India’s Sanitation for All: How to Make it Happen

The United Nations marks 19 November annually as World Toilet Day to raise awareness about access to hygienic toilets and the human costs of unsafe sanitation.

World Toilet Day celebrates toilets and raises awareness of the 4.2 billion people living without access to safely managed sanitation and is about taking action to tackle the global sanitation crisis and achieve Sustainable Development Goal 6: water and sanitation for all by 2030.

The annual event was adopted by the UN in 2013. This year, World Toilet Day focuses on sustainable sanitation and climate change.

As per UN Water, sustainable sanitation begins with a toilet that effectively captures human waste in a safe, accessible and dignified setting, which then gets stored in a tank, which can be emptied later by a collection service, or transported away by pipework. The next stage is treatment and safe disposal.

Safe reuse of human waste helps save water, reduces and captures greenhouse gas emissions for energy production, and can provide agriculture with a reliable source of water and nutrients.

According to UN figures, open defecation leads to the deaths of 1,000 children every day globally from diarrhoea related to poor sanitation and contaminated water sources. Safe sanitation, water supply and better hygiene can save the lives of 3.5 lakh children in a year.

According to the UN “Our World in Data”, part of Oxford University, “an estimated 775,000 people died prematurely as a result of poor sanitation in 2017. “This was 1.4% of global deaths. In low-income countries, it accounts for 5% of deaths,” it states.

The state of sanitation in India

The Poor sanitation, unsafe water sources, and no access to hand washing facilities” are among the top factors in the country; the list being topped by high blood pressure, air pollution, high blood sugar and smoking.

The reason why so many die from unsafe sanitation is that, in India, a high proportion of the population does not have access to “improved sanitation”. Improved sanitation is defined as facilities that “ensure hygienic separation of human excreta from human contact”. This includes facilities such as flush/pour flush (to piped sewer system, septic tank, pit latrine), ventilated improved pit (VIP) latrine, pit latrine with slab, and a composting toilet.

On World Toilet Day, India strengthens its resolve of #Toilet4All. The last few years have seen an unparalleled achievement of providing hygienic toilets to crores of Indians. It has brought tremendous health benefits along with dignity, especially to our Nari Shakti.

In 2015, 68% of the world population had access to improved sanitation facilities. In other words, almost one-third of people did not have access.

In India, only 40% of the population had access to improved sanitation. This is much lower than its next-door neighbours such as Sri Lanka (95%) and Pakistan and Bangladesh (both over 60%). At 40% access, India is clubbed with countries such as Zimbabwe and Kenya, and is below countries such as Zambia and Senegal.

The economic impact of poor sanitation

According to the World BankA lack of sanitation also holds back economic growth. Poor sanitation costs billions to some countries”.

In India’s case, the most oft-quoted study is a World Bank one from 2006 when such costs were pegged at $53.8 billion or 6.4% of India’s annual GDP. Even if this percentage (of GDP) has stayed the same, at current-day GDP, the losses (a rough approximation) would be close to $170 billion (or Rs 12 lakh crore).

The economic losses are mainly driven by premature deaths, the cost of health care treatment, lost time and productivity seeking treatment, and lost time and productivity finding access to sanitation facilities, according to the World Bank.

According to the World Health Organization, “every dollar spent on sanitation yields about $9 in savings on treatment, health-care costs and gains from more productive days”.


1) Successful pro-poor sanitation programs must be scaled up. Assistance is still not reaching large numbers of the poorest of the poor. Successful models must be replicated and scaled up to serve those who cannot provide for their own needs under existing service delivery systems.

2) Investments must be customized and targeted to those most in need. With more than 450 million Indians living below the poverty line, only a few of the poor who have inadequate sanitation can be assisted right away. Due to limited resources, programs should target groups or locations lagging behind the furthest.

3) Cost-effective options must be explored. Appropriate lower-cost solutions offer a safe alternative to a wider range of the population. Higher-cost options can be explored when economic growth permits. Regardless of cost, all systems should address sanitation all the way “from toilet to river.”

4) Proper planning and sequencing must be applied. Investing in incremental improvements is an approach that one could consider if affordability of sanitation investment is an issue. Careful planning is required to ensure that investments do not become wasteful and redundant.

5) Community-based solutions must be adopted where possible. An approach known as Community-Led Total Sanitation (CLTS) has been found to be effective in promoting change at the community level. Efforts must address sociocultural attitudes toward sanitation and involve women as agents of change. Another innovation is the socialized community-fund raising, which has met great success among the rural poor.

6) Innovative partnerships must be forged to stimulate investments. The key is to stimulate investments from as wide a range of sources as possible, including the private sector, nongovernment organizations (NGOs), and consumers themselves. This may require working with a wide range of partners through innovative public–private partnerships.

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