Poor sanitation leads to sickness and disease, which lead to low productivity, and, consequently, to poverty. The major global consequences of lack of sanitation are the 4 billion cases of diarrhoea reported by WHO and UNICEF each year, and the annual death toll of 2.2 million people. The provision of water services alone has a limited impact on health in the absence of safe sanitation. Improving sanitation can reduce cases of diarrhoea by a third, while adopting good hygiene practices can reduce these diseases by another third. The health of women and girls is especially affected.
The environment also suffers as inadequate services for the poor, especially in fast growing urban settings, contribute to the contamination of rivers and the environment. Sewage is often disposed of without treatment, even when water supply and sewerage systems are available, partly because insufficient attention is paid to education and training. Improved drainage, sewerage and solid waste services are essential to improving the quality of life and to reduce environmental impact, but to be effective services must engage with communities.
Of the 2.4 billion people who live without access to safe sanitation, more than three quarters (1.9 billion) live in Asia and in many areas open defecation is still common practice. In Latin America and the Caribbean (LA&C), sanitation coverage was estimated at 78% in the year 2000, but there are notable disparities between urban and rural areas and a very low percentage of sewage is treated before it is discharged into rivers and other water bodies. In Africa, even where coverage appears to be good, the suitability and quality of latrines may be deficient, creating hygiene problems rather than sanitary solutions.
EcoSan is one recommended option to avoid using drinking quality water for flushing, to protect the environment, save water and recover nutrients, thus preventing loss of economic value. However, a single latrine model does not suit everyone and cultural inhibitions need to be addressed.
Household-Centred Environmental Sanitation Approaches make the household the
focal point of environmental sanitation planning, focused on the social, economic and technological aspects of conservation, recycling and reuse of resources. WASPA (Wastewater Agriculture and Sanitation for Poverty Alleviation) promotes the use of waste water for urban agriculture under the right sanitary conditions.