NextBillion - An Initiative of the William Davidson Institute at the University of Michigan

Friday, September 18, 2015

“Why do we have toilets at school but not at home?” This question from one of her children prompted Nusrat, a wife and mother of six living in India, to apply for a sanitation loan.  Within two weeks of receiving the loan, Nusrat was able to purchase a toilet. Now, one year later, the monthly instalments on Nusrat’s loan have all been repaid and her family is happier, healthier, and safer.

In India today, more than half of households lack access to improved sanitation. In rural areas, this proportion rises to over 70 percent, or about 620 million people. In fact, India accounts for 60 percent of open defecation globally.

Poor sanitation contributes to diarrheal disease, which in turn results in premature mortality, childhood malnutrition and stunting, high healthcare costs, and massive productivity losses. Emerging research is showing that childhood stunting has lifelong effects on both health and cognitive ability.

As the United Nations member states prepare to adopt a new, universal set of goals, targets and indicators to guide their political policies and agendas over the next 15 years, I am encouraged to see that Sustainable Development Goal #6 is dedicated to ensuring availability and sustainable management of water and sanitation for all. While progress has been made, the Millennium Development Goal of halving the proportion of the world lacking access to improved sanitation remains unmet.

I believe that financing will be the most critical bottleneck that we will have to overcome if we are to achieve our ambitious goal of universal access to water and sanitation services. While we know that investment in achieving full coverage in a country is one of the most cost-effective development interventions a government can make, only a quarter of the world’s governments allocate the resources to achieve it. Foreign aid will play a crucial role but it’s not a panacea.

If we are to truly embrace these ambitions we’ll have to think differently about how we finance them. Viewing people in poverty as citizens with rights and resources versus beneficiaries of aid and charity is the first step.