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AfricaSan4: Why Open defecation may continue in Africa, until 2030

Special Report on the 4th Africa Sanitation and Hygiene Conference (Africasan4), Dakar, Senegal

                                                         By Babatope Babalobi, who was in Dakar


Africa’s Ministers of Water Resources and Sanitation have fixed 2030 as the terminal year to end open defecation, presently practiced by 233m Africans.  According to the ‘Ngor declaration’ issued at the end of a recent three day meeting, the Ministers aligned themselves with the aspiration of the draft Sustainable Development Goals which targets to “by 2030, achieve access to adequate and equitable sanitation and hygiene for all and an end to open defecation, paying special attention to the need of women and girls and those in vulnerable situations”.


Of the 233m people in Africa still practicing open defecation, Nigeria takes the lead with 39m people still defecating in the open, 34m in Ethiopia, 17m in Sudan, 13m in Niger, 10m in Mozambique, 9m people in Burkina aso, 9m  in Madagascar, 8m in South Sudan, 8m in Chad, 6m in Tanzania, while the rest of Africa has 80m people, according to WHO//UNICEF Joint Monitoring Programme (JMP) figures.

The issue of access and lack of access to safe and improved sanitation facilities came to the fore when Water and Sanitation professionals  convened in Senegal, a West African country for the 4th edition of the triennial Africa Sanitation and Hygiene Conference, popularly known as AfricaSan,  May 25 and 27 2015.


Organised by the Africa Minister’s Council on Water (AMCOW) the largest inter-governmental body on Water and Sanitation in Africa comprising 54 Ministers of Water Resource ministries in Africa,  AfricaSan4’s theme was ‘Making Sanitation a reality in Africa’, and took place in King Fahd Palace Hotels in Dakar, Senegal.


The kernel of discussions of the three day conference that  attracted close to 1000 participants from the government, civil society, media, donor bodies, private sector, and development community, was  how Africans can have sustainable access to improved sanitation facilities, which the WHO//UNICEF Joint Monitoring Programme (JMP) for water and sanitation defines as a ‘sanitation facility that hygienically separates human excreta from human contact’.


What are improved sanitation facilities, and sanitation facilities described as umimproved? Also, why do we need to use improve sanitation facilities? Categories of improved sanitation according to WHO/UNIMPROVED SANITATIONICEF/JMP include flush toilet, piped sewer system, septic tank, flush/pour flush to pit latrine, ventilated improved pit latrine (VIP), pit latrine with slab, composting toilet, and special case; while types of unimproved sanitation are flush/pour flush to elsewhere, pit latrine without slab, bucket, hanging toilet or hanging latrine, no facilities or bush or field popularly known as Open defecation.


The benefits of access to improved sanitation are legion, but are mainly good health, reduced poverty, and a higher standard of living; while the cost of lack of access to improved sanitation are socio-economical. According to the water, poor sanitation results  in high levels of environmental contamination and exposure to the risks of microbial infections, diarrhoeal diseases (including cholera), trachoma, schistosomiasis and hepatitis, according to the WHO/UNICEF joint monitoring report 2014: Progress on sanitation and drinking water.


The World Bank’s Water and Sanitation Program (WSP) has also identified economic losses of poor sanitation. In a  desk study, Economic Impacts of Poor Sanitation in Africa,  which covered 18 African countries- Benin, Burkina Faso, Chad, Central African Republic, Democratic Republic of Congo, Ghana, Kenya, Republic of Congo, Liberia, Madagascar, Mauritania, Mozambique, Niger, Nigeria, Rwanda, Tanzania, Uganda, and Zambia-  the WSP found the majority of these costs to production come from annual premature deaths, including children under the age of five, due to diarrheal disease. Nearly 90 percent of these deaths are directly attributable to poor water, sanitation, and hygiene.


Other significant costs were productivity losses from poor sanitation, and time lost through the practice of open defecation. Adverse impacts of inadequate sanitation that are likely to be significant, but difficult and expensive to estimate, include the costs of epidemic outbreaks; losses in trade and tourism revenue; impact of unsafe excreta disposal on water resources; and the long-term effects of poor sanitation on early childhood development.


Eighteen African countries lose around US$5.5 billion every year due to poor sanitation, with annual economic losses between 1 percent and 2.5 percent of GDP’, says a  report by the World Bank’s Water and Sanitation Program (WSP).  “This is powerful evidence for Ministers that their countries will not be able to grow sustainably without addressing these costs,” said WSP Manager Jaehyang So.


In realisation of the social and economic value of access to safe and improved sanitation facilities, World leaders in 2000 committed themselves to implementing Goal 7 target 10 which is halving by 2015 the proportion of people without access to water and sanitation among other Millennium Development Goals.


