WSP and the Sanitation MDG Challenge Ede Ijjasz-Vasquez Manager Water and Sanitation Program 2005 Council Meeting

Sanitation Presentation to the 2005 WSP Council, June 2005 – Switzerland 2 Presentation outline  Scale of the global sanitation challenge  Sanitation a determinant of human development  Critical issues  Evolution of WSP work in sanitation  Sanitation & hygiene promotion framework  A variety of approaches and lessons  Towards meeting the sanitation MDG target

Sanitation Presentation to the 2005 WSP Council, June 2005 – Switzerland 3 Scale of the global sanitation challenge  In 2002, 2.6 billion lacked access to basic sanitation:  In terms of absolute numbers without access to basic sanitation, Asia is the worst off. 79% of those without access lived in Asia, compared with only 12% in Africa  But, in terms of risk of missing the target, Africa is the worst off. It has 19 of the 30 or more countries deemed off- course and most likely to miss the targets for basic sanitation

Sanitation Presentation to the 2005 WSP Council, June 2005 – Switzerland 4 The challenge of meeting the sanitation MDG target  The WHO/UNICEFF 2002 assessment concluded that if the trends hold, the world will miss the sanitation target by half a billion people  To meet the target, nearly 2 billion people should gain access to basic sanitation by 2015  This calls for 370,000 people to gain access to basic sanitation a day up to 2015

Sanitation Presentation to the 2005 WSP Council, June 2005 – Switzerland 5 Source: Meeting the MDG Drinking Water & Sanitation Target:A Mid-Term Assessment of Progress UNICEF and World Health Organisation Access to improved sanitation, 2002 The challenge of meeting the sanitation Goal

Sanitation Presentation to the 2005 WSP Council, June 2005 – Switzerland 6 Sanitation a determinant of human development  Water and sanitation are essential for good health, especially for diarrhoeal disease control  Globally, some 3900 children die everyday from diseases associated with unsafe water supply and lack of access to basic sanitation  This is equivalent to 4-8 jumbo jets filled with children crashing and killing all on board everyday  Basic Sanitation is associated with dignity, convenience, and privacy.

Sanitation Presentation to the 2005 WSP Council, June 2005 – Switzerland 7 Source: Some basic indicators on the state of infrastructure from the research database, World Bank INFVP Sanitation indicators Sanitation Access Indicators Unweighted averages of sample countries by income group [sample size in brackets] Low Income 2001 GNI < $745 Lower-Middle Income $745 <2001 GNI< $2975 Upper-Middle Income $2976< 2001 GNI< $9205 High Income OECD 2001 GNI > $9206 Universe (# countries) Access to Improved Sanitation (% of households) 31 [44] 41 [65] 64 [37] 72 [48] 85 [15] 86 [23] 100 [9] 100 [9] Rural 22 [47] 30 [65] 51 [38] 58 [49] 75 [17] 76 [25] 99 [10] 100 [9] Urban 54 [47] 60 [65] 81 [42] 85 [48] 93 [21] 91 [26] 100 [9] 100 [9]

Sanitation Presentation to the 2005 WSP Council, June 2005 – Switzerland 8 Source: Closing the sanitation gap – the case for better public funding of sanitation and hygiene – Barbara Evans, Guy Hutton and Laurence Haller, March 2004 Meeting the Sanitation MDG (annual figures in US$ million) Economic Benefits of Meeting the Sanitation MDG

Sanitation Presentation to the 2005 WSP Council, June 2005 – Switzerland 9 Critical Issues  Rural Areas: worse off than urban areas  The poor: worse off than the rich  Mega-cities: paralyzed by high cost of centralized approaches  Congested urban slum areas: problems of land tenure and lack of affordability  High density rural settlements: risk of pollution of the living environment

Sanitation Presentation to the 2005 WSP Council, June 2005 – Switzerland 10 Evolution of WSP work in sanitation 80s - Engineering Planning (Lost cost technologies: VIP, SANPLAT, etc.) 90s - Strategic Planning (Strategic Sanitation Planning, Condominium System, PHAST ) From Market-based Planning (Social marketing, Total sanitation, PPP Hand Washing, MDG roadmap)

Sanitation Presentation to the 2005 WSP Council, June 2005 – Switzerland 11 SANITATION Sustainable, Effective, Efficient Hardware  Latrines/Pour flush toilets  On-site septic systems  Simplified sewers  Appropriate wastewater treatment Software  Sanitation promotion/marketing  Hygiene promotion  Community organization  Monitoring and Evaluation  Operations & Maintenance Enabling Environment for Scaling Up Public awareness and demand  Political leadership  National Sanitation policies  Sector Reform and appropriate management models  Institutional roles and responsibilities  Capacity building Resources & Finance  Financing strategies for sanitation  Financial sources  Household self-financing  Micro-finance for households & small scale providers  Financial instruments for reform  Tariffs & subsidies

Sanitation Presentation to the 2005 WSP Council, June 2005 – Switzerland 12 A variety of approaches and lessons n Different approaches to sanitation promotion –Increased health and hygiene awareness –Social marketing –Community and individual incentives and sanctions n Different implementation models –NGOs and/or externally funded projects –City or country-wide government programs –Public-private partnerships

