The world will not reach the goal of universal sanitation coverage, where every person in the world has access to toilets, by 2030 unless countries make comprehensive policy shifts and invest more funds, the World Health Organisation warned as it launched the first global guidelines on sanitation and health.

By adopting WHO’s new guidelines, countries can significantly reduce the 8,29,000 annual diarrhoea-related deaths due to unsafe water, sanitation and hygiene. For every $1 invested in sanitation, WHO estimates a nearly six-fold return as measured by lower health costs, increased productivity and fewer premature deaths.

Worldwide, 2.3 billion people lack basic sanitation (with almost half forced to defecate in the open). They are among the 4.5 billion are without access to safely managed sanitation services — in other words a toilet connected to a sewer or pit or septic tank that treats human waste.

“Without proper access, millions of people the world over are deprived of the dignity, safety and convenience of a decent toilet,” said Dr Soumya Swaminathan, WHO Deputy Director-General for Programmes.

Dr Maria Neira, Director, Department of Public Health, Environmental and Social Determinants of Health, WHO said, “The transmission of a host of diseases, including cholera, diarrhoea, dysentery, hepatitis A, typhoid and polio, is linked to dirty water and inadequately treated sewage. Poor sanitation is also a major factor in transmission of neglected tropical diseases such as intestinal worms, schistosomiasis and trachoma, as well as contributing to malnutrition.”

The guidelines state that sanitation interventions should ensure entire communities have access to toilets; the full sanitation system should undergo local health risk assessments to protect individuals and communities from exposure resulting from unsafe toilets; sanitation should be integrated into regular local Government-led planning to avert the higher costs associated with retro-fitting sanitation and to ensure sustainability. The health sector should invest more and play a coordinating role in sanitation planning to protect public health.