Population Policies: Advancing Access to Sanitation

November 6, 2014 OPINION/NEWS

Canal Wash03-2



Anant Mishra

According to the World Health Organization (WHO), sanitation is defined as: “the provision of facilities and services for the safe disposal of human urine and faeces.” Furthermore, unclean drinking water and poor sanitation are the second leading killer of children and account for deadly diseases such as cholera, typhoid, and Hepatitis A.

Globally, the lack of access to adequate sanitation facilities results in a high number of preventable hygiene related illnesses and deaths.  As of 2013, an estimated 2.5 billion people do not have access to sanitation facilities and more than 1 billion are forced to practice open defecation. The United Nations (UN) has previously attempted to address sanitation issues in the Millennium Development Goal 7: “Ensuring Environmental Sustainability” with Target 10: “Halve, by 2015, the proportion of people without sustainable access to safe drinking water and basic sanitation.”Over the past decade, the General Assembly (GA) has acted in a variety of methods to make the achievement of MDG 7, Target 10 a reality.  GA has directed policy efforts and conducted studies of various frameworks that pertain to issues regarding sanitation. Sanitation is multifaceted and dimensional as it involves the intersections and overlapping areas such as industry/development, the environment, and health within populations of Member States.

Access to basic sanitation and the proper and safe disposal of human waste can be achieved through several methods of disposal, including but not limited to pit latrines, composting toilets, and conventional toilets.  The World Health Organization has identified the most cost-friendly option when it comes to sanitation facilities is the pit latrine which, “ consists of a square, rectangular, or circular pit dug into the ground, covered by a hygienic cover slab or floor, with a hole through which excreta falls into the pit.” The advantage of the pit latrine method is that there does not have to be consistent access to a source of water.  Composting toilets “use natural processes to turn human excreta into a valuable soil amendment and typically use little to no water in commercial scale applications.” One environmental benefit of this type of waste disposal includes the ability to enable excreta to be used as compost in the future.  Unlike conventional toilets, composting toilets lead to less strain on sewer systems and septic tanks by reusing the end product.  The main disadvantage with this type of sanitation facility is the requirement of frequent maintenance in order to ensure that waste materials are properly decomposing so as not to be a hazard when reused.  The Conventional toilet is the most popular, and the most expensive, type of sanitation facility.  Conventional toilets, or water-flush and pour flush toilets, “depend on water to flush urine and faecal material from a toilet bowl either directly into a pit or more normally through a pipe to a pit, septic tank or sewer.”Conventional toilets are so widely used as they are the most hygienic and most effective in the removal of human waste from the living area. However, if not properly connected to a septic tank or when connected to an inadequate sewer system they can cause more damage than the less popular forms of sanitation facilities.  Conventional toilets also use a large amount of water and produce a large amount of wastewater that must be properly treated to prevent public health disasters, compounding the cost of this sanitation channel.

The connected relationship between access to sanitation and the overall well-being of populations is complex as it involves often unforeseen consequences due to changes in the population which lead to issues related to industrial growth, migration, war and conflict, and the mitigating effects of climate change.  The interactions of all the above variables can be compounding and can be devastating.  Thus, it is absolutely critical that Member States, regional bodies, and the global system as a whole, carefully monitor population policies on key issues such as sanitation. Conducting population studies ensures the stability and longevity of Member States’ populations.  Various UN organs and bodies carry this out by evaluating policies, making changes to existing ones, and creating new policies. This ongoing process and mechanism is necessary as populations and development are continuous and dynamic.

The GA has made access to sanitation a top priority for other bodies to follow in pursuit because of its link to implementing MDG 7 Target 10 and because of all the critical issues that are involved in the topic. The General Assembly’s strategic approach in constructing population policies must be comprehensive enough to serve as a solid foundation for all Member States to adhere to and serve as a base guide for other resolutions and plans by other committees and organs.  Population policies discussed by the General Assembly must also allow for derivatives in order to address specific area issues, especially regarding Least Developing Countries (LDC) and Developing Countries (DC) and subpopulation groups such as women and children.  Thus, these population policies on sanitation must assess the current conditions and areas/subfields that are the most critical, evaluate past and current project, initiatives, and policies, and encompass all stakeholders (individuals, governments, NGOs, UN Agencies, private sector, etc).


