1.2 Improve access to integrated sanitation services for all

 
Sanitation is a neglected aspect of development in most countries where public spending is limited, and where conflicting and competing priorities crowd the political agenda. As a result, billions of people in low and middle income countries still lack access to improved sanitation and sustainable service delivery. Poor sanitation and hygiene (together with poor water supplies) exact an extremely high toll on public health in developing countries, especially diarrhoeal diseases (which are water-, excreta-and hygiene- related) which cause the death of upwards of 1.5 million children under five, and also the death of over 1 million over five each year. In some countries of sub-Saharan Africa and South Asia, other hygiene and sanitation related diseases such as trachoma and schistosomiasis contribute significantly to the preventable disease burden. While WHO has estimated that 38% of child deaths can be attributed to the hygiene-sanitation-water risk complex it notes also that addressing this risk factor complex has the potential to reduce child mortality by 32%.

One of the fundamental and persistent challenges in the sanitation sector is to identify ways that existing proven approaches (management, technologies, social marketing and social mobilization, financial mechanisms for example) can be taken to an effective scale of operation. Indeed, sanitation needs to be addressed with the same level of importance that is being given to water supply, to ensure that the progress that is being achieved is balanced throughout the whole urban or peri-urban water cycle. That requires careful planning, including what needs to be done and how (targets and investment), as well as how it will be maintained and with what resources (organization, management and a defined proportion of cost recovery). In other words, progress in sanitation will require a very strong link between investment, capacity building and political commitment (national and regional).

The planning approach should consider, among other possibilities, transforming smaller-scale, typically ‘projectised’ interventions into larger scale or systematic programming with the prospect of reaching progressively larger populations at a regional or national level. At the same time, those approaches need to address scale whilst retaining integrity of approach in terms of equity, social exclusion and gender. PFA 1.2 seeks to address these imperatives outlined above, identifying and showcasing practical and tangible solutions that have addressed these constraints.

The structure of PFA 1.2 reflects the complexity of the challenges that face those working on sanitation. Therefore, by necessity, 1.2 will range across hardware and software issues, a wide range of sanitation options (a specific interest and point of differentiating from previous World Water Forum) and associated preconditions for improving access (including interalia, governance, monitoring, planning and capacity issues). Targets are organized around three themes, as follows:

• Basic sanitation: covering the more conventional focus of development discussions on this theme, namely, lower cost sanitation facilities targeted at the poorest and most marginalized in society
• Improving the sanitation chain: focusing on a broader understanding of sanitation, extending towards semi-centralised smart systems of wastewater treatment and management
• Improving integrated sanitation management, governance and policy processes: in this theme, targets focus specifically on cross cutting issues including: planning at national and local level and involvement of the different stakeholders, monitoring, working with operators, the ‘rights’ discussion and local action planning.

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* This column indicates when thematic and regional targets are matching and have a good potential for mutual contribution and partnership.

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