The lack of progress on sanitation threatens to undermine the child health benefits from gains in providing access to safe drinking water, a report from UNICEF and the World Health Organization warns.
The report, Progress on Sanitation and Drinking Water: 2015 Update and MDG Assessment (90 pages, PDF), found that 2.4 billion people, or one in three on the planet, still lack access to sanitation facilities. At the same time, the gains in access to safe drinking water are substantial, with some 2.6 billion people having gained access since 1990, including 427 million people in sub-Saharan Africa. The report also found that the number of children under the age of 5 who die each day from diarrhea caused by inadequate drinking water, sanitation, and hygiene has been halved over the last fifteen years. Progress on sanitation, however, has been hampered by inadequate investments in behavior-change campaigns, lack of affordable products for the poor, and social norms. While some 2.1 billion people have gained access to improved sanitation since 1990, and 68 percent of the world's population use an improved sanitation facility today, those numbers fall short of Millennium Development Goal targets by nearly 700 million people and 9 percentage points.
"What the data really show is the need to focus on inequalities as the only way to achieve sustainable progress," said Sanjay Wijesekera, head of UNICEF's Water, Sanitation and Hygiene programs.
According to the report, access to adequate water, sanitation, and hygiene is critical in the prevention and treatment of nearly all neglected tropical diseases, which affect more than 1.5 billion people worldwide, causing blindness, disfigurement, permanent disability, and death. The practice of open defecation also is linked to a higher risk of stunting, which affects 161 million children globally. To address the situation, the report calls for disaggregating data so as to better identify target populations; focusing efforts on the hardest to reach, particularly the poor in rural areas; developing technologies and approaches aimed at bringing sustainable sanitation solutions to poor communities at affordable prices; and improving hygiene in homes, schools, and healthcare facilities.
"Until everyone has access to adequate sanitation facilities," said Maria Neira, director of WHO's Department of Public Health, Environmental and Social Determinants of Health, "the quality of water supplies will be undermined and too many people will continue to die from waterborne and water-related diseases."