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Sanitation
Sanitation refers to public health conditions
related to clean drinking water and adequate
treatment and disposal of human excreta and
sewage.[1] Preventing human contact with feces
is part of sanitation, as is hand washing with
soap. Sanitation systems aim to protect human
health by providing a clean environment that
will stop the transmission of disease, especially The sanitation system: collection, transport, treatment,
disposal or reuse.
through the fecal–oral route.[2] For example,
diarrhea, a main cause of malnutrition and
stunted growth in children, can be reduced
through adequate sanitation.[3] There are many
other diseases which are easily transmitted in
communities that have low levels of sanitation,
such as ascariasis (a type of intestinal worm
infection or helminthiasis), cholera, hepatitis,
polio, schistosomiasis, and trachoma, to name
just a few.

A range of sanitation technologies and

approaches exists. Some examples are
community-led total sanitation, container-
based sanitation, ecological sanitation,
emergency sanitation, environmental
sanitation, onsite sanitation and sustainable
sanitation. A sanitation system includes the
capture, storage, transport, treatment and Access to safe drinking water and sanitation (2016)
disposal or reuse of human excreta and
wastewater.[4] Reuse activities within the
sanitation system may focus on the nutrients, water, energy or organic matter contained in excreta
and wastewater. This is referred to as the "sanitation value chain" or "sanitation economy".[5][6] The
people responsible for cleaning, maintaining, operating, or emptying a sanitation technology at any
step of the sanitation chain are called "sanitation workers".[7]:2

Several sanitation "levels" are being used to compare sanitation service levels within countries or
across countries.[8] The sanitation ladder defined by the Joint Monitoring Programme in 2016 starts
at open defecation and moves upwards using the terms "unimproved", "limited", "basic", with the
highest level being "safely managed".[8] This is particularly applicable to developing countries.

The Human Right to Water and Sanitation was recognized by the United Nations (UN) General
Assembly in 2010. Sanitation is a global development priority and the subject of Sustainable
Development Goal 6.[9] The estimate in 2017 by JMP states that 4.5 billion people currently do not
have safely managed sanitation.[9] Lack of access to sanitation has an impact not only on public health
but also on human dignity and personal safety.

Contents
Definitions
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Purposes
Economic impacts
Types (excreta management)
Basic sanitation
Container-based sanitation
Community-led total sanitation
Dry sanitation
Ecological sanitation
Emergency sanitation
Environmental sanitation
Improved and unimproved sanitation
Lack of sanitation
Onsite sanitation
Safely managed sanitation
Sustainable sanitation
Other
Types (other)
Wastewater management
Stormwater drainage
Solid waste disposal
Food safety
Hygiene promotion
Health aspects
SDG 6
Overview
Diarrhea
Environmental aspects
Indicator organisms
Climate change
Global development goals
Sustainable Development Goal Number 6
Various initiatives
Costs
History
Society and culture
See also
References
External links

Definitions
There are some variations on the use of the term "sanitation" between countries and organizations.
Sanitation is not an easy concept to understand.[11]:4 The World Health Organization defines the term
"sanitation" as follows:

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"Sanitation generally refers to the provision of

facilities and services for the safe disposal of human
urine and feces. The word 'sanitation' also refers to
the maintenance of hygienic conditions, through
services such as garbage collection and wastewater
disposal."[12]

Animated video to underline the

Sanitation includes all four of these technical and non-technical
importance of sanitation (here with a
systems: Excreta management systems, wastewater management focus on toilets) on public health in
systems (included here are wastewater treatment plants), solid developing countries
waste management systems as well as drainage systems for
rainwater, also called stormwater drainage.
However, many in the WASH sector only
include excreta management in their definition
of sanitation.

Hygiene promotion is seen by many as an

integral part of sanitation. The Water Supply
and Sanitation Collaborative Council defines
sanitation as "The collection, transport,
treatment and disposal or reuse of human
excreta, domestic wastewater and solid waste,
and associated hygiene promotion."[13]

Despite the fact that sanitation includes

wastewater treatment, the two terms are often
used side by side as "sanitation and wastewater Urban improved sanitation facilities versus rural improved
management". sanitation facilities, 2015.[10]

Another definition is in the DFID guidance

manual on water supply and sanitation programmes from 1998:[14]

"For the purposes of this manual, the word ‘sanitation’ alone is taken to mean the safe
management of human excreta. It therefore includes both the ‘hardware’ (e.g. latrines and
sewers) and the ‘software’ (regulation, hygiene promotion) needed to reduce faecal-oral
disease transmission. It encompasses too the re-use and ultimate disposal of human
excreta. The term environmental sanitation is used to cover the wider concept of
controlling all the factors in the physical environment which may have deleterious impacts
on human health and well-being. In developing countries, it normally includes drainage,
solid waste management, and vector control, in addition to the activities covered by the
definition of sanitation."

