November 10, 2009
Atlantic Water Summit highlights poor global progress on sanitation
Political leadership is needed to put sanitation at the forefront of development efforts
Washington, DC—A panel discussion at The Atlantic Water Summit on October 29 posed the question "Have we made progress?".
The resounding answer from panelists Roberto Lenton (Chair of the Water Supply and Sanitation Collaborative Council and WaterAid America Board Member), David Winder (WaterAid America's Acting CEO), Louis Boorstin (Director of Water, Sanitation and Hygiene at the Bill and Melinda Gates Foundation) and Ned Breslin (CEO of Water for People) was: not enough.
The panelists spoke about a range of issues, including global efforts to meet the Millennium Development Goal (MDG) targets of halving the proportions of people without access to safe water and sanitation between 1990 and 2015.
The discussion, which was moderated by Corby Krummer, Senior Editor at The Atlantic, highlighted the widespread political neglect of sanitation, a basic service essential for safeguarding people from deadly diarrheal diseases.
If the current dismal rate of progress continues, the Millennium Development Goal target to halve the proportion of people without sanitation by 2015 will not be reached in Sub-Saharan Africa for a century. 
David Winder, Acting CEO, WaterAid America
Currently sanitation is one of the most off-track of all the MDG targets aimed at reducing world poverty. Sub-Saharan Africa is in the worst situation, with the majority of countries not predicted to meet the sanitation target (see map). David Winder, Acting CEO of WaterAid America commented:
"If the current dismal rate of progress continues, the Millennium
Development Goal target to halve the proportion of people without
sanitation by 2015 will not be reached in Sub-Saharan Africa for a
century."
South Asia is not in much better shape. It is estimated that as result of continuing high rates of population growth almost 140 million more people will be without sanitation in 2015 than 1990.
The discussion posed a number of possible explanations for the failure to satisfy a basic right to so many people:
- Sanitation tends to be given low priority in government programs and usually lacks an institutional home. If no single Ministry is accountable for progress then it follows that no progress will be made.
- Those who suffer the greatest risk from lack of toilets are women and children who have the weakest position in decision making at community and national levels.
- It is a “hidden crisis”. The benefits of investment in sanitation are not systematically measured. Studies that have been done show that the return on investment in sanitation is about 9 to 1, but this is not widely discussed. Benefits include higher school attendance by girls, reduced expenditure on medicine as a result of fewer incidences of diarrhea, fewer hours lost through illness and resulting higher agricultural productivity.
- It is not straightforward to work in sanitation. Many people do not see the tangible benefits of sanitation. Programs need to focus on raising awareness of the consequences of lack of sanitation to ensure there is demand amongst communities themselves for sanitation.
One approach that is proving successful in bringing about behavior change and achieving healthier communities is called Community-Led Total Sanitation (CLTS). First introduced by WaterAid's partner organization Village Education Resource Center, with support from Dr. Kamal Kar, in Bangladesh in 1999 the approach is now being applied in other countries in Asia and West Africa.
Critical elements of CLTS are the encouragement and development of local leadership on water, sanitation and hygiene, the involvement of the whole community in understanding the harmful effects of open defecation on health and the preparation of community plans which ensure the support, involvement and commitment of all households.
The panelists outlined a number of actions that will be required to increase the possibility of reaching the MDG target for sanitation, and bringing this vital basic service to more people in need. These include:
- Political leadership that puts sanitation at the forefront of development efforts
- Increased coordination within governments to ensure a more effective and timely delivery of support to community-led efforts. This could include the creation of a single institution accountable for progress on sanitation such as the National Office of Sanitation in Senegal.
- The expansion of CLTS and other community-led approaches to more countries and communities through partnerships between government, local NGOs and communities.
- More effective targeting of aid funds for sanitation to countries and sectors in greatest need. One of the aims of the Global Framework for Action supported by WaterAid is to achieve this.
Other items discussed at the event included ways of influencing US Government policy on support for international water and sanitation programs. David Winder reported that WaterAid had taken the lead in creating a Working Group on Water and Sanitation in Interaction, the membership organization representing international development non-profit organizations.
- To read more about progress in meeting the sanitation MDG target in Africa, download the joint discussion paper from UNICEF, WaterAid and the World Bank's Water and
Sanitation Programme Progress on the 'eThekwini' commitments on sanitation (PDF 714KB), produced for Africa Water Week November 9-13, 2009.
