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2008 was a breakout year for sanitation. Under the banner of the International Year of Sanitation (IYS), toilets and hygiene for the environment, human development and health gained importance on the international political agenda. For individual professionals and interested organisations such as the Water Supply and Sanitation Collaborative Council (WSSCC), an oft-fragmented sector found a much-needed unanimity. And for the 2.5 billion poor people without safe sanitation, a host of new ideas, energy and approaches offered the hope that good toilets and proper hygiene for all people can be achieved.  

The United Nations General Assembly established 2008 as the IYS to put the global community back on track to achieve the Millennium Development Goal (MDG) sanitation target. The target is to halve, by 2015, the number of people without access to basic sanitation. Unfortunately, progress on the sanitation target (particularly in Sub-Saharan Africa) is slower than on that of a similarly worded water supply target. -- it may be missed by up to 700 million people. The reasons for this slow progress are many. Among them:  toilet talk is 'taboo'; compared to water supply, sanitation is 'harder' to achieve; it lacks high-profile champions; it is underfinanced (up to US$13 is spent on water supply compared to US$1 on sanitation); and so on.

Despite these obstacles, it is important that we get on track with the MDG target because poor sanitation and hygiene are the chief or underlying causes in the death of more than five million children every year, mainly through preventable diarrhoeal disease. More children have died from such diseases in the past 10 years than in all of the armed conflicts since World War II. Environmentally, the lack of sanitation creates serious  levels of pollution. Over one billion people have no toilet of any sort and defecate in the open – if they all defecated in one place, they would produce a pile of faeces big enough to fill a football stadium every day. The environmental and disease-causing implications are staggering.

So, improved sanitation has large, interlinked health and environmental ramifications for the future, mainly through preventing pollution of water resources, and in the reuse of excreta for agriculture. The fact is that one person or village, by polluting local water resources when the open defecated excreta washes in to streams and groundwater, can affect the health of many. In the future, the re-use of compost for agriculture will gain importance.

Good sanitation safeguards water resources and maximises the impact of drinking water quality improvements. For example, the risks of water contamination during household storage and handling sharply increase in places that lack toilets. Contamination of local water resources used to supply drinking water can lead to unnecessary investment in more distant and expensive sources. Water resources are an important productive asset. Agriculture, fish production, energy production, industry, transport, and recreation all suffer economic harm if the water is polluted by faecal contamination. For the world's biggest industry -- tourism -- health, safety and aesthetic considerations heavily influence people’s choice of a holiday destination, so good sanitation is a pre-requisite for a thriving tourism sector.

With good reason, then, the sector, led by the UN-Water Task Force on Sanitation, and including actors such as WSSCC, worked to raise the profile of sanitation in 2008. For the first time, the most fundamentally important messages about sanitation and hygiene were agreed upon and articulated. These messages are: access to basic sanitation 1) improves health, 2) generates economic development, 3) promotes social development, 4) protects the environment, and 5) is universally achievable.

To support efforts to reach out to political leaders, a series of regional sanitation meetings on large-scale, sustainable, affordable and appropriate sanitation and hygiene programmes were held in Africa, East Asia, Latin America and South Asia. The conferences attracted thousands of development experts and, notably, political leaders who stepped up with positive, specific and progressive declarations of intent. For example, at AfricaSan in February, 32 African ministers signed the eThekwini Declaration, which recognised the importance of spending at least 0.5% of GDP on sanitation and hygiene in order to save up to 2% of GDP on health- and environmentally-related costs. (In fact, every dollar invested in sanitation generates up to nine dollars in indirect economic benefits.)

The case for sanitation was also made in places where sector professionals have not traditionally been active, such as the G8 meeting in Japan, the UBS Global Philanthropy Forum in Singapore, and the Clinton Global Initiative annual conference in New York. And finally, new, more popularly-oriented books ("The Last Taboo", "The Big Necessity") introduced dignified toilet talk to more people. Big global media outlets covered the issue, as did leading journals in other sectors such as the health-oriented Lancet and, of course, the MEA Bulletin.

Some positive developments in sanitation that were magnified by the IYS include:

• sanitation is increasingly recognised as an important subject/sector in its own right,
• understanding has increased by policy- and decision-makers on the broader benefits of sanitation; sanitation professionals, too, now know more about why people do or don't want it, and how the latent demand of the unserved can be tapped through social marketing and Community Led Total Sanitation, for example.
• centralised top-down, supply-driven approaches are increasingly out of vogue, and decentralised, people-centred demand-driven approaches are in
• sustained use of services is being emphasised rather than the simple provision of facilities,
• hygiene, especially handwashing (which can save one million lives per year), is emphasised,
• ecological sanitation and other simple, affordable and appropriate sanitation solutions, have become the goal in the medium- to long-term future, and
• loan-based financing mechanisms and social entrepreneurs are increasingly applying their talents and creativity to sanitation, to complement traditional grant-based financing mechanisms.

WSSCC, a global multi-stakeholder partnership organisation with members in 80 countries, was active during the IYS, and with its new sanitation focus will continue to work to improve the lives of poor people by working globally and locally through its 34 national coalitions in developing countries. WSSCC's new Global Sanitation Fund (GSF), the first of its type, was launched in 2008 and is hopefully just the first of many innovative, new mechanisms to help close the financing gap. Active GSF implementation begins in 2009.

To be sure, there remains much work to be done by stakeholders in and out of the sanitation sector, and by WSSCC through its networking, knowledge management and advocacy programmes. Putting people at the centre of sanitation solutions is the key, a point highlighted during the IYS. After all, 2.5 billion people want to use the toilet.