Globally 2.5 billion people live without access to improved sanitation: 1 billion of these people practice open defecation. Despite significant gains – almost 1.9 billion people gained access to toilets or latrines since 1990 – sanitation remains one of the most off-track Millennium Development Goals (MDG) globally.  Only 64% of the world’s population has access to improved sanitation, but 70% of the Sub-Saharan Africa population and 59% of South Asia still lack access.  At current rates of progress, the world will miss the MDG for sanitation by over half a billion people.

Sanitation lies at the root of many other development challenges, as poor sanitation impacts public health, education, and the environment. Poor sanitation, water, and hygiene lead to about 700,000 premature deaths annually.  Without sanitation girls are more likely to drop out of school or are vulnerable to attacks while seeking privacy. Recent analysis shows that ending open defecation can save children’s lives by reducing disease transmission, stunting, and under-nutrition, which are important for childhood cognitive development and future economic productivity.

Lack of sanitation also holds back economic growth.  Poor sanitation costs billions to some countries, amounting to the equivalent of 6.3% of GDP in Bangladesh, 6.4% of GDP in India, 7.2% of GDP in Cambodia, 2.4% of GDP in Niger, and 3.9% of GDP in Pakistan annually.  The economic losses are mainly driven by premature deaths, the cost of health care treatment, lost time and productivity seeking treatment, and finding access to sanitation facilities. Pollution resulting from improper disposal and treatment of wastewater and domestic fecal sludge also affects both water resources and ecosystems. At the same time, fecal sludge and wastewater and can provide valuable resources (water, nutrients, and energy) and economic opportunities, especially in urban areas and in water-scarce environments.

Last Updated: Oct 02, 2013

With its impact on so many other aspects of human and economic development, sanitation will be one of the key drivers to ending extreme poverty by 2030, the goal recently articulated by World Bank President Jim Yong Kim. For this, the World Bank is committed to using innovative approaches to meet the sanitation challenges: ending open defecation, improving service delivery, and closing the loop from access to sanitation facilities to sustainable disposal of wastewater and sludge management. Currently sanitation represents 20% of the Water Supply and Sanitation lending portfolio, and a large share of non-lending technical assistance and knowledge development activities.

The World Bank sees the need for urban centers to prioritize investment in a mix of sanitation options to address ever-growing challenges of rapid urbanization. In addition to access to facilities, significant efforts are made to improve fecal sludge and wastewater management to minimize water pollution and other environmental damage. Meanwhile, rural areas require different investments; such as efforts on behavior change that create demand for improved sanitation and hygiene promotion among the poorest.

Another tenet of the strategy to expand access to sanitation is the recognition that private sector participation is essential to meet the needs of all citizens. To accelerate access to 2.5 billion people, governments need to leverage the private sector’s professional capacity and investment. Partnering with the private sector can tap into its capacity to innovate new affordable and aspirational products for poorer households, strengthen distribution and supply chains, and apply the best social and commercial marketing practices to change behavior, a particularly crucial consideration for sanitation. Private sector participation is also tapped in the collection and proper disposal of fecal sludge and wastewater.

Last Updated: Oct 02, 2013

In FY12 17 projects were approved that directly benefit over 2.6 million beneficiaries, 153,000 in urban areas and 2.4 million in rural areas. Furthermore, some 322,000 improved latrines and 101,000 new sewer connections are being provided under projects implemented in Bangladesh, Brazil, India, Kenya, Mozambique, and Uganda. Approximately 14 million tons per year of biochemical oxygen demand pollution will be removed after completion of wastewater treatment plants in Kenya, China, and the Philippines.

Additionally, the World Bank’s Water and Sanitation Program (WSP) has helped communities in India, Indonesia, and Tanzania improve access to sanitation for 22 million people since 2007 through a combination of enabling environment, marketing and behavior change, and knowledge-sharing activities. In Pakistan, WSP is collaborating with the Pakistan Poverty Alleviation Fund, a national-level government project supported by the World Bank, testing the Community-Led Total Sanitation (CLTS) approach to end open defecation for 300,000 people in six union councils.  In Indonesia, the Sanitation Sector Development Program (ISSDP) provides one example of the Bank’s engagement in tackling the challenge of sanitation in rapidly urbanizing areas, by fostering government commitment, increasing national and local investment, and promoting city-level sanitation planning in the context of decentralization.

Last Updated: Oct 02, 2013

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