Students walk hand-in-hand to newly built latrines at a school

According to World Health Organization (WHO) figures, about 800 million people in Africa lack access to basic sanitation. This leads to substantial health risks and negative economic and environmental impacts.

Some 842 000 people in low- and middle-income countries die as a result of inadequate water, sanitation, and hygiene each year, representing 58 percent of total diarrhoeal deaths. Poor sanitation is believed to be the main cause in some 280 000 of these deaths.

Diarrhoea remains a major killer but is largely preventable. Better water, sanitation, and hygiene could prevent the deaths of 361 000 children aged under 5 years each year.

Sewered communal toilets in Kibera, Kenya

Open defecation perpetuates a vicious cycle of disease and poverty. The countries where open defection is most widespread have the highest number of deaths of children aged under 5 years as well as the highest levels of malnutrition and poverty, and big disparities of wealth.

It is for these reasons that African Development (AfD) Bank has put in considerable financial muscle into the global effort to improve toilets, and sanitation in general.

The Bank partnered with the Bill and Melinda Gates Foundation and other multilateral development institutions recently in Beijing, in what was billed as the Reinvented Toilet Expo (RTE), a global search for more sanitary, healthier, and even lucrative solutions to the enduring challenge of human waste disposal.

At the recent African Water Week that ended in Libreville, Gabon, Wambui Gichuri, the Bank’s Director of Water Development and Sanitation pointed out that rapid population growth and the fastest urbanization rate in the world are compounding these challenges.

Gichuri said these are associated with a growing demand for water and increased generation of waste, yet without the attendant planning and investments.

“We need to work smarter,” said Gichuri, “working with science and technology to change the face of sanitation in Africa, from a problem causing millions of deaths, to a resource that generates revenue and improves the livelihoods of the people on the continent,” she said before the Beijing RTE event.

Clean and maintained toilets in private premises

The Bank announced a new initiative to promote innovation and inclusive sanitation services for sub-Saharan Africa’s urban inhabitants at the Beijing Expo. The Bank’s Africa Urban Sanitation Investment Fund Program, with support from the Gates Foundation, is funding the initiative designed to focus on the poor.

“The AfD Bank aims to establish the first African Urban Sanitation Investment Fund (AUSIF). The program builds on the partnership between the Gates Foundation, the African Water Facility and the AfD bank started in 2011,” Gichuri explained.

Gichuri affirmed the Bank and African Water Facility are committed to raising at least US$ 500 million in new, inclusive sanitation investments for the AUSIF from public and private sources. At least 30 percent of those resources will finance non-sewered sanitation innovation that directly serves low-income communities.

This partnership with the Gates Foundation and other development organizations will enable the African Water Facility, an initiative of the African Ministers’ Council on Water hosted by the Bank, to structure the AUSIF to leverage public and private sector investment.

Easy to clean toilet facility

Benefits of improved sanitation extend well beyond reducing the risk of diarrhoea. These include; reducing the spread of intestinal worms, schistosomiasis and trachoma, which are neglected tropical diseases that cause suffering for millions.

Others benefits are reducing the severity and impact of malnutrition; promoting dignity and boosting safety, particularly among women and girls and promoting school attendance.

Girls’ school attendance is particularly boosted by the provision of separate sanitary facilities; and potential recovery of water, renewable energy and nutrients from faecal waste.

The situation of the urban poor poses a growing challenge as they live increasingly in mega cities where sewerage is precarious or non-existent and space for toilets and removal of waste is at a premium. Inequalities in access are compounded when sewage removed from wealthier households is discharged into storm drains, waterways or landfills, polluting poor residential areas.

Limited data available on this topic suggests that a large proportion of wastewater in developing countries is discharged partially treated or untreated directly into rivers, lakes or the ocean.

Wastewater is increasingly seen as a resource providing reliable water and nutrients for food production to feed growing urban populations. Yet this requires management practices that ensure wastewater is sufficiently treated and safely reused; institutional oversight and regulation; and public education campaigns to inform people about wastewater use.

As the international authority on public health, WHO leads global efforts to prevent transmission of diseases, advising governments on health-based regulations.

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 through Sanitation safety planning, Guidelines on safe use of wastewater, excreta and greywater, and forthcoming Sanitation and Health Guidelines and Global strategy on water, sanitation and hygiene and neglected tropical diseases.

The WHO, along with UNICEF and other partners are also implementing a global action plan for ending preventable child deaths from pneumonia and diarrhoea by 2025.

This aims to meet several prevention and treatment targets, including promoting universal access to drinking water, sanitation, and hygiene in health care facilities and homes by 2030.

Increasing people’s access to improved sanitation, combined with delivering preventive chemotherapy, is also part of the five global public health strategies for the control and elimination of neglected tropical diseases.