Eight years later, specifically, on February 2008, Ministers responsible for Sanitation and Hygiene in 32 African countries met in South Africa and issued the Ethekwini declaration, making 10 commitments to boost access to sanitation in line with MDG7 target 10. Prime of this commitments are:

  • Commitment 3: To establish, review, update and adopt national sanitation and hygiene policies within 12 months of AfricaSan 2008; establish one national plan for accelerating progress to meet national sanitation goals and the MDGs by 2015, and take the necessary steps to ensure national sanitation programs are on track to meet these goals:
  • Commitment 5: To ensure that one, principal, accountable institution takes clear leadership of the national sanitation portfolio; establish one coordinating body with specific responsibility for sanitation and hygiene, involving all stakeholders, including but not limited to those responsible for finance, health, water, education, gender, and local government;
  • Commitment 6: To establish specific public sector budget allocations for sanitation and hygiene programs. Our aspiration is that these allocations should be a minimum of 0.5% or GDP for sanitation and hygiene;
  • Commitment 8: To development and implement sanitation information, monitoring systems and tools to track progress at local and national levels and to work with global and regional bodies to produce a regular regional report on Africa’s sanitation status, the first of which to he published by mid-2010.


Also in April 2014, at the third High Level Meeting (HLM) of the Sanitation and Water for All (SWA) Partnership, 43 developing countries and 12 donor partners made 383 commitments to address barriers to access to water and sanitation. According to a 2015 update by the SWA, ‘almost 80% of the commitments water made by countries in the African region’. 


AfricaSan4 was therefore billed to monitor progress of African countries in achieving both the 2000 commitments as it relates to sanitation in MDG7 target 10; the SWA financial commitments, and more importantly the more specific sanitation commitments contained in the 2008 ethekwini declarations. This will serve as a spring forward to chart the way forward in implementing the sanitation commitments in the oncoming Sustainable Development Goals, expected to replace the MDGs whose terminal life expires this year.


 ‘Africasan4  is particularly strategic because it is taking place in the milestone’, said Bai Mass Taal,  the Executive Secretary of AMCOW, Bai Mass Taal. Of course, 2015 is the terminal year for the MDGs goals set in fifteen years, ago, and AfricaSan4 therefore provided an ample international platform to monitor national and continental progress in achieving the MDGs.

Bai Mass Taal, AMCOW's Executive Secretary

Bai Mass Maal, AMCOW’s Executive Secretary


According to Taal: ‘AfricaSan4 was expected to come up with commitments that will improve access to improved sanitation in the continent through the post 2015 development era. It will also outline the specific performance indicators for measuring the implementation of these actions in the next fifteen years’


How has African countries performed in achieving MDG 7 target 10 and the ethekwini commitments? The score card has not been impressive judging from indicators released during the meeting by the WHO/UNICEF Joint Monitoring Programme (JMP) for Water Supply and Sanitation and other stakeholders.


Globally, about 2.5 billion people remained without access to improved sanitation facilities, with 547m of this figure being in Africa. According to the WHO/UNICEF/JMP figures, in 2012, 115m urban residents in Africa rely on shared toilet or public sanitation facilities, and 65m people in rural areas did. Seven out of ten people in Africa, about 230m people, are without sanitation and are living in rural areas, most of them practice open defecation. Between 2000 and 2012, the number of people practising open defecation increased by 6m from 277m to 233m.


In 2012, sanitation coverage was less than 25% in 21 countries in Africa, little over half (53%) of the urban population in Africa used an improved sanitation facility, while only 30% of the population in rural areas used improved sanitation facility. ‘This data reminds us of the enormity and urgency of the challenge we face’, says Bai-Mass Taal


Fears that African countries may not be able achieve MDG7 target 10 have long been expressed by global bodies, including the United Nations Development Programme, that  published the landmark Human Development Index  report on the water supply and sanitation sector in 2006.


Titled: “Beyond Scarcity, Power, Poverty and the Global Water Crisis”, the 2006 UNDP HDI gave 2046 as the probable year many countries in sub Saharan Africa will attain the water target and 2076 as the probable year Africa will attain the MDG sanitation target! However, the UNDP report also stated that the targets are achievable with greater political will and resources:


“The word crisis is sometimes overused in development. But when it comes to water, there is a growing recognition that the world faces a crisis that, left unchecked, will derail progress towards the Millennium Development Goals and hold back human development. For some, the global water crisis is about absolute shortages of physical supply. The UNDP Report rejects this view. It argues that the roots of the crisis in water can be traced to poverty, inequality and unequal power relationships, as well as flawed water management policies that exacerbate scarcity”.


There is a strong nexus between water and sanitation, and it is well known that access to safe sanitation cannot be improved unless safe drinking water is available to those that presently lack it.


At AfricaSan4, the Water and Sanitation Programme of the World Bank,  listed ways to increase access, these are: implementing policy and financial support to lead to increased spending on sanitation services in order to attain set targets; ensuring funds and mechanisms are in place for adequate  operations and maintenance to sustain services; and targeting the poor by proving additional support to increase access for the poorest to ensure socio economic benefits are spread equitably among the population.