Sanitation can include personal sanitation and public hygiene. Personal sanitation work can include
handling menstrual waste, cleaning household toilets, and managing household garbage. Public
sanitation work can involve garbage collection, transfer and treatment (municipal solid waste
management), cleaning drains, streets, schools, trains, public spaces, community toilets and public
toilets, sewers, operating sewage treatment plants, etc.[11]:4 Workers who provide these services for
other people are called sanitation workers.

Purposes

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The overall purposes of sanitation are to provide a healthy living environment for everyone, to protect
the natural resources (such as surface water, groundwater, soil), and to provide safety, security and
dignity for people when they defecate or urinate.

The Human Right to Water and Sanitation was recognized by the United Nations (UN) General
Assembly in 2010.[15][16][17] It has been recognized in international law through human rights
treaties, declarations and other standards. It is derived from the human right to an adequate standard
of living.[18]

Effective sanitation systems provide barriers between excreta and humans in such a way as to break
the disease transmission cycle (for example in the case of fecal-borne diseases).[19] This aspect is
visualised with the F-diagram where all major routes of fecal-oral disease transmission begin with the
letter F: feces, fingers, flies, fields, fluids, food.[20]

One of the main challenges is to provide sustainable sanitation, especially in developing countries.
Maintaining and sustaining sanitation has challenges that are technological, institutional and social in
nature. Sanitation infrastructure has to be adapted to several specific contexts including consumers'
expectations and local resources available.

Sanitation technologies may involve centralized civil engineering structures like sewer systems,
sewage treatment, surface runoff treatment and solid waste landfills. These structures are designed to
treat wastewater and municipal solid waste. Sanitation technologies may also take the form of
relatively simple onsite sanitation systems. This can in some cases consist of a simple pit latrine or
other type of non-flush toilet for the excreta management part.

Providing sanitation to people requires attention to the entire system, not just focusing on technical
aspects such as the toilet, fecal sludge management or the wastewater treatment plant.[21] The
"sanitation chain" involves the experience of the user, excreta and wastewater collection methods,
transporting and treatment of waste, and reuse or disposal. All need to be thoroughly considered.[21]

Economic impacts

The benefits to society of managing human excreta are considerable, for public health as well as for
the environment. As a rough estimate: For every US$1 spent on sanitation, the return to society is
US$5.50.[22]:2

For developing countries, the economic costs of inadequate sanitation is a huge concern. For example,
according to a World Bank study, economic losses due to inadequate sanitation to The Indian
economy are equivalent to 6.4% of its GDP. [23] Most of these are due to premature mortality, time
lost in accessing, loss of productivity, additional costs for healthcare among others.[23] Inadequate
sanitation also leads to loss from potential tourism revenue.[23] This study also found that impacts are
disproportionately higher for the poor, women and children. Availability of toilet at home on the other
hand, positively contributes to economic well-being of women as it leads to an increase in literacy and
participation in labor force.[24]

Types (excreta management)

The term sanitation is connected with various descriptors or adjectives to signify certain types of
sanitation systems (which may deal only with human excreta management or with the entire
sanitation system, i.e. also greywater, stormwater and solid waste management) – in alphabetical
order:

Basic sanitation
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In 2017, JMP defined a new term: "basic sanitation

service". This is defined as the use of improved
sanitation facilities that are not shared with other
households. A lower level of service is now called
"limited sanitation service" which refers to use of
improved sanitation facilities that are shared
between two or more households.[9]

Container-based sanitation

Container-based sanitation (CBS) refers to a

sanitation system where human excreta is collected Percentage of population served by different types
in sealable, removable containers (or cartridges) that of sanitation systems[25]
are transported to treatment facilities.[26] Container-
based sanitation is usually provided as a service
involving provision of certain types of portable toilets,
and collection of excreta at a cost borne by the users.
With suitable development, support and functioning
partnerships, CBS can be used to provide low-income
urban populations with safe collection, transport and
treatment of excrement at a lower cost than installing
and maintaining sewers.[27] In most cases, CBS is based
on the use of urine-diverting dry toilets.

