The world is striving to ensure all people have access to safe sanitation services, including toilets, by 2030. This is an ambitious though achievable goal. At present more than 4.2 billion people globally live without access to safe sanitation services. More than 673 million people still practice open defecation. Inadequate access to safe sanitation services increases human-feces contact, and with it the transmission of a range of diseases, including cholera, typhoid, hepatitis A and E, trachoma and tapeworm. The WHO South-East Asia Region is particularly affected. More than 600 million people lack access to basic sanitation services. Open defecation remains common.
As the theme of this year’s World Toilet Day emphasizes, no one can be left behind. By ensuring all people have access to toilets, Member States will accelerate progress towards Sustainable Development Goals (SDG) 3 and 6, on health and sanitation, respectively. They will also reduce sexual assault and empower women and girls (SDG 5), in addition to decreasing poverty (SDG 1) and promoting economic growth (SDG 8). Loss of productivity to water- and sanitation-related diseases costs countries up to 5% of gross domestic product. The return on every dollar invested in safe sanitation is estimated to accrue at least six times over, due primarily to lower health costs, increased productivity and fewer premature deaths.
Member States have made steady progress. Region-wide, coverage of basic sanitation services is now close to 70%. Several Member States have achieved coverage of more than 90%. India continues its unprecedented efforts to bring safe sanitation to all in a country that accounts for one-sixth of humanity. In September Nepal became open defecation-free. In keeping with the Region’s primary health care approach to universal health coverage, which is one of eight Flagship Priorities, WHO and its Member States are striving to ensure all primary facilities have adequate sanitation services, including toilets.
The Region’s progress must continue. As part of Member State efforts to implement the Region’s ‘Sustain. Accelerate. Innovate’ vision and achieve several Flagship Priorities, in addition to the SDGs, key opportunities should be leveraged.
First, health authorities should strengthen public awareness campaigns that highlight the links between sanitation, disease and good health, and which emphasize the need to eliminate open defecation. Specific prominence should be given to addressing factors that influence exposure to fecal pathogens. Key messaging should be disseminated as widely as possible, including in schools, prominent institutions and via popular media. Both urban and rural areas should be targeted, with disparities in the use of sanitation facilities accounted for.
Second, focus should be given to finding sustainable sanitation solutions that go beyond toilet construction. For example, mechanisms that guarantee periodic maintenance of toilets, including proper containment, transportation and treatment of wastewater, should be developed. Sanitation solutions that can be quickly implemented, are cost effective and efficient should be identified and rolled out to cover as many people as possible. Innovative thinking is crucial to developing high-impact interventions.
Third, opportunities to promote ongoing sanitation safety planning among all stakeholders should be identified and pursued. Doing so will facilitate the coordination of efforts to prioritize improvements and fill gaps. It will also augment system monitoring and enable stakeholders to better identify risks. As part of this, accelerated efforts must be made to improve Water, Sanitation and Hygiene (WASH) services in health care facilities and schools to reduce hospital-acquired infections, reduce maternal mortality, increase the use of health facilities and increase school attendance.
WHO will continue to support countries in their endeavors, including by enhancing the uptake of key decision-making aids such as the Global Analysis and Assessment of Sanitation and Drinking-Water (GLAAS) and Tracking Financing to WASH (Trackfin). Both tools aggregate and present data in a way that allows policymakers to identify and assess existing financial and other gaps in the provision of WASH services. This enables them to make smarter decisions that drive maximum impact and make the most of WASH-focused investments.
Our efforts are ongoing. Though the Region has made substantial progress on WASH and its related Flagship Priorities and SDGs, further advances are needed. We must meet all targets and goals. On World Toilet Day, WHO reiterates its commitment to supporting countries bring safe sanitation services, including toilets, to all, and ensuring all primary health care facilities have adequate WASH services. Sanitation is a human right. Together we must expand access to safe toilets and leave no one behind.