Background on Sanitation and Population Policies  

Access to sanitation has historically been discussed in conjunction to the discussion of worldwide access to clean drinking water.  This of course stems from the inherent link between the two components.  The dependent relationship is apparent in the UN’s “Water for Life” outline of basic sanitation, which is defined as “facilities that ensure hygienic separation of human excreta from human contact including: flush or pour-flush toilet/latrine to a piped sewer system, a septic tank or a pit latrine; ventilated improved pit latrine; pit latrine with slab; or a composting toilet.”

Aside from physical and health factors, access to sanitation is also a basic human right as it encompasses the right to water, as outlined in the collaborative document of “The Right to Water” assembled by the UN Office of the High Commissioner for Human Rights, World Health Organization, and UN Habitat. Accordingly, GA Resolution 64/292 affirmed the notion that sanitation is essential to the realization of human rights.  This resolution is the framework for all stakeholders to provide resources of various areas to help all Member States, particularly DCs and LDCs, to provide clean and accessible drinking water and sanitation for all populations. Other committees have followed suit with similar resolutions including General Comment 15 by the Committee on Economic, Cultural, and Social Rights in 2002. Additionally, water and sanitation has been elevated in importance and has been incorporated into almost every functioning UN body, organ, and committee such as the UN Development Programme, UNICEF, and the UN Environment Programme.  This topic continues to be discussed in sessions and summit meetings, and addressed in policies, publications, and reports by these various bodies and committees. The UN has taken on initiatives such as World Toilet Day and the declaration of 2008 as the International Year of Sanitation to further promote broader and safer access to sanitation.

Population policies originated from the Population Division in the UN Department of Economic and Social Affairs. The Population Division was established in 1946 and has played a critical role in connecting stakeholders and continuing dialogue on issues surrounding population and development by producing documents on demographic estimates and projections and monitoring progress of MDGs and other UN frameworks. The reports and studies from the Population Division include areas such as environment, fertility, literacy, and migration.  These studies have served to assist and become the framework for other UN bodies to construct their own policies and documents. One of the key sections of the Population Division is the Population Policy Section.  The main operative of this division is to monitor policy issues such as fertility and family planning, ageing, maternal health, HIV/AIDS, industrialization, and migration.  The Population Policy Section plays a central role in ensuring the implementation of the Programme of Action of the 1994 International Conference on Population and Development, which focused on implementing internationally agreed upon development goals related to population, including the Millennium Development Goals.

The Policy Section is also responsible for implementing the United Nations Inquiry among Governments on Population and Development, which was set-up in 1963 by the Commission on Population and Development. Between 1963 and 2013, the Secretary General has conducted ten rounds of the Inquiry.  The Policy Section has built and maintains a comprehensive, global Population Policies Database, going back to the mid-1970s.  These conducted inquiries have been an asset in monitoring national population policies and issues affecting and caused by exponential population growth. The inquiries and other reports are stored and maintained in the World Population Policies Database, which provides all UN bodies and organs, Member, Observer, and non-member States comprehensive and up-to-date relevant population information of various areas.  Updates are made biennially with a thorough and detailed review of national plans and initiatives, program reports from various sources such as NGOs, and legislative documents for each country.