Community-led total sanitation

Community-Led Total Sanitation (CLTS) is an approach Example of sanitation infrastructure: Shower,

to achieve behavior change in mainly rural people by a double-vault urine-diverting dry toilet (UDDT)
process of "triggering", leading to spontaneous and and waterless urinal in Lima, Peru
long-term abandonment of open defecation practices.
CLTS takes an approach to rural sanitation that works
without hardware subsidies and that facilitates communities to recognize the problem of open
defecation and take collective action to clean up and become "open defecation free".

Dry sanitation

The term "dry sanitation" is not in widespread use and is not very well defined. It usually refers to a
system that uses a type of dry toilet and no sewers to transport excreta. Often when people speak of
"dry sanitation" they mean a sanitation system that uses urine-diverting dry toilet
(UDDTs).[28][29][30]

Ecological sanitation

Ecological sanitation, which is commonly abbreviated to ecosan, is an approach, rather than a

technology or a device which is characterized by a desire to "close the loop" (mainly for the nutrients
and organic matter) between sanitation and agriculture in a safe manner. Put in other words: "Ecosan
systems safely recycle excreta resources (plant nutrients and organic matter) to crop production in
such a way that the use of non-renewable resources is minimised". When properly designed and
operated, ecosan systems provide a hygienically safe, economical, and closed-loop system to convert
human excreta into nutrients to be returned to the soil, and water to be returned to the land. Ecosan
is also called resource-oriented sanitation.

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Emergency sanitation

Emergency sanitation is required in situations including natural

disasters and relief for refugees and Internally Displaced Persons
(IDPs).[31] There are three phases: Immediate, short term and
long term.[31] In the immediate phase, the focus is on managing
open defecation, and toilet technologies might include very basic
latrines, pit latrines, bucket toilets, container-based toilets,
chemical toilets. The short term phase might also involve
technologies such as urine-diverting dry toilets, septic tanks, Emergency pit lining kits by
decentralized wastewater systems. Providing handwashing Evenproducts
facilities and management of fecal sludge are also part of
emergency sanitation. The Sphere Project handbook provides
protection principles and core standards for sanitation to put in place after a disaster or conflict.

Environmental sanitation

Environmental sanitation encompasses the control of environmental factors that are connected to
disease transmission. Subsets of this category are solid waste management, water and wastewater
treatment, industrial waste treatment and noise pollution control.

Improved and unimproved sanitation

Improved sanitation and unimproved sanitation refers to the management of human feces at the
household level. This terminology is the indicator used to describe the target of the Millennium
Development Goal on sanitation, by the WHO/UNICEF Joint Monitoring Programme for Water
Supply and Sanitation.

Lack of sanitation

Lack of sanitation refers to the absence of sanitation. In practical

terms it usually means lack of toilets or lack of hygienic toilets
that anybody would want to use voluntarily. The result of lack of
sanitation is usually open defecation (and open urination but this
is of less concern) with associated serious public health issues.[33]
It is estimated that 2.4 billion people still lacked improved
sanitation facilities as of 2015.[34]

Share of population using safely

Onsite sanitation managed sanitation facilities in
2015[32]
Onsite sanitation (or on-site sanitation) is defined as "a sanitation
system in which excreta and wastewater are collected and stored
or treated on the plot where they are generated".[35]:173 The degree of treatment may be variable, from
none to advanced. Examples are pit latrines (no treatment) and septic tanks (primary treatment of
wastewater). On-site sanitation systems are often connected to fecal sludge management (FSM)
systems where the fecal sludge that is generated onsite is treated at an offsite location. Wastewater
(sewage) is only generated when piped water supply is available within the buildings or close to them.

A related term is a decentralized wastewater system which refers in particular to the wastewater part
of on-site sanitation. Similarly, an onsite sewage facility can treat the wastewater generated locally.

