World Toilet Day: Time to kick up a stink about sanitation

Earlier this year, the UN General Assembly unanimously declared today, November 19, as World Toilet Day. With good reason. A staggering third of humanity – 2.5 billion people – don’t have access to one of the most basic human and social needs – safe sanitation.

The consequences are shocking. Over 1.2 million people die every year from diseases attributable to poor sanitation, water and hygiene.

Talking poo and wee isn’t sexy. But these are life and death issues for millions of people in the global south. It’s time to give a crap about toilets. Good sanitation is a human right. It saves lives.

Inadequate toilet and washing facilities impact particularly adversely on people with serious diseases, such as HIV. It makes them vulnerable to potentially life-threatening secondary infections.

World AIDS Day is on 1 December. For the 35.3 million people worldwide living with HIV, basic sanitation is especially important. Having an already weakened immune system means that keeping free of infections is of critical importance. This is a tough call for a person whose neighbourhood streets are contaminated with raw sewage or whose latrines the leech into the water supply.

You don’t need to be a medical expert to recognise the dangerous impact that a lack of access to good sanitation, clean water and washing facilities can have on the 95 per cent of people with HIV who live in the developing world.

Stigma and discrimination around HIV have destructive consequences - often more so in the developing world than in the west.

The international development charity, WaterAid, is working in developing countries to improve sanitation standards. It reports that some communities have prevented neighbours, and even family members, with HIV from accessing shared water taps and latrines. The charity is attempting to challenge this social exclusion through outreach education.

Despite the known benefits of sanitation, safe water and improved hygiene, ensuring sufficient access to these services for people living with HIV/AIDS remains a major challenge.

In some parts of the developing world, for example in Nigeria, Africa’s most populous country, access to sanitation has fallen from 38 per cent in 1990 to just 31 per cent today. Across the continent, the numbers lacking sanitation increased by 13.7 million to over 610 million people in the year 2010 to 2011.

With two-thirds of people living with HIV in sub-Saharan Africa, it’s a horrifying thought that 70 per cent of the continent lack an adequate toilet, while 37 per cent don’t have access to safe drinking water. No wonder HIV and secondary infections remain major killers.

Donor governments in the West could and should do more. A WaterAid report released last year showed that global funding for basic water and sanitation services - the simple toilets desperately needed by those without access – fell by around £600 million from 2009 to 2010.

Even when donors do provide aid for water and sanitation, far too much of it goes to countries that already have comparatively high levels of access, or is invested in large infrastructure projects which can totally miss rural communities and the urban poor.

Governments in the West and in the developing world need to make good on their promises to provide these basic services; in particular, their commitment to the Millennium Development Goal of halving the proportion of people lacking access to adequate sanitation by 2015.

This key pledge is arguably the most off track of all the Millennium Development Goals and, at current rates of progress, is likely to be over ten years too late. Half a billion people who were promised improved sanitation are being badly let down because the financing and political prioritisation has been lacking.

While increasing access to antiretroviral drugs is crucial for the survival of people with HIV, it is also clear that efforts to combat HIV infections would also benefit from a stronger focus on improving access to sanitation, water and hygiene.

World Toilet Day may well be a laughing matter in much of the UK. However, for over a third of humanity, good sanitation, washing facilities and clean water are deadly serious life savers.