Without toilets we won't end malnutrition

4 min read
Image: WaterAid/Kate Holt

The new Global Goals commit UN member countries to ending malnutrition and achieving universal access to water and sanitation by 2030. As the 2016 Global Nutrition Report launches, WaterAid’s advocacy coordinator Dan Jones reflects on the urgent need for concerted action.

The launch today of the 2016 Global Nutrition Report brings into sharp focus the scale of the challenge we all face to fulfil the new Global Goals to end poverty and address inequality by 2030.

How can it be that we live in a world where malnutrition affects one in three people globally? It is an outrage that 159 million children are stunted. Malnutrition is a global crisis, on the rise in every country; it undermines efforts to expand access to quality education, it punishes the most vulnerable the most, and every year it reduces GDP by 11% across Africa and Asia.

Yet, considering the number of people who live without access to clean, safe water, without soap for handwashing, or without a proper toilet, the scale of the malnutrition crisis is far from surprising. 

The World Health Organization has estimated that half of all undernutrition is associated with infections caused by drinking dirty water contaminated with faeces and eating food with unclean hands.

650 million people worldwide do not have access to safe water, so it is no wonder that malnutrition is crushing the hopes of generations of children.

One in three of the world’s population (2.3 billion) don't have access to a proper toilet, and many are forced to go in the open, spreading deadly diseases. This situation should force us to act, and act together. 

Development revolution

These crises know no sectoral boundaries, nor divisions between government ministries. They cannot be tackled in our traditional issue ‘siloes’. We must transform the way we act, think and speak about development if we are to hope to meet the challenge.

At the recent World Health Assembly in Geneva, chef and campaigner Jamie Oliver called on health ministers to join a ‘food revolution’. A ‘development revolution’ is just as necessary.

A key message of the Global Nutrition Report is that ending malnutrition is a political choice that is achievable, but only with a massive increase in effective funding and much more efficient coordination across relevant sectors. 

This is absolutely aligned with WaterAid’s thinking – we seek through our ‘Healthy Start’ campaign and advocacy work to integrate water, sanitation and hygiene (WASH) into global and national action plans for nutrition and health.

We must not see achieving WASH for all as a separate, isolated goal. It is the key to transforming lives, helping bring health and future prosperity to all.

‘Integration’ is one of the favourite buzzwords of the new sustainable development agenda. It is vital that we turn that buzzword into action, quickly and effectively. 

No matter that WASH is labelled ‘Goal 6’ while nutrition is ‘Goal 2’ – the bottom line is that we will never achieve either goal if we act in narrow tunnels. 

We must begin immediately to deepen and strengthen our understanding of what works across sectors. Initiatives like the Global Nutrition Report point the way, calling for SMART (Specific, Measurable, Attainable, Relevant and Time-bound) investments in interventions that deliver. 

Narrow interventions alone cannot end malnutrition

The nutrition report highlights that direct ‘nutrition-specific’ interventions such as micronutrient supplementation and fortification, even when scaled up to 90% coverage rates, are thought to address only 20% of the global stunting burden. 

Tackling the underlying issues, including access to WASH, is key to addressing the other 80%.

WASH needs to be carefully integrated into national and international policies, plans, programmes, and funding for ending malnutrition. 

Interventions to ensure the use of water free from faecal contamination, the effective separation of faeces from human contact through improved disposal of excreta, and the simple act of regular handwashing are all fundamental to better health and nutrition for mothers, their newborn babies, and children in the vital first years of life.

Outside our programmatic siloes, this is all obvious. How can babies survive if they are born in hospitals without clean water? How can children avoid malnutrition when their intestines are full of worms from dirty water? How can we end poverty without working together? 

But now comes the difficult part – putting these words in to swift and transformative action. Let us all be determined to do so.

Dan Jones tweets as @danrodmanjones