Some 829 000 people in low- and middle-income countries die as a result of inadequate water, sanitation, and hygiene each year, representing 60% of total diarrhoeal deaths. Poor sanitation is believed to be the main cause in some 432 000 of these deaths and is a major factor in several neglected tropical diseases, including intestinal worms, schistosomiasis, and trachoma. Poor sanitation also contributes to malnutrition.
In 2013, the UN Deputy Secretary-General issued a call to action on sanitation that included the elimination of open defecation by 2025. The world is on track to eliminate open defecation by 2030, if not by 2025, but historical rates of progress would need to double for the world to achieve universal coverage with basic sanitation services by 2030. To achieve universal safely managed services, rates would need to quadruple.
In 2010, the UN General Assembly recognized access to safe and clean drinking water and sanitation as a human right and called for international efforts to help countries to provide safe, clean, accessible and affordable drinkinAnitg water and sanitation. Sustainable Development Goal target 6.2 calls for adequate and equitable sanitation for all.
As the international authority on public health, WHO leads global efforts to prevent transmission of diseases, advising governments on health-based regulation and service delivery. On sanitation, WHO monitors global burden of disease and the level of sanitation access and analyses what helps and hinders progress. Such monitoring gives Member States and donors global data to help decide how to invest in providing toilets and ensuring safe management of wastewater and excreta.
WHO works with partners on promoting effective risk assessment and management practices for sanitation in communities and health facilities through the WHO Guidelines on sanitation and health, safe use of wastewater, recreational water quality and promotion of sanitation safety planning and sanitary inspections. WHO also supports collaboration between WASH and health programmes such as neglected tropical diseases, cholera, polio and antimicrobial resistance. Aspect of climate resilience are incorporated in all WHO sanitation guidance documents.
State of the world's sanitation: An urgent call to transform sanitation for better health, environments, economies and societiesGuidelines on sanitation and healthSanitation safety planning Sanitary inspection packagesTechnical brief on water, sanitation, hygiene (WASH) and wastewater management to prevent infections and reduceGuidelines for the safe use of wastewater, excreta and greywaterGuidelines for safe recreational water environmentsWASH and health working together: a how-to guide for Neglected Tropical Disease programmesWASH and waste in health facilities
Several sanitation "levels" are being used to compare sanitation service levels within countries or across countries. The sanitation ladder defined by the Joint Monitoring Programme in 2016 starts at open defecation and moves upwards using the terms "unimproved", "limited", "basic", with the highest level being "safely managed". This is particularly applicable to developing countries.
The Human Right to Water and Sanitation was recognized by the United Nations (UN) General Assembly in 2010. Sanitation is a global development priority and the subject of Sustainable Development Goal 6. The estimate in 2017 by JMP states that 4.5 billion people currently do not have safely managed sanitation. Lack of access to sanitation has an impact not only on public health but also on human dignity and personal safety.
"Sanitation generally refers to the provision of facilities and services for the safe disposal of human urine and faeces. The word 'sanitation' also refers to the maintenance of hygienic conditions, through services such as garbage collection and wastewater disposal."
Sanitation includes all four of these technical and non-technical systems: Excreta management systems, wastewater management systems (included here are wastewater treatment plants), solid waste management systems as well as drainage systems for rainwater, also called stormwater drainage. However, many in the WASH sector only include excreta management in their definition of sanitation.
Hygiene promotion is seen by many as an integral part of sanitation. The Water Supply and Sanitation Collaborative Council defines sanitation as "The collection, transport, treatment and disposal or reuse of human excreta, domestic wastewater and solid waste, and associated hygiene promotion."
The overall purposes of sanitation are to provide a healthy living environment for everyone, to protect the natural resources (such as surface water, groundwater, soil), and to provide safety, security and dignity for people when they defecate or urinate.
Effective sanitation systems provide barriers between excreta and humans in such a way as to break the disease transmission cycle (for example in the case of fecal-borne diseases). This aspect is visualised with the F-diagram where all major routes of fecal-oral disease transmission begin with the letter F: feces, fingers, flies, fields, fluids, food.
Sanitation technologies may involve centralized civil engineering structures like sewer systems, sewage treatment, surface runoff treatment and solid waste landfills. These structures are designed to treat wastewater and municipal solid waste. Sanitation technologies may also take the form of relatively simple onsite sanitation systems. This can in some cases consist of a simple pit latrine or other type of non-flush toilet for the excreta management part.
Providing sanitation to people requires attention to the entire system, not just focusing on technical aspects such as the toilet, fecal sludge management or the wastewater treatment plant. The "sanitation chain" involves the experience of the user, excreta and wastewater collection methods, transporting and treatment of waste, and reuse or disposal. All need to be thoroughly considered.
For developing countries, the economic costs of inadequate sanitation is a huge concern. For example, according to a World Bank study, economic losses due to inadequate sanitation to The Indian economy are equivalent to 6.4% of its GDP. Most of these are due to premature mortality, time lost in accessing, loss of productivity, additional costs for healthcare among others. Inadequate sanitation also leads to loss from potential tourism revenue. This study also found that impacts are disproportionately higher for the poor, women and children. Availability of toilet at home on the other hand, positively contributes to economic well-being of women as it leads to an increase in literacy and participation in labor force.
In 2017, JMP defined a new term: "basic sanitation service". This is defined as the use of improved sanitation facilities that are not shared with other households. A lower level of service is now called "limited sanitation service" which refers to use of improved sanitation facilities that are shared between two or more households.
The term "dry sanitation" is not in widespread use and is not very well defined. It usually refers to a system that uses a type of dry toilet and no sewers to transport excreta. Often when people speak of "dry sanitation" they mean a sanitation system that uses urine-diverting dry toilet (UDDTs).
Environmental sanitation encompasses the control of environmental factors that are connected to disease transmission. Subsets of this category are solid waste management, water and wastewater treatment, industrial waste treatment and noise pollution control. According to World health organization (WHO) Environmental sanitation was defined as the control of all those factors in the physical environment which exercise a harmful effect on human being physical development, health and survival. One of the primary function of environmental sanitation is to protect public health 041b061a72