Today, 419 million people – one in 20 – do not have access to a toilet, leaving them no choice but to defecate in the open.

One in five people globally – 1.5 billion – do not have a decent toilet of their own (‘basic’ or ‘safely managed’ sanitation). In many cases, faeces and urine end up untreated in the environment, contaminating it and threatening people’s health.

This is a deadly crisis. Where people don’t have clean water and sanitation, disease spreads fast. More than 273,000 children under five die every year from diarrhoeal diseases as a result. That's almost 750 children a day, or one child nearly every two minutes. This shouldn’t be normal.

For girls and women, the lack of toilets also affects their privacy and safety – they often wait until dark to find a quiet place to defecate, which increases the risk of being harassed or even sexually attacked.

Without toilets in schools, children are left to defecate in the open. This makes them vulnerable to diarrhoeal illnesses and causes them to miss lessons. Girls in particular are affected by a lack of private toilets, and often drop out completely when they start their periods. This continues to reinforce and widen the gap between boys and girls, holding girls back from realising their full potential. Recruiting teachers into schools without decent toilets is also difficult.

The knock-on effects are considerable. In many countries, the economic cost of poor sanitation and hygiene amounts to more than 5% of their GDP.

Despite commitments by many governments, and the UN’s recognition of sanitation as a human right, it remains neglected. 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. 

For the life-changing impacts of clean water and good hygiene to be delivered, decent toilets must be normal for everyone, everywhere. This is why we put sanitation at the centre of our work.

Rethinking rural sanitation

With UNICEF and Plan International UK, we developed a set of resources to help you design, cost and implement programmes for rural sanitation.

14 year old Devi, daughter of  Jit Bahadur Shrestra, with her family's new latrine, Jogidanda village, Bahuntilpung VDC, Sindhuli district, Nepal, December 2011.
Image: WaterAid/ Tom van Cakenberghe

Our approach

Together, we can make a bigger difference. With governments, development partners, utility companies, community-based organisations, businesses and entrepreneurs, and local people, we work every day to improve people’s access to sanitation.

To ensure improvements are sustainable, we promote behaviour change and work with communities to review various sanitation options so they can make informed decisions about which best meets their needs.

We address the entire sanitation chain to make sure human waste is safely managed, including transportation or storage, treatment, and disposal or re-use. We advocate the dignity, health and safety of the sanitation workers operating that chain.

We prioritise the poorest and most marginalised people, to ensure no one is denied this basic human right – only if entire communities use toilets will people’s health, livelihoods and wellbeing be improved.

Ensuring sanitation for all takes more than building toilets or motivating communities. We use our experience of delivering services to help governments and service providers identify blockages and improvements in their sanitation service delivery systems. In doing so, we contribute to ensuring everyone, everywhere has sustainable access to sanitation.

Sanitation is at the core of our programme delivery, and through our advocacy and campaigns we raise awareness of the fact that improvements in sanitation are key to the success of many other areas of development – including health, environment, education, housing and infrastructure. We call on governments nationally and internationally to make sanitation a political priority, and support them to deliver on their commitments. Together, we can achieve the Sustainable Development Goal to end open defecation and ensure everyone, everywhere has sanitation by 2030.


Explore our sanitation publications and resources

News and blogs 

Opinion pieces and discussions relating to sanitation