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Safely managed sanitation

A relatively high level of sanitation service is now called "safely managed sanitation" by the JMP
definition. This is basic sanitation service where in addition excreta are safely disposed of in situ or
transported and treated offsite.[9]

Sustainable sanitation

Sustainable sanitation considers the entire "sanitation value chain", from the experience of the user,
excreta and wastewater collection methods, transportation or conveyance of waste, treatment, and
reuse or disposal.[21] The term is widely used since about 2009. In 2007 the Sustainable Sanitation
Alliance defined five sustainability criteria to compare the sustainability of sanitation systems. In
order to be sustainable, a sanitation system has to be economically viable, socially acceptable,
technically and institutionally appropriate, and it should also protect the environment and the natural
resources.[2]

Other

Other terms used to describe certain types of sanitation include:

Community-based sanitation (often related to decentralized wastewater treatment or DEWATS)

Types (other)

Wastewater management

Wastewater management consists of collection, wastewater

treatment (be it municipal or industrial wastewater), disposal or
reuse of treated wastewater. The latter is also referred to as water
reclamation.

Sanitation systems in urban areas of developed countries usually

consist of the collection of wastewater in gravity driven sewers, its
treatment in wastewater treatment plants for reuse or disposal in
rivers, lakes or the sea. Sewage treatment plant, Australia.

In developing countries most wastewater is still discharged

untreated into the environment. Alternatives to centralized sewer systems include onsite sanitation,
decentralized wastewater systems, dry toilets connected to fecal sludge management.

Stormwater drainage

Sewers are either combined with storm drains or separated from them as sanitary sewers. Combined
sewers are usually found in the central, older parts or urban areas. Heavy rainfall and inadequate
maintenance can lead to combined sewer overflows or sanitary sewer overflows, i.e., more or less
diluted raw sewage being discharged into the environment. Industries often discharge wastewater
into municipal sewers, which can complicate wastewater treatment unless industries pre-treat their
discharges.[36]

Solid waste disposal

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Disposal of solid waste is most commonly conducted in landfills,

but incineration, recycling, composting and conversion to biofuels
are also avenues. In the case of landfills, advanced countries
typically have rigid protocols for daily cover with topsoil, where
underdeveloped countries customarily rely upon less stringent
protocols.[37] The importance of daily cover lies in the reduction
of vector contact and spreading of pathogens. Daily cover also
minimises odor emissions and reduces windblown litter.
Likewise, developed countries typically have requirements for
perimeter sealing of the landfill with clay-type soils to minimize Hiriya Landfill, Israel.
migration of leachate that could contaminate groundwater (and
hence jeopardize some drinking water supplies).

For incineration options, the release of air pollutants, including certain toxic components is an
attendant adverse outcome. Recycling and biofuel conversion are the sustainable options that
generally have superior lifecycle costs, particularly when total ecological consequences are
considered.[38] Composting value will ultimately be limited by the market demand for compost
product.

Food safety

Sanitation within the food industry means the adequate

treatment of food-contact surfaces by a process that is effective in
destroying vegetative cells of microorganisms of public health
significance, and in substantially reducing numbers of other
undesirable microorganisms, but without adversely affecting the
food or its safety for the consumer (U.S. Food and Drug
Administration, Code of Federal Regulations, 21CFR110, USA).
Sanitation Standard Operating Procedures are mandatory for
food industries in United States. Similarly, in Japan, food hygiene Modern restaurant food preparation
has to be achieved through compliance with food sanitation area.
law.[39]

In the food and biopharmaceutical industries, the term "sanitary equipment" means equipment that is
fully cleanable using clean-in-place (CIP) and sterilization-in-place (SIP) procedures: that is fully
drainable from cleaning solutions and other liquids. The design should have a minimum amount of
deadleg, or areas where the turbulence during cleaning is insufficient to remove product deposits.[40]
In general, to improve cleanability, this equipment is made from Stainless Steel 316L, (an alloy
containing small amounts of molybdenum). The surface is usually electropolished to an effective
surface roughness of less than 0.5 micrometre to reduce the possibility of bacterial adhesion.

