A "Fresh Life" toilet built by Sanergy in Nairobi, Kenya © Bill & Melinda Gates Foundation/Frederic Courbet

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Sanitation is essential to human progress. Not only does it symbolise growth and advancement, it empowers people and communities to grow and advance.

According to the World Health Organization, every $1 invested in sanitation yields, on average, $5.50 in economic returns. This is because a lack of sanitation often results in cycles of contamination and infection that impose a heavy cost on human, economic, and environmental health. Adults fall sick and can’t work and provide for their families. Children have to weather brutal bouts of diarrhoea and pneumonia just to reach the age of five. Communities with poor sanitation end up impoverished in numerous other ways.

It’s hard to imagine the nature of this situation without seeing it. That’s why Bill Gates recently created Talking Toilets, a 360 video that puts you face to face with the consequences of poor sanitation, and opens your eyes to possible solutions.

When those solutions are in place, the difference for communities couldn’t be more dramatic: healthy and productive residents; more children growing up, attending school, and reaching their full potential as adults; a social environment that is more vibrant and full of potential, as well as more appealing to businesses.

The fact that fecal pollution persists in many developing countries isn’t proof that governments don’t care. Rather, it’s an indication that conventional solutions, such as sewer systems and centralised treatment plants, require levels of upfront capital and ongoing maintenance that few municipalities can afford. Such approaches also require large amounts of water and electricity to operate, which can be difficult in countries where shortages of each already are concerns.

Fortunately, governments around the world are improving sanitation with innovative non-sewered solutions that are more flexible and affordable — often at one-seventh the cost of sewers. The city of Warangal, in the Indian state of Telangana, is a good example of non-sewered sanitation managed right. In March 2016, following a comprehensive study of sanitation gaps in the city, the government established India’s first regulatory framework for sanitation at the municipal level.

While it’s true that conveniently located household toilets are important for personal dignity and safety, city leaders know they represent only one link in an extensive, often ignored, fecal sludge management chain. This chain extends from point of use and safe containment to point of treatment and safe disposal. If any links in the chain are missing or faulty, then the sanitation outcomes of their entire city are imperilled. Through their regulatory framework, Warangal’s leaders have taken steps to ensure their city’s sanitation is comprehensive and complete.

For example, officials know it isn’t enough to empty and clean pit latrines on a regular basis. The people doing the work also need to be protected against contamination. So, they drafted regulations requiring safety gear for sanitation crews. The government also knows that when toilets aren’t built properly, they leak contaminants into the nearby environment — increasing residents’ risk of infection and decreasing residents’ propensity to use them. So, it established licensing requirements for masons and constructors, ensuring toilets were built to specifications.

Since then, Warangal’s regulatory standards and enforcement mechanisms have helped define roles and responsibilities, setting the terms of engagement across their fecal waste management value chain. They also have helped catalyse local industry to expand the range of sanitation products and services on the market. Yet the Warangal approach is only one of many options for policymakers to explore.

In some cases, a public government-provided utility is still the best-fit option. In other cases, municipalities structure markets so that sanitation services are carried out by for-profit ventures, or even public-private partnerships. This is because entrepreneurs and commercial enterprises can engage and innovate in ways governments often can’t. Innovation drives competition, helping to progressively lower costs and transfer savings back to consumers. It also provides something that local economies need to prosper: jobs.

In Senegal, Kenya, and elsewhere, businesses large and small are generating job opportunities across the fecal sludge management chain. One example is Sanergy, which provides and maintains pay-per-use toilets for communities in the slums of Nairobi. Each toilet is owned by a franchisee. Sanergy has now launched over 1,000 facilities through 500 franchisees, who serve 50,000 residents daily. Sanergy also employs 200 people to build, install and safely empty the toilets and process their contents into organic fertiliser for commercial purchase.

Turning waste into useful goods will be a necessity in the future, as the global population and the demand for water, electricity and strategies for climate resiliency continue to rise. The ultimate goal for sanitation providers and innovators, therefore, is to fully transform how we view, manage and even leverage fecal waste to improve health, bolster economies and accelerate human progress. This is the goal all of us must join together to achieve.

At the Bill & Melinda Gates Foundation, we’re working toward this goal by directing innovation towards new approaches to sanitation that don’t rely on sewers — from new business models and technologies that support the collection, transport and treatment of waste to a fully reinvented toilet. In the future, many toilets won’t flush waste away to be treated elsewhere; they’ll treat waste on-site. Prototypes developed as part of our “Reinvent the Toilet Challenge” showed it’s possible to recover clean water from human waste and convert the rest into something useful, like electricity and biological charcoal. So instead of expending precious resources every time you use the bathroom, you’ll be producing them.

In the meantime, there is a lot that governments can do now to improve sanitation for their residents, rich and poor. Regulations that specify safety and function, as well as enable and incentivise commercial sanitary ventures, are straightforward actions that don’t require upfront capital and ongoing financing. These efforts not only make sense; they make dollars and cents. Importantly, they are helping cities and countries across the globe harness the potential of billions of people, rather than waste it.

Brian Arbogast is director of the Water, Sanitation and Hygiene Program at the Bill & Melinda Gates Foundation.

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