Experts estimate that $9 in productivity, health and other benefits are returned for every dollar invested installing toilets for people in countries that today are off-track in meeting the UN Millennium Development Goal (MDG) for sanitation.
Some argue that meeting the sanitation MDG is also a prerequisite to the goals of reducing global poverty.
Achieving the sanitation goal - to simply halve the number of people without access to a toilet by 2015 – would cost $38 billion, less than 1% of annual world military spending. That investment, however, would yield $347 billion worth of benefits - much of it related to higher productivity and improved health.
According to UN figures, meeting the sanitation MDG target would add 3.2 billion annual working days worldwide. Universal coverage would add more than four times as many working days.
Some 2.6 billion people – over a third of humanity – lack access to adequate sanitation. Each of those devotes a conservatively estimated 30 minutes a day queuing for public toilets and / or seeking seclusion. The cumulative time involved equals about two working days per month.
A more drastic consequence, however, is the number of workdays lost to diarrhoeal disease – either by ill workers or when she or he is caring for a sick child or relative.
In addition, many women avoid workdays during menstruation when workplaces have no toilets.
Health Impacts
Diarrhoeal disease is a leading cause of death and illness, killing 1.8 million people each year. Poor hygiene and lack of access to sanitation together contribute to 88 per cent of all deaths from diarrhoeal disease, with children paying the highest price: 5,000 deaths a day. Hundreds of millions of other children suffer reduced physical growth and impaired cognitive functions due to intestinal worms.
Improved access to sanitation would also lead to very high avoided health sector costs, according to UN research.
On a typical day in sub-Saharan Africa, for example, half the hospital beds are occupied by people afflicted with faecal-borne disease. Treating preventable infectious diarrhoea consumes 12 percent of the region's total health budget.
Globally, $552 million in direct treatment costs would be avoided by meeting the MDG sanitation target.
Around the world, an estimated 200 million tons of human waste and untold millions of tons of wastewater are discharged uncontained and untreated, into watercourses every year. As a result, humans are regularly exposed to bacteria, viruses and parasites – spread through direct or indirect contact with these watercourses. Such exposure is the leading cause for diarrhoeal disease (including dysentery and cholera), parasitic infections, worm infestations and trachoma.
Sanitation and Children
Healthy children learn more than children suffering from worm infections, which sap nutrients and calories and lead to listlessness and trouble concentrating. Up to two thirds of all schoolchildren in some African countries are infected with parasitic worms.
Schools without private and separate sanitation facilities for boys and girls have higher incidence of diarrheal disease but also lower attendance and a higher dropout rate, especially for girls whose parents may remove them from the education system when they start menstruating. This fuels the discrepancy in primary school completion rates: one in four girls do not complete primary school, compared to one in seven boys.
More girls in school means higher rates of female literacy -- for every 10 percent increase in female literacy, a country's economy can grow by 0.3 percent.
UN experts estimate the reduction in diarrhea engendered by meeting the sanitation target would add an estimated 272 million days of school attendance.
Ensuring economic benefits
Many UN studies have shown that public- and private-sector investment into sanitation can lead to economic benefits for communities. In particular, small entrepreneurs can benefit from infrastructure development. That, in turn, requires enabling policies to be in place.
Many sectors are already impacted by sanitation-triggered illnesses of their workers, including agriculture, fish-farming, energy production, large-scale industrial processes, small-scale industry, transport and recreation.
Health, safety and comfort standards for sanitation as well as aesthetic considerations also heavily influence the choice of tourist destinations.
Report on progress
Between 1990 and 2004, an estimated 1.2 billion people gained access to improved sanitation, an increase of 10 percent. To meet the Millennium Development Goals' sanitation target, however, over 1.6 billion more will need to be reached by 2015, with developing countries facing the biggest challenge. Globally, this translates into 626,000 people per day being given access to an improved sanitary facility.
While many regions are on track to meet the MDG sanitation target, we will miss this global target by a wide margin.