Hygiene promotion

In many settings, provision of sanitation facilities alone does not guarantee good health of the
population. Studies have suggested that the impact of hygiene practices have as great an impact on
sanitation related diseases as the actual provision of sanitation facilities. Hygiene promotion is
therefore an important part of sanitation and is usually key in maintaining good health.[41]

Hygiene promotion is a planned approach of enabling people to act and change their behaviour in an
order to reduce and/or prevent incidences of water, sanitation and hygiene (WASH) related diseases.
It usually involves a participatory approach of engaging people to take responsibility of WASH
services and infrastructure including its operation and maintenance. The three key elements of

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promoting hygiene are; mutual sharing of information and

knowledge, the mobilisation of affected communities and the
provision of essential material and facilities.[42]

Health aspects

SDG 6

Overview

The World Health Organization (WHO) collated existing

information on sanitation and health in 2018 in their "Guidelines
on Sanitation and Health".[43] Health impacts of the lack of safe
sanitation systems can be grouped into three categories: Direct
impact (infections), sequelae (conditions caused by preceding
infection) and broader well-being.[43]:2 These categories include
Hygiene education (on proper
the following:[43]:2 handwashing) in Afghanistan

Direct impact: Fecal-oral infections, helminth

infections and insect vector diseases (see also
waterborne diseases, which can contaminate
drinking water)
Conditions caused by preceding infection: Stunting/
growth faltering, consequences of stunting
(obstructed labour, low birthweight), impaired
cognitive function, pneumonia (related to repeated
diarrhea in undernourished children), anaemia The "F-diagram" (feces, fingers, flies, fields,
(related to hookworm infections) fluids, food), showing pathways of fecal-oral
Broader well-being: Immediate: Anxiety, sexual disease transmission. The vertical blue lines
assault (and related consequences), adverse birth show barriers: toilets, safe water, hygiene and
outcomes; Long-term (school absence, poverty, handwashing.
decreased economic productivity, antimicrobial
resistance)

For any social and economic development, adequate sanitation in

conjunction with good hygiene and safe water are essential to
good health. Lack of proper sanitation causes diseases. Most of
the diseases resulting from sanitation have a direct relation to
poverty. The lack of clean water and poor sanitation causes many
diseases and the spread of diseases. It was estimated in 2002 that
inadequate sanitation was responsible for 4.0 percent of deaths A video shedding light on the unsafe
and 5.7 percent of disease burden worldwide.[44] and undignified working conditions
of many sanitation workers in India
Lack of sanitation is a serious issue that is affecting most
developing countries and countries in transition. The importance
of the isolation of excreta and waste lies in an effort to prevent diseases which can be transmitted
through human waste, which afflict both developed countries as well as developing countries to
differing degrees.

Approximately two billion people are infected with soil-transmitted helminths worldwide; they are
transmitted by eggs present in human feces which in turn contaminate soil in areas where sanitation
is poor.[45]

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The effects of sanitation has impacted the society of people throughout history.[46] Sanitation is a
necessity for a healthy life.[47]

Diarrhea

Diarrhea plays a significant role: Deaths resulting from diarrhea are estimated to be between 1.6 and
2.5 million deaths every year.[48] Most of the affected are young children below the ages of five.[49]
Children suffering from diarrhea are more vulnerable to become underweight (due to stunted growth)
which makes them more vulnerable to other diseases such as acute respiratory infections and malaria.
Diarrhea is primarily transmitted through fecal-oral routes.

This situation presents substantial public health risks as the waste could contaminate drinking water
and cause life-threatening forms of diarrhea to infants. Improved sanitation, including hand washing
and water purification, could save the lives of 1.5 million children who die from diarrheal diseases
each year.[50]

In 2011, infectious diarrhea resulted in about 0.7 million deaths in children under five years old and
250 million lost school days.[51][52] It can also lead to malnutrition and stunted growth among
children.[53][33]

Numerous studies have shown that improvements in drinking water and sanitation (WASH) lead to
decreased risks of diarrhoea.[54] Such improvements might include for example use of water filters,
provision of high-quality piped water and sewer connections.[54]

Open defecation – or lack of sanitation – is a major factor in causing various diseases, most notably
diarrhea and intestinal worm infections.[51][55] For example, infectious diarrhea resulted in about 0.7
million deaths in children under five years old in 2011 and 250 million lost school days.[51][56] It can
also lead to malnutrition and stunted growth in children. Open defecation is a leading cause of
diarrheal death; 2,000 children under the age of five die every day, one every 40 seconds, from
diarrhea.[57]

Environmental aspects

Indicator organisms

When analysing environmental samples, various types of indicator organisms are used to check for
fecal pollution of the sample. Commonly used indicators for bacteriological water analysis include the
bacterium Escherichia coli (abbreviated as E. coli) and non-specific fecal coliforms. With regards to
samples of soil, sewage sludge, biosolids or fecal matter from dry toilets, helminth eggs are a
commonly used indicator. With helminth egg analysis, eggs are extracted from the sample after which
a viability test is done to distinguish between viable and non viable eggs. The viable fraction of the
helminth eggs in the sample is then counted.

