/UNICEF Joint Monitoring Programme (JMP), 3.4 billion people – roughly 2 in 5 – still don’t have access to safely managed sanitation. This gap is not just a statistic; it affects people's health, dignity, and opportunities for development, contributing to an estimated 1.4 million preventable deaths every year. To achieve universal access to sanitation by 2030, we need to ramp up efforts five-fold, with a focus on safely managed sanitation.

Why safely managed sanitation?

A recent systematic review reinforces the importance of the SDG shift towards universal, safely managed sanitation by showing that improvements to lower service levels only deliver a limited reduction in diarrheal diseases. This suggests that unless everyone has access to toilets which dispose of human waste safely, the public health benefits of sanitation will not be fully realised, as waste will still pollute the environment, water bodies and coastal ecosystems.

Sanitation is not just a human right. It is a public good, and a moral imperative. Ensuring human waste is separated from people throughout its entire life cycle has an impact on public health, and the economic benefits attached to it, not to mention its importance for gender equality, human dignity and climate mitigation and adaptation.

What do we need to achieve safely managed sanitation?

Achieving this global ambition requires a shift away from tackling individual aspects of sanitation towards a more holistic approach that strengthens the whole system required to deliver safe and sustainable sanitation to all. The system is complex and requires effort at national, sub-national and local levels, with a range of different partners and alliances, to ensure the right policies, resources, skills, willpower, and behaviours are in place. Since the ambition is high, it is crucial to identify the catalytic parts of this complex system in different contexts, to ensure sanitation interventions are relevant and have the best chance of addressing the most significant sanitation risks. 

The recent Safely Managed Sanitation Summit, convened in Kathmandu by UNICEF and WHO with the support of WaterAid, aimed to foster a shared vision for safely managed sanitation, exchange innovative strategies for accelerating progress, and strengthen collaboration among global partners. It also aimed to unpack the barriers that affect progress globally, and the steps that can be taken to increase progress. At the summit, we created a series of videos to capture reflections from government representatives and other partners on persistent challenges and ways forward to accelerate the implementation of safely managed sanitation. 

Enhancing policies and regulations for safely managed sanitation

Infrastructure alone can’t ensure universal access to sustainable sanitation. Strong leadership at all levels is crucial, along with clear policies, adequate resources and balanced regulations to improve service quality, ensure worker safety, and protect the environment. 

Linking with the climate sector to achieve safely managed and climate-resilient sanitation

Climate change and sanitation are interconnected, making climate resilience crucial for the water, sanitation and hygiene sector. Water scarcity can block sewers, and flooding can cause latrines to collapse, leading to disease outbreaks. Sanitation also affects our climate through greenhouse gas emissions. Mitigation and adaptation measures are needed to address both climate and sanitation challenges.

Strengthening data systems for safely managed sanitation 

Strong monitoring systems are essential for guiding decisions, allocating resources, and tracking progress on sanitation. Reliable data that cover the entire sanitation service chain is crucial for good governance. Major data gaps, especially in on-site sanitation, need to be filled by inspections, regulatory data, provider surveys, and spot checks. To meet the targets of SDG6, governments should set context-based national goals using tools like shit flow diagrams, regulator KPIs, and global monitoring tools like GLAAS and the JMP.

Exploring financing for safely managed sanitation

Universal access to safely managed sanitation needs a strong enabling environment with financial mechanisms. Sanitation is a public good, but the private sector also plays a crucial role, offering financing and innovation opportunities, and a well-regulated sector can boost business and innovation. It’s also crucial to reduce sanitation costs and provide affordable financing for households, as they often already invest significantly in the sanitation chain.

Delivering safely managed sanitation services at scale

To scale sanitation services, the sector must adopt comprehensive, context-specific and risk-based approaches. This involves diverse sanitation models for urban, rural, and growing areas. Success requires robust regulation, local human resources, financial planning, community engagement, behaviour change, innovative waste management, and support for sanitation workers.

Understanding human resources and capacity strengthening for safely managed sanitation

The foundation for delivering safely managed sanitation services is people. Human resources (HR) underpins all other aspects, including policy, data, service delivery, and financing. Yet countries face significant shortages in HR capacity, while lacking standardised job descriptions, competency frameworks and comprehensive data on the sanitation and hygiene workforce needed.

Building a well-trained workforce is essential to maintaining a strong and effective sanitation service chain. Strengthening the workforce is more than just capacity building, it addresses both the shortage of staff (quantity) and the skills gaps (quality).

  • Maya Igarashi Wood is Sanitation Lead for International Programmes, WaterAid 
  • Laura Kohler is Sanitation Senior Advisor and Acting Senior Policy Analyst, WaterAid.
  • Kate Medlicott is Team Leader – Sanitation and Wastewater in the WHO's Water, Sanitation, Hygiene and Health Unit. 
  • Ann Thomas is Senior Advisor for WASH at UNICEF. 

Top image: Julius Chisengo is pit emptier from Dar-es-Salaam, Tanzania.