Human Impact of Sanitation  

Access to Sanitation encompasses many tenets addressed and outlined in various human rights documents.  Specifically, the Universal Declaration on Human Rights (UDHR), ratified in 1948 has under Article 25, the declaration of the right to an adequate standard of living to protect the health and overall well-being. The right to water and sanitation is the nucleus of one’s overall health as poor hygiene and lack of clean drinking water can often times lead to death, especially in DCs and LDCs.  As urban growth increases as such a rapid rate so does the scarcity of essential rights and services such as water, healthcare, and sanitation.  Various UN bodies have made efforts to protect the rights for standard living of these marginalized groups.  This is evidenced in summits such as the 1979 Convention on the Elimination of All Forms of Discrimination against Women, which produced frameworks that called on all Member States to protect the rights of rural women by ensuring that these women had adequate living conditions. What is important to understand is that these important and forward moving declarations withstanding, lack of access to sanitation and the health effects to which it leads is still a serious issue for many parts of the world.  It is imperative that programmes and their implementation are reviewed and optimized for more effective and farther reaching plans to deliver this right to all citizens of the world.

Besides overall population concerns regarding the right to sanitation, the UN has paid particular attention to addressing marginalized groups such as women, children, and the disable’s access to sanitation.  These subgroups in populations are often ignored, bear the greatest burdens, and suffer dire consequences.  Women, children, and minorities are often treated as second class citizens and access to sanitation is very often limited to the working males in a home.  Aside from widespread disease and fatality, many women and children are victims to a lack of sanitation services and have no outlet by which to escape these circumstances.  In places such as sub-Saharan Africa, more than a quarter of the population spends more than 30 minutes per round trip to collect water. Women and children in many rural areas in LDCs are tasked with gathering water for drinking and sanitation that consists of making arduous treks. It is noted that during these long trips, women and children sometimes become victims to violence and rape, especially in areas of conflict.  Children are also often alienated from social situations and access to education due to a lack of sanitation facilities causing them to ‘smell’ and be teased as anecdotal evidence has demonstrated.  Other reports show many parents voluntarily pull girls out of school after puberty because of the lack of access to separate and adequate sanitation facilities conflicting with cultural norms.   There is a positive correlation in many LDCs between access to sanitation services and school attendance, especially by girls. This fact further perpetuates issues of lack of education and human capital leading to a continuation of extreme poverty in such areas.  Without proper infrastructure and innovation, the implementation and achievement of MDG 7 and equal access of the right to sanitation cannot be achieved.


Sanitation in Sub Saharan Africa 

The continent of Africa is one of 2 major regions that are in danger of not achieving the MDG goals pertaining to sanitation by 2015.  Many of the most pressing conditions and vulnerabilities stem from the region of Sub-Saharan Africa, where less than 25 percent of the population uses and has access to sanitation facilities. This has resulted in the widespread practice of open defecation, which is now listed as the primary cause of faecal oral transmission of disease.  Current estimates indicate, 115 people in Africa die every hour from open defecation and other diseases that stem from poor sanitation, hygiene, and contaminated water.

The driving forces behind this ongoing dilemma related to sanitation are primarily linked to the continuous population growth and rural-urban migration. As the population continues to grow, so does the demand for water. There is a reality of a severe lack of water resources and adequate sanitation systems that cannot meet the demands of the growth in population.  The results of this scenario have caused Sub-Saharan Africa to have the highest prevalence of urban slums in the world and this number is expected to double around 400 million by 2020 if conditions do not change or improve.

To put it simply, Sub-Saharan Africa suffers from the tenets behind economic water scarcity, which means that the institutional, financial and human capacities by the Member States in the region are lacking. Additionally, regional sanitation issues are compounded by competition among stakeholders for public funding, as well as existing heavy public debt burdens that is prevalent in almost all Member States within the region. This is demonstrated by the severe cutting and insufficient domestic funding for Water Sanitation and Hygiene (WASH) commitments, in which over 80 percent of the countries in Sub-Saharan Africa are not meeting the requirements to reach their targets for sanitation and drinking-water.  These countries and many others face challenges that exacerbate sanitation issues including a to lack of coordination of roles and responsibilities, inadequate translation of needs/demands to laws and policies, and ongoing extreme climate issues, especially frequent floods and droughts.