Climate change

Climate change can have negative impacts on existing sanitation services in several ways: damage and
loss of services from floods and reduced carrying capacity of waters receiving wastewater.[58] Water
and sanitation services contribute to greenhouse gas emissions. To reduce those emissions, the
following can be done: Choice of wastewater treatment technologies, improved pumping efficiency,
use of renewable sources of energy, and within-system generation of energy offer potential for

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reducing emissions.[58]
Sustainable sanitation systems can lead to reductions in greenhouse gas
emissions by producing renewable energy in the form of biogas, heat recovery or directly from
excreta.[59] These options have additional mitigation potential.

Global development goals

Sustainable Development Goal Number 6

In the year 2016, the Sustainable Development Goals replaced the

Millennium Development Goals. Sanitation is a global
development priority and the subject of Sustainable Development
Goal 6 (SDG 6).[9] The target is to ensure everyone everywhere
has access to toilets by 2030.[60]

One indicator for the sanitation target is the "Proportion of

population using safely managed sanitation services, including a
hand-washing facility with soap and water".[9] The current value
in the 2017 baseline estimate by JMP is that 4.5 billion people United Nations SDG 6 Logo
currently do not have safely managed sanitation.[9] JMP is the
Joint Monitoring Programme by UNICEF and WHO to
monitor SDG6 progress.

SDG 6 Targets

The goal includes 6 detailed targets to assist in bringing

clean water and sanitation and their indicators of success.
The targets are as followed from the UN SDG website (http
s://www.un.org/sustainabledevelopment/water-and-sanitat
ion/): "Target 6.1 - By 2030, achieve universal and equitable
access to safe and affordable drinking water for all6.2 - By
2030, achieve access to adequate and equitable sanitation Number of Handwashing Facilities in the
and hygiene for all and end open defecation, paying special world, 2017
attention to the needs of women and girls and those in
vulnerable situations. 6.3 - By 2030, improve water quality
by reducing pollution, eliminating dumping and minimizing release of hazardous chemicals and
materials, halving the proportion of untreated wastewater and substantially increasing recycling and
safe reuse globally. 6.4 - By 2030, substantially increase water-use efficiency across all sectors and
ensure sustainable withdrawals and supply of freshwater to address water scarcity and substantially
reduce the number of people suffering from water scarcity. 6.5 - By 2030, implement integrated water
resources management at all levels, including through transboundary cooperation as appropriate. 6.6
- By 2020, protect and restore water-related ecosystems, including mountains, forests, wetlands,
rivers, aquifers and lakes. 6.a - By 2030, expand international cooperation and capacity-building
support to developing countries in water- and sanitation-related activities and programmes, including
water harvesting, desalination, water efficiency, wastewater treatment, recycling and reuse
technologies. 6.b - Support and strengthen the participation of local communities in improving water
and sanitation management"[61]

Since the Covid-19 pandemic, the fight for clean water and sanitation is more important than ever.
Handwashing is one of the most common prevention methods for Coronavirus, yet two out of five
people do not have access to a hand-washing station[62].

Millennium Development Goal Number 7 until 2015

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The United Nations, during the Millennium Summit in New York

in 2000 and the 2002 World Summit on Sustainable
Development in Johannesburg, developed the Millennium
Development Goals (MDGs) aimed at poverty eradication and
sustainable development. The specific sanitation goal for the year
2015 was to reduce by half the number of people who had no
access to potable water and sanitation in the baseline year of
1990. As the JMP and the United Nations Development
Programme (UNDP) Human Development Report in 2006 has
shown, progress meeting the MDG sanitation target is slow, with
a large gap between the target coverage and the current reality.

In December 2006, the United Nations General Assembly

declared 2008 "The International Year of Sanitation", in
recognition of the slow progress being made towards the MDGs
sanitation target.[63] The year aimed to develop awareness and
more actions to meet the target.

There are numerous reasons for this gap. A major one is that Example for lack of sanitation:
sanitation is rarely given political attention received by other Unhygienic pit latrine with ring slab
topics despite its key importance. Sanitation is not high on the in Kalibari community in
international development agenda, and projects such as those Mymensingh, Bangladesh
relating to water supply projects are emphasised.

