One in four people[1] are unable to access basic water, sanitation and hygiene (WASH) services due to a systemic lack of investment in fundamental infrastructure. Access to sanitation in particular is vital to public health, but however much we like to think of it as a technical problem that can be solved by technical solutions (more loos!), sanitation and hygiene is also governed by all sorts of social, religious and institutional norms and taboos. While international initiatives like World Toilet Day have begun the important work of dismantling taboos and changing unhealthy practices, there is a lingering disconnect between the research on the topic, the work happening on the ground and the general public perception of why WASH matters.

In international development, sanitation is at the heart of what we do. It is in the numbers of preventable childhood deaths, in the gendered lack of access to education and livelihood, in conflict and fragility management and in the fight for a more sustainable and safer world. Sanitation is key to healthy living and productive spaces and societies, yet among all the technical debate on sanitation infrastructure, there is still a distinct lack of ‘talking shit’ in development.

While sanitation provision does fall under categories which indeed are largely technical, the decision-making mechanisms around them are not. Decisions around sanitation are crucial to the way we lead our everyday lives, and decisions around who can access them or not often end up reflecting ingrained power hierarchies and inequalities. A ‘poo-litical’ analytical framework is therefore needed if we are to interrogate the barriers to universal access to WASH.

‘Poo-liticising’ sanitation financing

The biggest and most crucial barrier to universal sanitation coverage is financing, as establishing and maintaining sanitation infrastructure is costly business and requires careful financial planning and spending. While WASH related aid spending have steadily increased over the years[2], the funding has been coupled with the assumption that more financing will automatically pave the way for WASH services for all, as decisions around financing such services are seen as ‘pain free’ and ‘straightforward’ technically sound investments. The World Health Organisation has for example estimated that every $1 invested in sanitation has a $5.50 return in lower health costs, more economic productivity, and fewer premature deaths[3], making a compelling economic argument for investing in sanitation infrastructure.

However, this technical framing often hides the less rational political nature of infrastructure investments. Smaller scale infrastructure projects like connecting individual homes to WASH infrastructure lack the public-facing profile bigger infrastructure investments in transport or energy receive, making them less attractive for policy makers, despite their long-term benefits[4]. Larger WASH infrastructure investments in growing cities can also generate bad publicity as growth in urban places often comes from marginalised, ‘unwanted/unpopular’ populations, such as rural workers looking for jobs or people who face protracted displacement due to conflict or environmental change[5]. Investing in the sanitation facilities of such spaces is vital for public health and wellbeing but offers little political pay-off in the short run, making it a risky policy choice for politicians who balk at the idea of losing public support.

Furthermore, a warranted yet predictably damaging issue has been the focus on urban sanitation development, which has often come at the cost of rural sanitation development spend. This focus has meant that we run the risk of not realising universal access to safely managed sanitation until the next century, leaving millions of vulnerable and poor people behind. These examples illustrate that financing is not an issue in terms of availability of resources, it is also a deeply political issue which can be solved by shifting the narrative around why sanitation matters. 

Ending the Dark Ages of Sanitation

While there has been some remarkable progress in sanitation access in countries like India and China[6] and the academic literature has seen an upswing in interest and innovation in solutions[7], we still have a long way to go until we can achieve universal WASH coverage. Sanitation coverage, even in places where it is largely accessible to a majority of private household and businesses, has shown to systematically leave the poorest[8] and most vulnerable[9] population of the world behind.

Sociologist Rose George has characterised our current predicament as ‘the dark ages of sanitation’[10], where the constant cultural and political stigmatisation of this issue has meant that it is not in the political imagination in the way it should be.

Yet there are glimpses of hope. A recent survey shows that people generally rank access to clean water and sanitation as the second most important Sustainable Development Goal, only eclipsed by the ‘zero hunger’ SDG aimed at eradicating global hunger. This growing awareness just needs to be further contextualised in our political realities in order to create the shift needed to realise the goals of universal sanitation coverage.

To end the dark ages of sanitation, it is more important than ever that we employ a contextualised and power-sensitive analysis to access to sanitation. We need WASH specialists and support to help establish facilities, but we also need to tell the story of what lack of sanitation means in practice and the policy mechanisms enabling the sanitation gap. We need to discuss the shortened lives, the inability to work, the shutting out of public life, the gendered injustice of it all in new lenses, putting human stories behind it while being mindful not to exploit those suffering the worst from lack of WASH in order to progress depoliticised solutions to a very political issue.

Note: The terminology of ‘poo-litics’ is borrowed from the brilliant Colin McFarlane and Jonathan Silver in “Infrastructure,‘seeing sanitation’ and the urban political in an era of late neoliberalism”, The Urban Political, Palgrave Macmillan, Cham, 2018. 123-143.

Photo credit: Photo by Gilles Desjardins on Unsplash.


[1] https://www.who.int/news-room/fact-sheets/detail/sanitation

[2] http://www.oecd.org/dac/financing-sustainable-development/development-finance-data/water-relatedaiddataataglance.htm

[3] https://www.who.int/news-room/fact-sheets/detail/sanitation

[4] https://www.odi.org/blogs/10522-four-political-errors-avoid-achieving-water-and-sanitation-all

[5] https://www.odi.org/sites/odi.org.uk/files/resource-documents/11202.pdf

[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6192828/

[7] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6192828/

[8] https://www.washdata.org/sites/default/files/documents/reports/2019-07/jmp-2019-wash-households.pdf

[9] https://www.ohchr.org/Documents/Issues/Water/A_HRC_42_47_User_Friendly_Version.pdf

[10] George, R. (2008) The big necessity: The Unmentionable World of Human Waste and Why It Matters, Macmillan.