As the world marks World Toilet Day today, with just three years to 2015, there is a need to consider why the MDG targets on access to sanitation have not been met.
In May 2011, the World Health Organization (WHO) and the United Nations Children’s Fund  (UNICEF) convened a consultation in Berlin, co-hosted by the German Government, to start a process of formulating proposals for the post-2015 goals, targets and corresponding indicators for water, sanitation and hygiene. The consultation reviewed the current global drinking-water and sanitation monitoring landscape, identified the strengths and weaknesses of the current MDG target and indicators, discussed the relevance of the principles underlying the human right to water and sanitation for consideration in future goals and targets, and reached agreement on a roadmap towards the formulation of a menu of options. Technical working groups were established to deal with drinking-water, sanitation, hygiene and a fourth area, cutting across these three, on equity and non-discrimination. All working groups were asked to:
1. Focus on a “politically bankable” and relevant goal;
2. Review existing relevant indicators and monitoring mechanisms for their potential to be used for global monitoring post-2015;
3. Use the principles underlying the Human Right to Safe Water and Sanitation; and
4. Build on existing indicators and monitoring mechanisms to ensure continuity in the global monitoring.
The World Bank’s Water and Sanitation Program (WSP) chaired the sanitation technical working group. The working group includes practitioners, academics, human rights and monitoring specialists and representatives of civil society organizations. Drawing on background papers commissioned by the working group and through a series of face-to-face and virtual meetings, the sanitation technical working group prepared a proposal to be presented in The Hague for the second Post-2015 Consultation scheduled for early December 2012.
A major challenge for this working group was to come up with new goals and targets that were aspirational and realistic – given that the relatively modest MDG sanitation target (to cut in half the number of people without access to improved sanitation) is one of the most lagging MDGs and is not likely to be met by 2015 at the global level and not met in the majority of countries in Sub-Saharan Africa, South Asia and East Asia.
Globally, there are still 2.5 billion people (almost 40% of the world) without access to improved sanitation and, of them; 1.1 billion are defecating in the open. In too many countries, access to improved sanitation – especially for the poor – is abysmally low. For example, in Niger, only 4% of the rural population has access to improved sanitation and in India, almost 700 million people are still defecating in the open. The proposed new goal for Post-2015 Sanitation is much more ambitious in that it calls for “Universal use of sustainable sanitation services that protect public health and dignity”. Thus, the working group’s proposed targets are based on the objectives of:
• Progressive realization through increasing the numbers of people using services
• Progressive realization through reducing the equality gap
• Progressive realization through increases in service levels
• Driving progress in schools and health centers as well as households
• Achievement of universal coverage for as many parameters as possible within the 2015-2040 timeframe
• Sustained coverage over the long term
Based on the above, the proposed draft sanitation and related hygiene targets are:
Target 1: By 2025 no one practices open defecation, and inequalities in the practice of open defecation have been progressively reduced
Target 2: By 2030 everyone uses handwashing facilities when at home, all schools and health facilities provide all users with adequate sanitation, handwashing facilities and menstrual hygiene facilities, and inequalities in access to each of these services have been progressively reduced
Target 3: By 2040, everyone uses adequate sanitation when at home, the excreta from at least half of schools, health centers and households with adequate sanitation are safely managed, and inequalities in access to each of these services have been progressively reduced
Target 4: All sanitation and hygiene services are delivered in a progressively affordable, accountable, financially and environmentally sustainable manner
Achieving this new goal and related targets is doable – but will require a better understanding of how to deliver basic sanitation service – especially for the poor and a significantly increased focus and sustained effort by governments with support of the World Bank, WSP and others.