The Joint Monitoring Programme for Water Supply and

Sanitation of WHO and UNICEF (JMP) has been publishing
reports of updated estimates every two years on the use of various
types of drinking-water sources and sanitation facilities at the
national, regional and global levels. The JMP report for 2015
stated that:[34]

Between 1990 and 2015, open defecation rates have

decreased from 38% to 25% globally. Just under one billion Modified logo of International Year
people (946 million) still practise open defecation worldwide in of Sanitation, used in the UN Drive
2015. to 2015 campaign logo
82% of the global urban population, and 51% of the rural
population is using improved sanitation facilities in 2015, as
per the JMP definition of "improved sanitation".[64]

Various initiatives

In 2011 the Bill & Melinda Gates Foundation launched the Reinvent the Toilet Challenge to promote
safer, more effective ways to treat human waste. The program is aimed at developing technologies
that might help bridge the global sanitation gap.

Project Concern International (https://www.pciglobal.org/clean-water/) works to promote safe

sanitation, water, and hygiene within schools in Guatemala, Nicaragua, and Tanzania and created
98% functioning water infrastructure in Malawi from 2014-2019.

Costs
A study was carried out in 2018 to compare the lifecycle costs of full sanitation chain systems in
developing cities of Africa and Asia. It found that conventional sewer systems are in most cases the
most expensive sanitation options, followed, in order of cost, by sanitation systems comprising septic
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tanks, ventilated improved pit latrines (VIP), urine diversion dry toilets and pour-flush pit
latrines.[65] The main determinants of urban sanitation financial costs include: Type of technology,
labour, material and utility cost, density, topography, level of service provided by the sanitation
system, soil condition, energy cost and others (distance to wastewater treatment facility, climate, end-
use of treatment products, business models, water table height).[65]

Some grassroots organizations have trialled community-managed toilet blocks whose construction
and maintenance costs can be covered by households. One study of Mumbai informal settlements
found that US$1.58 per adult would be sufficient for construction, and less than
US$1/household/month would be sufficient for maintenance.[66]

History
Major human settlements could initially develop only where fresh
surface water was plentiful, such as near rivers or natural springs.
Throughout history people have devised systems to get water into
their communities and households, and to dispose (and later also
treat) wastewater.[67] The focus of sewage treatment at that time
was on conveying raw sewage to a natural body of water, e.g. a
river or ocean, where it would be diluted and dissipated.

The Sanitation in the Indus Valley Civilization in Asia is an

example of public water supply and sanitation during the Bronze
Age (3300–1300 BCE).

Sanitation in ancient Rome was quite extensive. These systems

consisted of stone and wooden drains to collect and remove
The treatment components of the
wastewater from populated areas—see for instance the Cloaca
Nano Membrane Toilet from the
Maxima into the River Tiber in Rome. It is estimated that the first
BMGF "Reinvent the toilet
sewers of ancient Rome were built between 800 and 735 BCE.[68] challenge"
Nevertheless, there was widespread presence of several helminth
types (intestinal worms) that caused dysentery.[69]

There is little record of other sanitation in most of Europe until the High Middle Ages. Unsanitary
conditions and overcrowding were widespread throughout Europe and Asia during the Middle Ages.
This resulted in pandemics such as the Plague of Justinian (541–542) and the Black Death (1347–
1351), which killed tens of millions of people.[70] Very high infant and child mortality prevailed in
Europe throughout medieval times, due partly to deficiencies in sanitation.[71]

Society and culture

There is a vast number of professions that are involved in the field of sanitation, for example on the
technical and operations side: sanitation workers, waste collectors, sanitary engineers.

See also
List of abbreviations used in sanitation
List of water supply and sanitation by country
Environmental health
Pollution
Self-supply of water and sanitation
Sustainable Sanitation Alliance

https://en.wikipedia.org/wiki/Sanitation 13/18
14/10/2020 Sanitation - Wikipedia

Water, sanitation, hygiene (WASH)

World Toilet Day

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External links
Media related to Sanitation at Wikimedia Commons
IRC /en/ World Health Organization overview on sanitation (http://www.irc.nl/)
Sanitation, Hygiene and Wastewater Resource Guide (World Bank) (http://water.worldbank.org/wa
ter/shw-resource-guide)
Sustainable Sanitation Alliance (http://www.susana.org)

UN's SDGs - Goal 6 (https://sdgs.un.org/goals/goal6)

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