Globally 2.4 billion people live without access to improved sanitation: Almost 1 billion of these people practice open defecation. Despite significant gains — almost 2.1 billion people gained access to toilets or latrines since 1990 — sanitation was one of the most off-track Millennium Development Goals (MDG) globally. Only 68% of the world’s population has access to improved sanitation, but 70% of the Sub-Saharan Africa population and 53% of South Asia still lack access. The world missed the MDG target for sanitation by almost 700 million people.

Sanitation lies at the root of many other development challenges, as poor sanitation impacts public health, education, and the environment. Almost 1,000 children under five die each day from diarrhea caused by inadequate water, sanitation and hygiene. 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 can provide valuable resources (water, nutrients, and energy) and economic opportunities, especially in urban areas and in water-scarce environments.

Last Updated: Sep 22, 2016

The World Bank Group (WBG) has been addressing water and sanitation issues globally with large-scale finance and technical assistance to countries. To meet the growing demand for investment financing driven by the best knowledge available, the WBG created a single, integrated Water Global Practice. Launched in 2014, the Global Practice brings together financing, implementation, and knowledge in one platform.

With its impact on so many aspects of human and economic development, sanitation will be one of the key drivers to ending extreme poverty by 2030. For this, the World Bank Group 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 almost half of the Water Supply and Sanitation (WSS) lending portfolio, and a large share of non-lending technical assistance and knowledge development activities.

A major change in the past year has been a significant growth in the sanitation component of the WSS portfolio, in large part due to the considerable influence of the WBG Water and Sanitation Program (WSP)’s long-term engagement in this area, particularly in the rural sanitation sub-sector. Through advocacy, innovative approaches, and policy dialogue, WSP engagements are now yielding impact at scale in large rural and urban sanitation projects in countries such as India, Vietnam, Egypt, Mozambique, Tanzania, Ethiopia, and Ghana.

The World Bank Group 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 2.4 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: Sep 22, 2016

By combining global knowledge with country investments, the World Bank Group generates more firepower for transformational solutions to help countries grow sustainably into the 21st century. These are some highlights from our work on sanitation:

  • 16.6 million people provided with access to improved sanitation facility from 2013 to 2015.
  • The current WBG investment program is expected to benefit over 23 million beneficiaries with access to improved sanitation services; of which 8 million live in cities and 15 million in rural areas. In addition, the program is expected to provide 17 million people with training on improved hygiene practices.
  • Approximately 100,000 tons per year of biochemical oxygen demand pollution will be removed after completion of wastewater treatment plants in Ecuador, Egypt, India, China, Vietnam, among others.
  • Additional beneficiaries from technical assistance to clients include: 100,000 rural households in the Philippines (scale up of sanitation program on behavior change); 18.6 million people in Rajasthan, India (scale up rural sanitation program); 310,000 estimated beneficiaries in Niger (water and sanitation programs); 1 million people in Peru (water and sanitation program for periurban areas).
    • India Swachh Bharat Mission Support Program - This $1.5 billion IBRD loan, along with WSP technical assistance, supports the Government of India’s national program on rural sanitation, which aims to end open defecation in rural areas by 2019.

Last Updated: Sep 22, 2016

More Photos »