Toilets The Unglamorous Solution for Saving Lives

Toilets – The Unglamorous Solution for Saving Lives and Improving Human Development in Asia

Bangkok - Toilets may seem an unlikely catalyst for human progress, but the evidence is overwhelming: almost half the developing world lacks access to sanitation, according to the 2006 Human Development Report.

Coverage rates in South Asia are almost as low as in Sub-Saharan Africa, with two of every three people in both regions lacking access to basic sanitation. Half the people of East Asia lack access to sanitation.

Sanitation improvements can advance human development. They can protect people – especially children – from disease and ill health. They can help lift people out of poverty, raise productivity, boost economic growth and create employment, according to the 2006 Human Development Report -- Beyond scarcity: Power, poverty and the global water crisis.

“Lack of toilets is a drain on human development,” says Hakan Bjorkman, Deputy Resident Representative for the UN Development Programme (UNDP) in Thailand. “Increasing access to water and sanitation could have huge benefits, not just for people’s health and survival, but also to develop economic opportunities, reduce poverty, improve the situation for women, and increase chances for education,” he says.

The global water crisis claims more lives through disease than any war claims through guns, says the Report. In fact, diarrhea kills six times more people than armed conflict does. Around the world, 1.1 billion people lack access to water, of whom 720 million are in Asia. There are 2.6 billion people who lack access to sanitation, of whom 1.9 billion are in Asia.

What are some of the human costs? Some 1.8 million children die each year as a result of diarrhea – which is 4,900 deaths a day, one every 17.6 seconds. At any given time, almost 50 per cent of all people in developing countries are suffering from a health problem caused by water and sanitation deficits. Roughly 443 million school days are lost each year through water-related illnesses.

The biggest barrier to progress is the unwillingness of national and international political leaders to put sanitation and safe disposal on the international development agenda, according to the Report. Making matters worse is that women’s voices are seldom heard, whereas women consistently rank sanitation high on their list of priorities for a life of dignity and good health. Studies from Cambodia, Indonesia and Vietnam found that women consistently place higher value on having a toilet than do men, reflecting greater disadvantages women face through insecurity, loss of dignity and ill health associated with having no decent sanitation.

Cities such as Jakarta and Manila have lower levels of sewerage coverage (8% - 10%) than West African cities such as Dakar and Abidjan. In Manila, pit latrines are widespread while waste treatment and disposal infrastructure is underdeveloped.

Some governments have a strong track record in providing access to sanitation. Since 1990 Thailand has increased the national sanitation coverage rate from 80% to 100%. Progress in rural areas has been particularly marked: more than 13 million people in rural areas have gained access in two decades. Every district has been required to identify coverage gaps from the village upwards – and to develop strategies for closing them. Government agencies in Thailand developed technologies that were affordable and accessible to the poor, provided training in maintenance and financed revolving funds to meet the capital costs. Community health programmes have increased awareness of the health benefits of sanitation.

If we continue as we are, we will miss the Millennium Development Goal of halving those without access to water by 234 million people. Approximately 800 million people will still lack access. The sanitation target will be missed by 430 million people, with 2.1 billion in total still without decent sanitation. If we take action and meet the targets, more than 1 million lives could be saved over the next decade. Economic benefits could amount to $38 billion.

Water and sanitation suffer from chronic under-funding. Public spending is typically less than 0.5% of GDP. This figure is dwarfed by military spending. In Pakistan, the military budget is 47 times the water and sanitation budget.

The Report outlines some steps for progress in improving access to sanitation:

Better political leadership – Sanitation must be part of their national development policies

Service providers must respond to the needs of communities, with women having a voice in shaping priorities

Innovative financial arrangement or subsidies must be established, extending financial support to the poorest households to ensure sanitation is an affordable option

Address inequality by identifying who has access and who does not, with explicit targets set for reducing inequalities based on gender, wealth and location.

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