To Achieve Sanitation for All, Start with Better Toilet Markets

By John Sauer, Senior Technical Advisor for WASH, PSI

We have just under 10 years until the 2030 deadline for the UN Sustainable Development Goals (SDG). And unfortunately, sanitation is one of the worst-performing sectors.

Currently, only about 30% of Sub-Saharan Africa’s (SSA) population has basic or safely managed sanitation coverage. There are some stark statistics:

  • 20% of people in SSA still defecate in the open,
  • 31% have unimproved sanitation such as a toilet with an open pit
  • 18% have limited access to basic sanitation, such as sharing a latrine with other families or using a public toilet

Increases in sanitation coverage are not keeping pace with population growth in many countries; the number of people with unimproved sanitation continues to increase despite efforts to decrease it. From 2015 to 2017, there was an increase of 20 million people in SSA who did not have access to improved sanitation—from 300 million people to 320 million. In 2019, the WHO reported that there were still over 204 million open defecators and 184 million people with limited sanitation. The World Bank reports that at the current rate of progress, it will take more than one hundred years to reach universal coverage of basic sanitation.

So, what’s wrong and why are we achieving lackluster progress for basic sanitation in rural SSA?

One reason for this abysmal state of affairs is that current efforts toward increasing basic sanitation access are not designed for scale from the outset. Current approaches, and the activity-based grants that fund them, have been unable to harness economies of scale or sustained financing – and have therefore fizzled out after grant funding ends. The approaches that have been tested with the current funding paradigm include widespread subsidy, community-led total sanitation (CLTS) and market-based sanitation.

Primarily funded as one-off, ad hoc grants within limited geographic areas and focused primarily on completing toilet installations on tight timelines, those programs have been unable to leverage private, financial and government resources, including talent and money, so that grant funding could be used catalytically, rather than for short-lived and dispersed projects. Market-based approaches have shown great potential to reach hundreds of millions of people, but there are several consistent challenges that halt significant progress towards scale. These include:

  1. The range of toilet products currently available are expensive, complicated to install, expensive to transport, and can’t be standardized for use across countries and regions. Prevailing technology is centered on components like concrete slabs – big and heavy, difficult and expensive to transport, and produced in small quantities. Many are disliked by consumers.
  2. The volumes and margins that business can make in sanitation are slim, because the existing products are too difficult to sell at scale. Decentralized production and assets have resulted in expensive, low-margin production. As a result, only small-scale, low capacity enterprises with limited geographic reach – that don’t lend themselves to economies of scale – show interest.
  3. Bigger actors – like importers and national distributers – perceive sanitation as high risk for low reward, so they don’t get involved. This means there is no creation of a sustainable service sector to serve growing and shifting populations.
  4. There is an over-reliance on the role of local governments in rural areas and government entities with a mandate in sustaining sanitation interventions beyond the life of a project. Government bodies are understaffed and under-resourced, with many competing priorities, yet projects are often designed with government action as the primary strategy for sustainability following the end of the project. This is rarely realized. Plans for rural government’s roles are usually not based on an accurate reading of the local political economy or budget realities and existing resources are often used inefficiently.
  5. There are neither enough resources nor enough innovations directed towards activities that engage larger private sector players, which are the key to scaling effective sanitation solutions beyond the life of a grant. These activities and innovations include research and development for better products, gathering and sharing of market intelligence, market actor facilitation, addressing policy issues that inhibit or add costs to working in sanitation, and deploying funding instruments that are fit for scaling and that incentivize new actors and investors into the sector.

Business-as-usual will not deliver on the promise of SDG 6, which tasks us with ensuring the availability of and sustainable management of water and sanitation for all by 2030. The sanitation sector must refocus and reprioritize to put sub-Saharan Africa on a pathway to achieving the second sub-goal of SDG 6, to improve “access to adequate and equitable sanitation,” which will ultimately improve the well-being and social/economic development of at least 500 million people who currently live without basic and safely managed sanitation.

The time to change course is now.

NOTE: Social Finance, Oxfam and PSI have been putting thought into how to solve the Sub-Saharan Africa (SSA) rural sanitation challenge and all contributed to this blog.

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