The Global Sanitation Crisis



In 2013, the Economist magazine touted the toilet as the world’s most useful invention, because it had “transformed the lives of billions of people.” Indeed, since the 19th century, improved sanitation has saved billions of people from death and disease and helped communities and economies thrive. Business was a critical factor in the sanitation revolution. In England, this was illustrated by the title of Edwin Chadwick’s report, “The Sanitary Conditions of the Labouring Population,” published in 1842. Considered a landmark in England’s revolution, it led to the 1848 Public Health Act. Today, businesses that recognize and commit to act on the critical linkages between sanitation and worker health, education, business productivity, clean environments, and thriving markets have tremendous potential to reduce business risks, leverage opportunities, and make a meaningful contribution to a more dignified life for all.

For decades, sanitation — the safe and clean disposal of human urine and feces and related hygiene bpractices — has been widely overlooked as a sustainable development issue. This inattention has been due largely to widespread sensitivities about managing human waste and a lack of understanding of its pervasive impacts. However, sanitation is quickly gaining prominence as one of the most important development challenges of the 21st century, and for good reason: 2.5 billion people around the world do not have access to a toilet (UNICEF and WHO 2014). More than a billion people and one out of every three in rural areas defecate in the open, exposing themselves and their neighbors to fecal bacteria that lead to diarrhea and other diseases, and fouling waterways on which safe drinking water, ecosystem health, and many industrial production processes rely (UNICEF and WHO 2008). Just one gram of fecal material can contain 10 million viruses, a million bacteria, a thousand parasite cysts, and a hundred parasite eggs (Sanitation Drive 2015 and UN-Water 2014). Figure 1 indicates the percentage of the population with improved sanitation in 2012 by country. Detailed data can be accessed on the website of the Joint Monitoring Programme (JMP) for Water Supply and Sanitation (

Percentage of population using improved sanitation in 2012

There are 46 countries where less than half the population has access to an improved sanitation facility. (Source: UNICEF and WHO 2014)

The consequences of these unacceptable conditions are staggering: roughly half a million children die every year from diarrhea caused by unsafe water and poor sanitation (UN IGME 2013). Half the hospital beds in developing countries are filled with people suffering from diseases caused by poor water, sanitation, and hygiene (UNDP 2006). Inadequate sanitation also contributes to chronic health and nutrition problems, impedes the education of children (especially adolescent girls), reduces productivity, and makes women more vulnerable to sexual assault.


A growing momentum

Though for decades sanitation has been an underacknowledged and underresourced development challenge, there has been significant recent progress in addressing this challenge:

  • In 2002, the UN Committee on Economic, Social and Cultural Rights adopted General Comment 15 stating that sanitation is “fundamental for human dignity and privacy.”
  • In 2002, one of the targets in the United Nations’ Millennium Development Goal (MDG) agenda was to halve by 2015 the proportion of the population without sustainable access to basic sanitation. Unfortunately, the world is expected to miss this goal by over half a billion people by 2015 (UNICEF and WHO 2014).
  • 2008 was named the International Year of Sanitation.
  • In 2010, the UN General Assembly explicitly recognized the human rights to safe water and sanitation.
  • In 2013, the United Nations launched a Call to Action on Sanitation to meet the MDG target, and in 2014 a special campaign began to put an end open defecation by 2025.
  • In recent years, the potential role of business in addressing sanitation challenges is becoming increasingly prominent: UN Deputy Secretary-General Jan Eliasson spoke to the importance of business and sanitation at CEO Water Mandate sessions at the UN Global Compact Leaders Summit, and the World Business Council for Sustainable Development (WBCSD) has launched its WASH at the Workplace initiative.
  • As the Post-2015 Development Agenda process continues to advance, it is widely expected that sanitation will be featured prominently as either a stand-alone goal or an important cross-cutting issue in the Sustainable Development Goals.
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