6 in 10 Africans remain without access to proper toilet: poor sanitation threatens public health

GENEVA, March 2008 – Sixty-two percent of Africans do not have access to an improved sanitation facility -- a proper toilet -- which separates human waste from human contact, according to the WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation. A global report will be released later this year, however, preliminary data on the situation in Africa was released today as part of World Water Day 2008. The Day, built around the theme that “Sanitation Matters" seeks to draw attention to the plight of some 2.6 billion people around the world who live without access to even a toilet at home and thus are vulnerable to a range of health risks.

Using proper toilets and hand-washing - preferably with soap - prevents the transfer of bacteria, viruses and parasites found in human excreta which otherwise contaminate water resources, soil and food. This contamination is a major cause of diarrhoea, the second biggest killer of children in developing countries, and leads to other major diseases such as cholera, schistosomiasis, and trachoma.

“Sanitation is a cornerstone of public health” said Dr Margaret Chan, WHO’s Director-General. “Improved sanitation contributes enormously to human health and wellbeing. We know that simple, achievable interventions reduce the risk of contracting diarrhoeal disease by a third. Sanitation matters because a toilet at home spares a family from illness, health care expenses, and time lost from work and school.”

“Nearly forty per cent of the world’s population lacks access to toilets, and the dignity and safety that they provide" said Ann M. Veneman, UNICEF Executive Director. “The absence of adequate sanitation has a serious impact on health and social development, especially for children. Investments in improving sanitation will accelerate progress towards the Millennium Development Goals and save lives.”

Improving access to sanitation is a critical step towards reducing the impact of these diseases. It also helps create physical environments that enhance safety, dignity and self-esteem. Safety issues are particularly important for women and children, who otherwise risk sexual harassment and assault when defecating at night and in secluded areas.

Also, improving sanitation facilities and promoting hygiene in schools benefits both learning and the health of children. Child-friendly schools that offer private and separate toilets for boys and girls, as well as facilities for hand-washing with soap, are better equipped to attract and retain students, especially girls. Where such facilities are not available, girls are often withdrawn from school when they reach puberty.

In health-care facilities, safe disposal of human waste of patients, staff and visitors is an essential environmental health measure. This intervention can contribute to the reduction of the transmission of health-care associated infections which affect 5 to 30 percent of patients.

Although WHO and UNICEF estimate that 1.2 billion people worldwide gained access to improved sanitation between 1990 and 2004, an estimated 2.6 billion people - including 980 million children – had no toilets at home. If current trends continue, there will still be 2.4 billion people without basic sanitation in 2015, and the children among them will continue to pay the price in lost lives, missed schooling, in disease, malnutrition and poverty.

“The focus on sanitation is fundamental to human beings,” says Pasquale Steduto, UN-Water chairman. “MDG target on sanitation is seriously lagging behind schedule. The entire UN System has a shared responsibility in mobilizing concrete actions toward its achievement; investments must increase immediately.” UN-Water is the coordinating mechanism of the UN agencies, programmes and funds that play a significant role in tackling global water and sanitation concerns.