Bill & Melinda Gates Foundation

Funding A Safe Way to Poop

November 17, 2011

The next time you feel nature’s urge, meditate on this fact: a rural population equivalent to the combined citizenry of China, the United States, Mexico, and Japan doesn’t have a good way to take a poop. And their lack of access to sanitation perpetuates cycles of poverty.

Back in July, the foundation launched a new strategy focused on helping 2.6 billion people around the world gain access to safe, affordable toilets that they can afford and will want to use and maintain.  Of those 2.6 billion people, three out of four live in poor, rural communities in the developing world. That’s 1.9 billion people.

1.1 billion people squat in the bushes or out in the fields, when nature demands. Another 800 million use unsanitary, makeshift facilities.

These conditions help to spread infectious disease, and they cause severe diarrhea and chronic inflammations of the gut that prevent millions of young children from absorbing essentials nutrients. This damages the development of young minds, bodies, and immune systems and negatively impacts the future productivity of individuals, families, and nations.

So what’s the solution? Well, you couldn’t give away toilets and latrines fast enough to make a real dent in the problem. Even if that approach worked, which it doesn’t.

Instead, we need to get people to take ownership of the challenge and provide them with support from local governments and the private sector when they need it. Here at the foundation, our work in rural sanitation aims to create demand for sanitation and provide people with the help they need to adopt improved sanitation “at scale,” which is a fancy way to say “everywhere.”

Some people might say, “Haven’t donors been investing in water supply and sanitation improvements for decades? Don’t you guys know how to do this already?” I would say, “Yes, sort of.”

We know a lot about how to improve sanitation a few villages at a time, but we actually know surprisingly little about what it takes to make whole districts, let alone whole states or nations, “open defecation free.”

Part of the challenge is that sanitation is largely a household issue, not a community one, and a lot of investment that donors made in water supply and sanitation was really investment in:

WATER SUPPLY and sanitation.

That’s an imbalance that we are trying to help address by focusing the majority of our efforts squarely on sanitation.

Just scaling up pilots or isolated village projects is not going to get us where we need to go. Instead, we need to identify approaches that will work at scale right from the start. For lack of a better phrase, we currently call these approaches “delivery systems.”

So what does an effective delivery system look like?

Well, it needs to put the needs of the consumer first. This means that costs need to be no more than a few dollars per person, they need to be implemented and monitored with support from local governments and the private sector, and they need to work forever.  And – oh, yes – they need to cover millions of people effectively.

By 2015, the foundation aims to have at least another 30 million people worldwide living in open-defecation-free communities through grants to partners. And we aim to learn by then what has worked well, and not so well, in scaling up mass access to sanitation.

We’re pleased this week to announce two significant new grants to valued partners. BRAC, a Bangladesh-based NGO, has received funding to focus on creating demand for affordable sanitation among the poorest.  And PLAN International is developing different approaches to create, support, and service sanitation demand in Ethiopia, Ghana, and Kenya.

We’re also supporting better policies and practices that can help our on-the-ground partners achieve scale in a sustainable and more cost-efficient way. 

Think of better ways to improve coordination among government agencies at the state and country level, innovative ways to finance services and expand affordable access to the poor, better measurement of results so that we know what’s working, and better distribution of key findings through regional learning and training centers.

We recognize that our contributions are just a small part of a much larger whole, including investments by country governments, local communities, and other donors and NGOs, and we looking forward to using this space to keep you up to date on what’s happening with our efforts in rural sanitation.

 
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