Why is global sanitation so elusive?

New research shows that factors such as inadequate funding and lack of political commitment pose significant challenges to meeting the world’s sanitation goals.

Improving access to sanitation isn’t a very sexy environmental topic, generating less interest than many other talked-about subjects such as climate change, water scarcity, and chemical plasticizers. Despite its lowly reputation, inadequate sanitation harms millions of people by causing diarrhea and dehydration. In developing countries, for example, up to 1.5 million children under the age of five die annually from diarrhea caused by exposure to germ-infested water.

ANN RODGERS

This pit latrine, located in a village in Ghana, is waterless and is built almost entirely of local materials. It is an example of improved sanitation that can prevent up to 32% of deaths from unsafe water worldwide, according to WHO.

James Mihelcic, David Watkins, and Lauren Fry of the Sustainable Futures Institute of Michigan Technological University decided to dissect the global challenges to upgrading sanitation facilities. Considering a wide range of data, they systematically analyzed various commonly cited challenges on a country-by-country basis. They found that water scarcity is not the biggest stumbling block, as many people might think. The researchers also showed that the choice of sewage-treatment technology, such as waterless latrines or flush toilets, is vital to success. These results appear in recent ES&T research (2008, 4298–4304).

The UN has set targets for improving sanitation under its eight Millennium Development Goals (MDGs). Approved in 2000, the MDGs are aimed at improving the health of the world’s people. Goal seven is to halve the proportion of people without access to safe water and adequate sanitation by 2015.

Most of the world’s countries, with the exception of those in sub-Saharan Africa, are on track to meet the MDG for safe water supply. But very little progress has been made in upgrading sanitation services. According to the World Health Organization (WHO), a 58% improvement in the rate at which countries gain access to improved sanitation facilities is necessary to meet the target by 2015.

Relying on publicly available data compiled by the UN, the World Bank, and others, the scientists analyzed six of the most common challenges to sanitation: inadequate investment, poor or nonexistent government policies, governance (a measurement of a country’s capacity for debate, regulation, and policy), lack of resources, gender disparity, and water availability.

Their first finding was that a lack of water was not a major stumbling block. “We were kind of surprised by that, especially since so many people live in water-scarce environments,” Mihelcic says.

The researchers did find that 46 million people, many of whom live in cities, will struggle with water scarcity related to sewage treatment if they install water-hungry sanitation technology such as sewers. This number is not high when compared with the 2 billion people currently without access to latrines or basic sanitation facilities, Mihelcic says. But these data do raise questions about which technologies to recommend for communities that are experiencing water stress, he adds.

In poor and developing countries, most sewage is discharged untreated into surface waters. This impacts water quality, which is a key factor in maintaining the health of millions of people who rely on fishing for food. For example, 12 countries, including Morocco, Egypt, Pakistan, Saudi Arabia, Mexico, and China, have poor water quality, large numbers of fishers, and water-stressed populations of more than 1 million. Using flush toilets with piped sewage in such places would be unwise, especially because the downstream treatment is very expensive, Mihelcic says.

The scientists also cite financial investment as a key challenge. Since 1961, the World Bank has contributed as much as $1.5 billion more to water supply projects than to sanitation projects.

Lower funding also results from interrelated factors such as lack of political will and user preferences. People can see clean water and appreciate its benefits, but they are less aware of the enhancements stemming from sanitation projects. Although researchers and others explain the link between health problems and poor sanitation facilities, often the message isn’t received by people in developing countries. “They may not understand the science, and because it is about parasites and bacteria that they can’t see, they may not believe it,” Watkins adds. This unawareness also puts pressure on local leaders to use grant money to build health centers or water supply projects, rather than invest in sanitation facilities.

Watkins says his group’s next step is to gather data on work hours lost because parents stay home with sick children and school days lost because of childhood illness. Other researchers are working on these questions as well, he notes. “We want to show that an investment in sanitation is a sound economic investment,” Watkins says. —CATHERINE M. COONEY