Poor sanitation has devastating—often overwhelming—consequences. As sanitation advocate Rose George writes in “Why there’s a Sanitation Crisis and What We Can Do About It,” the health, social, and economic toll is hard to overestimate. Research from the World Bank’s Water and Sanitation Program’s (WSP’s) ongoing Economic Impacts of Sanitation Initiative shows that inadequate sanitation costs developing economies from 1% to 7% equivalent of their GDP and that investments in increasing access to improved sanitation and hygiene are needed. These findings are based on research conducted in Southeast Asia and India (similar studies are in progress for Bangladesh, Pakistan, and countries in Africa, Latin America, and the Carribean).
A key to improving sanitation is learning how to work at scale and how to strengthen the sustainability of improved sanitation. WSP has been implementing large-scale learning projects to investigate both questions. One place to look for insight is in Bangladesh, where access to basic sanitation in rural areas has grown significantly since 2003, when the Government of Bangladesh formulated a national sanitation policy and strategy that has been implemented by local governments.