Tracking progress on sanitation should be easy. And yet, when we come to assess how far the world has come in delivering this most basic right, it pays to look beyond the headline statistics and really think about what we are measuring. Since today is World Toilet Day, it is a good moment to look at how well the world has done on its promise to halve the population living without access to basic sanitation and at how post-2015 targets could galvanise progress in this critical area.
Today, some 2.5 billion people do not have access to any kind of improved sanitation, with implications for health, education, dignity and safety. The effects include not only diarrhoea – which kills thousands of children each day – but also worms, schistosomiasis and liver fluke, among many other scourges that leave undermine people’s strength and capabilities. Girls’ school attendance may be compromised by lack of access to private toilets, while practices like open defecation carry pernicious environmental impacts, notably groundwater contamination. The World Health Organization (WHO) recently estimated that $260 billion each year is lost globally owing to inadequate water supply and sanitation.
Not only are too many people living without proper sanitation, but the expansion in access to improved sanitation has been slow. Twenty years ago, just two in ten households in low-income countries had improved sanitation. Today, that figure stands at just under four in ten households. Although some 1.8 billion people have gained access to sanitation over these two decades, the absolute number of people who lack sanitation today is not much less than it was in 1990. And it is well known that the progress towards the sanitation target has lagged behind progress on many other MDG targets. If we go on at this rate, the 2015 target will not be reached till 2026.
When we think about what should follow the MDGs, post-2015, there is a logic in setting aspirational goals and monitoring their achievement across all people in the world. But it has been argued that such goals should be accompanied by shorter-term country specific ‘stepping-stones’. It seems that we require targets to serve a dual role: to establish and monitor progress toward global achievements, regardless of where they take place, and to give all countries an incentive to make progress, regardless of their relative size and starting point. Despite all the talk of country-level targets and incentives, there will always be a tendency to ‘aggregate up’ to the global level.
At ODI we are thinking about how to frame targets that will both monitor global progress and spur national achievements. Our new infographic on sanitation targets and post-2015 contributes to this end. Conventional ways of monitoring the MDGs at the global level have looked at outcomes among all people – for sanitation, this has meant comparing the share of people who now lack improved sanitation with that of 20 years ago. Here, the average global reduction in people without sanitation is about 34%, with just two countries – China and India – accounting for half of this global achievement. So through this lens, we are led to focus on the achievements of countries where most people live.
Of course it is important to know how many people have benefited from progress and to give all people equal ‘weight’ regardless of where they are. At the same time, if we look at achievements solely through this lens, we may overlook the need for incentives to ensure that progress is distributed broadly across all countries. For example, the remarkable progress of countries like Samoa and Djibouti is hidden. When we look instead at average change – to give countries, rather than people, an equal weight – the average global reduction is just 26% and we need to take into account progress in 22 countries to reach half of global achievement. This is not to say that each country should have the same target, but rather that progress in all countries should also count when setting global incentives.
Both calculations are important pieces of the puzzle. We can only take a more rounded view by using multiple lenses to look at progress. And we need this rounded view to measure not only the progress that has occurred but also to create the best possible incentives to spur greater progress still. The message of this year’s World Toilet Day is clear: sanitation cannot wait. We need to speed up, and to do that effectively, we need to get the targets, and the measurements, right.