Funding for safe, shared toilets in fast-growing developing-world cities is at risk of neglect from donors, policymakers and planners, a new journal article authored by sanitation specialists, senior economists and leading academics has warned.

Authors from the World Bank, WaterAid and Water & Sanitation for the Urban Poor have joined leading academics from the University of Leeds and the University of Colorado – Boulder in calling for shared toilets as an essential stepping-stone towards universal sanitation.

The UN Sustainable Development Goal 6 aspires to providing access to safely-managed sanitation for all by 2030. Safely-managed, the new ‘gold standard’ of sanitation, means not only a toilet in every household, but also ensuring human waste is properly treated so that it poses no risk to human health or the environment.

But a senior group of economists and policy analysts have warned of the risk that governments will interpret this as the only acceptable standard. The result, they warn, could be a focus on improving services to those who already have basic access to sanitation, rather than making it a priority to provide some sort of access to poor and vulnerable populations who have none.

An editorial carried in the Journal of Water, Sanitation and Hygiene for Development calls on governments, policymakers and donors to recognise the role that high-quality shared toilets can play in addressing the urgent needs of those living in dense slums, where a toilet in every household is not often an option, and warn against dwindling investment, planning and delivery of this essential step toward better health and dignity for the urban poor.

WaterAid senior policy analyst Andrés Hueso said:
“We know that in this globalised world, one slum’s waste problem quickly becomes a much wider issue, as demonstrated during the crises of Ebola and Zika, both of which were exacerbated due to poor sanitation.

“Everyone everywhere deserves a safe, private toilet. But we know that for densely populated slums, where large families may live in single rooms and private toilets are simply not yet an option, well-designed and well-managed shared sanitation provides an essential stepping stone to dignity and better health.

“Decades ago, before household toilets became the norm, tenement outhouses and shared privies in London and New York played an important – if imperfect — role in helping to prevent disease from spreading. The governments, donors and planners in today’s ambitious and fast-growing cities in Africa and South Asia should acknowledge that well-managed shared toilets can be part of a path to further progress.”

Senior World Bank economist Sophie Trémolet said:
“Economic returns and public health gains from interim solutions for those who are currently without sanitation can be far greater than delivering gold-standard service to a few, most of whom already have another, if less than perfect, option.

“Despite the fact that shared toilets are not currently counted as safely managed toilets in the SDG framework, we need to maintain incentives for governments, entrepreneurs and communities to invent, invest in and run appropriate shared toilet solutions as a stepping stone towards other solutions. We also need to work on developing practical ways to distinguish well-managed shared toilets from those which simply do not pass the mark. Some isolated initiatives have sprung up, such as EcoTact or Freshlife toilets in Kenya run by aspiring young entrepreneurs. We need those to become mainstream and inspire other actors to turn uninspiring assets into symbols of modernity.”

WaterAid Nigeria’s Country Director, Dr Michael Ojo said:
“Nigeria has a huge population and extremely rapid rural–urban migration; however, economic development and urban planning have not kept pace with the sheer volumes of people arriving – and being born – every day in its towns and cities. The high population density of urban areas means that diseases like cholera or Ebola can spread further and faster without sanitation and hygiene practices to block their path and an outbreak found in a slum can quickly become a city-wide, national or international epidemic.

“Everyone – no matter where they live – deserves affordable access to water, sanitation and hygiene. Yet at present rates of progress only one-third of people in Sub-Saharan Africa will have a safe, private toilet by 2030. The message to consider all options of getting sanitation to everyone, including shared latrines, couldn’t be more apt particularly for a country like Nigeria.

“WaterAid has been implementing its own evolving version of community-led total sanitation (CLTS) in Nigeria since 2006 and has been contributing even more to the sanitation efforts in Nigeria with the Sustainable Total Sanitation (STS) project which seeks to progressively develop a more effective and sustainable total sanitation implementation model at a significant scale. WaterAid Nigeria launched the Water Easy Toilet (WET) – a dual model improved toilet – as part of its sanitation marketing (SanMark) approach and as a way of providing entrepreneurial opportunities and at the same time encouraging households towards uptake of latrines that meet their aspirations as part of efforts to end open defecation.

“Our analysis shows just how many nations in the world are failing to give sanitation the political prioritisation and financing required – with Nigeria featuring strongly at the top of that list. Government leaders need to increase efforts to meet their commitments to the Sustainable Development Goals, including achieving targets to reach everyone everywhere with adequate sanitation and hygiene as well as water by 2030.”

Poor sanitation increases the risk of illness, particularly in slums and informal settlements which are common at the edges of many fast-growing cities in the developing world. Globally, an estimated 289,000 children under five die each year of diarrhoeal illnesses directly linked to dirty water, poor sanitation and poor hygiene. Good sanitation is the bedrock of public health. Where poor sanitation exists, improvements in health and nutrition aren’t sustainable and children are repeatedly exposed to and at considerable risk of harm throughout their childhood.

The 17 United Nations Sustainable Development Goals agreed by world leaders in September 2015, aim to end extreme poverty and create a fairer, healthier, more sustainable world by 2030. Among them is Goal 6 to ensure access to water and decent toilets for all.