Nearly 40 percent of world’s population lacks access to a proper toilet


The Nation’s Health
May 2008

Sixty-two per cent of Africans do not have access to an improved sanitation facility — a proper toilet — which separates human waste from human contact, according to the World Health Organization/UNICEF Joint Monitoring Programme for Water Supply and Sanitation. A global report will be published later this year, however, preliminary data on the situation in Africa was released March 20 as part of World Water Day 2008. The event, built around the theme “Sanitation Matters,” seeks to draw attention to the plight of some 2.6 billion people around the world who live without access to a toilet at home and thus are vulnerable to a range of health risks.

“Sanitation is a cornerstone of public health,” said WHO Director-general Margaret Chan, MD, MPH. “Improved sanitation contributes enormously to human health and well-being, especially for girls and women. We know that simple, achievable interventions can reduce the risk of contracting diarrheal disease by a third.”

Although WHO and UNICEF estimate that 1.2 billion people worldwide gained access to improved sanitation between 1990 and 2004, an estimated 2.6 billion people — including 980 million children — had no toilets at home. If current trends continue, there will still be 2.4 billion people without basic sanitation in 2015, and the children among them will continue to pay the price in lost lives, missed schooling, disease, malnutrition and poverty.

“Nearly 40 percent of the world’s population lacks access to toilets, and the dignity and safety that they provide,” said Ann M. Veneman, UNICEF executive director. “The absence of adequate sanitation has a serious impact on health and social development, especially for children. Investments in improving sanitation will accelerate progress towards the Millennium Development Goals and save lives.”

Using proper toilets and hand washing — preferably with soap — prevents the transfer of bacteria, viruses and parasites found in human excreta which otherwise contaminate water resources, soil and food. This contamination is a major cause of diarrhea, the second biggest killer of children in developing countries, and leads to other major diseases such as cholera, schistosomiasis and trachoma. Improving access to sanitation is a critical step toward reducing the impact of these diseases. It also helps create physical environments that enhance safety, dignity and self-esteem.

Safety issues are particularly important for women and children, who otherwise risk sexual harassment and assault when defecating at night and in secluded areas.

Also, improving sanitation facilities and promoting hygiene in schools benefits both learning and the health of children. Child-friendly schools that offer private and separate toilets for boys and girls, as well as facilities for hand washing with soap, are better equipped to attract and retain students, especially girls. Where such facilities are not available, girls are often withdrawn from school when they reach puberty.

In health-care facilities, safe disposal of human waste of patients, staff and visitors is an essential environmental health measure. This intervention can contribute to the reduction of the transmission of health-care associated infections which affect 5 percent to 30 percent of patients.

“The focus on sanitation is fundamental to human beings,” said Pasquale Steduto, United Nations water chairman. “The (Millennium Development Goals) target on sanitation is seriously lagging behind schedule. The entire UN System has a shared responsibility in mobilizing concrete actions towards its achievement; investments must increase immediately.”

UN-Water is the coordinating mechanism of the UN agencies, programs and funds that play a significant role in tackling global water and sanitation concerns.

World Water Day provides an opportunity to draw attention to the International Year of Sanitation 2008. In December 2006, the United Nations General Assembly called for a focus on addressing sanitation and hygiene problems.

The International Year of Sanitation 2008 aims to raise the profile of sanitation issues on the international agenda and to accelerate progress towards meeting the Millennium Development Goal target of reducing by half the proportion of people living without access to improved sanitation by 2015. Within the UN system, the focal point for the International Year of Sanitation is the United Nations Department of Economic and Social Affairs, in collaboration with the UN-Water Task Force on Sanitation.

Sanitation is not a dirty word. Sanitation matters.

Story courtesy World Health Organization, March 20, 2008. This story does not include original reporting by The Nation’s Health staff.

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