Today, 3.5 billion people – almost one in two – don’t have access to safely managed sanitation services.

The global sanitation crisis represents a deadly crisis. People who do not have a toilet of their own often have no other option but to defecate in the open. This means that untreated faeces and urine leak into the surrounding  environment, contaminating it and risking the spread of disease. 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 women and girls, not being able to access a decent toilet affects more than just their physical health. It affects their dignity and safety as they often have to wait until dark to find a private place to defecate, which increases the risk of them being harassed or even sexually attacked.

Girls are also particularly affected when their school doesn't have decent toilets; they often drop out completely when they start their periods as they have nowhere safe or private to manage them. This reinforces and widens 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 made by many governments, and the UN’s recognition of sanitation as a human right in 2010, it remains a neglected area of international development. 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. 

What's more, climate change threatens progress made so far as floods, droughts and extreme weather disrupt sanitation services, often exacerbating an existing public health crisis. To date, sanitation and its links to water scarcity, climate adaptation and mitigation has been overlooked in climate dialogues. But if the global community is serious about climate adaptation and mitigation practices, it cannot fail to acknowledge the role sanitation can play to both curb climate change and adapt to it, leading to climate resilience. 

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

Climate resilience through sanitation

Sanitation is key to building overall climate resilience, but must themselves be resilient to the impacts of climate change. This report sets out the approaches needed to take a systems-wide perspective along the entire sanitation service chain.

Dagitu and her elder sister Gedam are very happy to see there is new toilet built at Edget Behibret Elementary School that also caters the needs of students with physical disabilities, Burie, West Gojjam, Amhara, Ethiopia. November 2018.
Image: WaterAid/ Genaye Eshetu

Our approach

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

To ensure improvements are sustainable, we take a systems strengthening approach:

  • We prioritise people living in poverty and people who are marginalised to ensure no one is denied this basic human right. Only if we ensure communities use toilets that are safely managed will people's health, livelihoods and wellbeing be improved.
  • 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, through emptying, transport, treatment, disposal or reuse. This also includes its storage and onsite treatment in specific, often rural, contexts. 
  • Recognising the human resource gap for sanitation service delivery and the importance of the people providing these vital services, we advocate for the dignity, health and safety of the sanitation workers operating within that chain.

Ensuring sanitation for all involves more than building toilets or motivating communities. We use our experience of delivering services to help governments and service providers identify blockages and make improvements to their sanitation service delivery systems. 

And through our advocacy and campaigns, we raise awareness that access to sanitation is key to achieving many other development goals, including those in health, the environment, education, housing and, increasingly, climate change mitigation and adaptation. We call on local and national governments 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.

Latest resources and expert opinion

Top image: Niraj, 15, walks towards the male toilet block at his school in Bardiya, Nepal, August 2023.

Second image: Dagitu and her elder sister, Gedam, are happy to see a new accessible toilet at Edget Behibret Elementary School, that also caters the needs of students with physical disabilities, Amhara, Ethiopia. November 2018.

Page last updated: April 2024