Sanitation Presentation to the 2005 WSP Council, June 2005 – Switzerland 13 Case studies… Urban utilities n Senegal – Urban sanitation project of Dakar –Approach: Social marketing and hygiene promotion –70% subsidy for capital cost –Construction of over san facilities in 2 years –Institutional arrangements: National utility, LGs, private sector (SSIPs) n Burkina Faso – Strategic sanitation program of Ouagadougou –Approach: Social marketing and hygiene promotion –30% subsidy for capital cost –Construction of approx san facilities per year since over 10 years –Institutional arrangements: National utility, private sector (SSIPs) –Subsidy financed from water bill n Bolivia – El Alto Pilot Project (EAPP) –Approach: Condominial approach and hygiene promotion –Provision of condominial sewerage connections to 4,050 households in 9 neighborhoods –Innovative engineering design, community participation, micro-credit lines –Institutional arrangements: Utility, Ministry for basic services, CBOs, private sector (SSIPs)

Sanitation Presentation to the 2005 WSP Council, June 2005 – Switzerland 14 Case studies…Rural examples n Southern Region of Ethiopia: Rural sanitation program –Approach: Health education/promotion and social peer pressure (extension health package) –0% subsidy for capital cost –Increased access to sanitation from 20% to 75% in 2 years –Institutional arrangements: Ministry of health, LGs, Community health workers, voluntary health promoters n Andhra Pradesh, India: Total sanitation campaign –Approach: Total sanitation – Hygiene promotion and social peer pressure (Community- led total sanitation) –0% subsidy for capital cost –Over 1.5 million toilets built in one year –Institutional arrangements: National and local governments n Vietnam: Rural sanitation marketing –Approach: commercial marketing – Hygiene promotion –0% subsidy for capital cost –100% sanitation access in 2 provinces –Institutional arrangements: LG, NGO, SSIPs

Sanitation Presentation to the 2005 WSP Council, June 2005 – Switzerland 15 Lessons learnt from case studies n Get political support and consensus on vision and approach, including subsidy policy: In Mozambique the sales of the standard 1.5 meter slabs fell by about 80% following the cut of subsidy, which increased the cost to users by more than fourfold. n Build on the potential of the local market to develop strategy and program: n Understand the drivers for demand: In Senegal, the implementing agency of the peri-urban on-site sanitation program has accredited 12 SSIPs, 5 consulting firms, 48 CBOs and 3 NGOs for the construction of 60,000 sanitation facilities n Improve the enabling environment (financial resources allocation, policies, institutional arrangements, M&E, regulation): In Burkina Faso, the sanitation services levy on all water bills has contributed to the success in spurring sanitation investment because of the direct transfer of surcharge revenues to a dedicated sanitation account managed directly by the utility without the intervention of the central government n Mainstream hygiene promotion in all programs to install a culture of hygienic lifestyle (hardware is not enough !!!): An evaluation of 8 rural sanitation experiences shows that the four most successful programs included hygiene promotion activities. In the pilot El Alto Condominial Project, hygiene promotion led to the increase of demand for bathrooms for households from 38% to 73%.

Sanitation Presentation to the 2005 WSP Council, June 2005 – Switzerland 16 Lessons learnt from case studies - 2 n Support SSIPs and the local sanitation industry to supply what people want, are willing to pay and will use and maintain (e.g. Access to credit and/or building materials; Capacity building and skills development; Accreditation of workshops and show-rooms; Supply chains): In 2 provinces of Vietnam, IDE (an international NGO) supported a marketing sanitation program, which used local masons, who get 50% of the cement on credit and in return can extend credit to their customers. n Allocate public resources strategically to maximize public and private benefits (hard/soft ware, waste final disposal & reuse, marketing, R&D, capacity building and training, urban/rural, smart subsidies, etc.): For the rural sanitation marketing program of Vietnam, for every external dollar (US) spent in business development support, US$ 1.5 of household investment was generated, of which US$ 0.36 went to the local network of masons and the remaining US$ 1.14 to the rural construction material retailers.

Sanitation Presentation to the 2005 WSP Council, June 2005 – Switzerland 17 Lessons learnt from case studies - 3 n Prioritize sanitation and hygiene in PRSPs and other financial instruments to scale-up programs and interventions: In Uganda, WSP contributed and helped raised the profile of sanitation in the second Health Sector Strategic Plan (HSSP II) and the Poverty Eradication Action Plan (PEAP) that should lead to a better integration and efficient use of resource at district and sub-district levels. n Target the poor through better demand assessment and segmentation: IDE classified the poor according to the Vietnam government’s definition of households eligible to receive social assistance from the government, and identified as such by the communities. To be eligible to receive this assistance, a household has to show a monthly income per head of VND 100,000 (about US$ 6). n M&E to learn and improve services and infrastructures delivery: In Senegal, 5 consulting firms are in charge of the quality control of the constructions undertaken by the SSIPs. 48 CBOs and 3 NGOs are also involved in social mobilization and intermediation between consumers and suppliers.

Sanitation Presentation to the 2005 WSP Council, June 2005 – Switzerland 18 Towards meeting the sanitation MDG target  Agree on approach and get political commitment Advocacy Subsidy policy Cost-effective approach  Get the enabling environment right Policy environment Institutional leadership and sector reform Sustainable financing  Stimulate demand for sanitation and hygiene practices improvements Customer behavior & drivers of consumer demand Marketing and promotion campaign Behavior change

Sanitation Presentation to the 2005 WSP Council, June 2005 – Switzerland 19 Towards meeting the sanitation MDG target - 2  Learn from and use the power of the market Range of desirable and affordable sanitation improvement technologies, including EcoSan Standardization of technology options Capacity building for services providers Linkages between demand and supply Local sanitation industry (accreditation, licensing, endorsement)  Regulate the sector M&E of quality and cost Waste transportation and final disposal Land tenure, especially in densely populated slums Accountability

Sanitation Presentation to the 2005 WSP Council, June 2005 – Switzerland 20 Thank you for your attention!