Many UN organs and committees have taken on initiatives to combat the ongoing Sub-Saharan sanitation situation.  These programs encompass an array of approaches and areas that serve to upgrade existing sanitation facilities, build new sanitation facilities, break the stigma of using sanitation facilities, and educate the population on better sanitation practices that will help reduce the rate of hygiene related deaths and illnesses. Many of these programs are in partnerships and conjunction with local and national of regional Member States and include: UN-Habitat- Human values in Water, Sanitation, and Hygiene Education Programme (HVWSHE); Water and Sanitation Trust Fund (WSTF); Water for African Cities; and the Water and Sanitation Program (WSP): Economic Sanitation-Africa. Additionally, many Member states of the Sub-Saharan region have committed to (re)establishing transparent WASH services and policies, and are making strides towards confirming that rights to water and sanitation are a fundamental human right and should be incorporated into laws and legal code.

The example created by the situation described in Sub-Saharan Africa in an important lesson for the rest of the world.  The consequences caused by lack of access to proper sanitation can and will occur outside of this region and even in DCs and developed countries if ignored.  As the global population increases exponentially and urban areas become centres of immigration and emigration Member States must be prepared to provide basic rights to citizens including access to sanitation.  It is estimated that by 2030, 2 billion people will be living in areas within cities that will be classified as “the slums? with 60 percent of this subset of the population predicted to live in Asian cities. It is easy for cities to become overwhelmed with the poor population in urban areas which can lead to poor planning of infrastructure and services that actually hinder the improvement of the local economy.  Local and National Governments must focus on effective sustainable urban development and infrastructure as well as creating strategic partnerships in order to become an engine of growth and provide essential services such as sanitation services.



In 2013, UN Deputy Secretary-General Jan Eliasson in a keynote address stated: “we must break taboos. As was the case for the word ‘toilets’ a few years ago, it is time to incorporate ‘open defecation’ in the political language and in the diplomatic discourse.” Indeed, we can no longer be hindered by taboos and not adequately address the impact access to sanitation has on populations.  Education, infant mortality, economic growth, and environmental sustainability are directly impacted by sanitation practices, especially in LDC and DCs.  The dynamic growth in populations and ongoing migration in developed and developing Member States only further accentuates population policies in regards to access to sanitation need to be evaluated and modified to correlate to the changes.  There have been initiatives proposed in recent summits such as the Rio +20 Summit in 2012 that have tried to address sanitation issues.  However, new challenges have come to the surface and thus, new population policies need to be generated to address how to advance existing access to sanitation as well as find more innovative methods to create new access.  Furthermore, particular attention must be given to marginalized subpopulations such as women and children, especially within Developing and Less Developed Member States.  These Member States are the most in need of beneficial practices to access to sanitation for the sake of their own economic and political stability as well as future growth.

Even with all the successes that have come of GA’s work there have been set-backs such as cholera outbreaks and water contamination from unsound environmental industrial practices.  While strides are being made towards achieving the MDG 7 Target 10, there are still areas and Member States that remain unaffected or marginally improved by these advancements.  The complex problems that arise from the relationship between humans and development are dynamic and ongoing.  The development and implementation of new technologies and policies without the awareness of consequences or setting up safeguards risks floundering unless monitored and evaluated by UN bodies such as GA .  These problems and issues surrounding sanitation are very serious and in some cases, have already left populations in destruction. Consequently, the continued practice of evaluating and conducting population policies must remain intact, ensuring that lessons can be learn from the past, addressing those of the present, and set up a sustainable foundation for future generations.





Anant Mishra

Anant Mishra is a former youth representative for United Nations. Almost 4 years of experience, he has served in number of committees including United Nations Conference for Trade and Development and United Nations General Assembly primarily focusing on international trade, education, finance, economics. food crisis And disputes. He is available on [email protected]



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