Already, the Sustainable Development Goals, expected to be adopted before the end o this year has proposed a specific water and sanitation goal as one of its 17 goals. Goal 6 is to  ensure availability and sustainable management of water and sanitation for all; and its sub targets include: (6.1) by 2030, achieve universal and equitable access to safe and affordable drinking water for all; (6.2) by 2030, achieve access to adequate and equitable sanitation and hygiene for all, and end open defecation, paying special attention to the needs of women and girls and those in vulnerable situations; and (6.b) support and strengthen the participation of local communities for improving water and sanitation management.


It is against this regional and global commitments that sanitation professionals gathered in Dakar last week of May, 2015 to consider ways of  ‘Making Sanitation for All a reality in Africa’, particularly  ending open defecation.


The key themes of the AfricaSan4 were centred around four sessions aimed at exploring how best performing countries have made progress towards these commitments, and to extract wider lessons. They are:creating an enabling environment, with a focus on examining progress towards the eThekwini commitments for enabling environment; finance and monitoring with a focus on examining progress towards the ethekwini commitments for financial and monitoring; cross cutting issues including the human right to sanitation, sustainability in sanitation services, gender equality and equity, civil Society role in sector governance and performance, sanitation and livelihoods, and governance, accountability and tackling corruption.


There  were also 10 special sessions on  capacity building and human resource development, technical and innovation fair, Community Led Total Sanitation and Sustainability, sanitation and maternal and newborn health, rural sanitation implementation, moving hygiene to scale, urban sanitation, sanitation experiences in urban and rural Senegal, public private cooperation to realise sanitation value chain, and how to create innovative awareness and behaviours change campaigns around sanitation and hygiene.  UNICEF convened a session to examine how to generate demand for sanitation, reviewing challenges of scaling up elimination of open defecation programms; and address the challenge of improving supply chains and services for improved sanitation to meet the growing demand.


The main speakers at the meeting are: President Macky Sall of Senegal; ;  Hon. Monsieur Mansour Faye- Minister of Water and Sanitation, Republic of Senegal/AMCOW’s President; Catarina de Albuqerque – UN Special Rapporteur on the right to safe drinking water and sanitation;  Bai-Mass Taal AMCOW’s Executive Secretary; Mohammed El Azizi, Director Water and Sanitation; African Development Bank;  Girish Mennon, Chief Executive Officer, WaterAid; and Ms Uschi Eid, Chair of the United Nations  Secretary General Advisory Board on Water and Sanitation (UNSGAB)


The conference received reports indicating that several countries in Sub Saharan Africa have made substantial progress in reducing open defecation, although the sub Saharan African region will not meet the Sanitation MDG. Also progress has been made in the eThekwini commitments which strengthen the enabling environment and lay the foundation for accelerated access to sanitation; while the sanitation sector is becoming more cohesive with increasing alignment of country sanitation priorities across processes such as AfricanSan and Sanitation and Water for All.

However, the consensus at the meeting is that African leaders have been long on commitments, but short in fulfilling them, they have been quick in making promises, but very slow in translating them into action. ‘What is missing is not the availability of policy framework but the political will, we must establish systems to track progress and ask government to account’, says Lovy Rasolofamanana, Country Representative, WaterAid, Madagascar. Echoing the same sentiment, one of the conference’s main speakers- Catarina de Albuqerque,  UN Special Rapporteur on the right to safe drinking water and sanitation said : ‘Political will is less about saying great things at conferences but about doing things when you get home’.


In the similar vein, AMCOW’s Executive Secretary, Bai Mass Taal pointed out that ‘only a few countries have dedicated budget lines for Sanitation’,  and called  for awareness raising and advocacy to sensitised political leaders for the  benefit of the sector.


At the end of the three day meeting, the key messages that resounded in the various sessions include the following:

  • Africa is strong on policy making, but weak on implementation.
  • Only two African countries- South Africa and Namibia have devoted at least 0.5% of their Gross Domestic Product (GDP) to finance sanitation budget in line with the ethekwini commitments.
  • Only nine African countries, mostly in the Maghreb region have met the MDG target for sanitation.
  • Only Burkina Faso has met 100% of his financial commitments to finance sanitation programmes in line with the SWA
  • Public finance is key to expanding sanitation coverage, and governments must do more to mobilise internal resources to finance sanitation.
  • Most efforts to drive sanitation access in Africa is done by external development parties.
  • Implementation and adoption of human right to water is key to universal access to sanitation.
  • There is a strong link between access to safe water and sanitation, and maternal and newborn baby health; and further research needs to be conducted to further investigate how water and hygiene can improve healthcare.
  • The private sector needs to be encouraged to participate in ‘sanitation business’ especially sanitation supply chain. Government should create enabling environment to stimulate private sector investment in sanitation.
  • Community Led Total Sanitation is still key in ending Open Defecation and needs to be scaled up at country levels.
  • Corruption still remains a sore point in expanding coverage of sanitation services, as the issue is not just about providing more funds, but ensuring the available funds are well managed.
  • There are wide inequalities in sanitation access between urban and rural areas: “inequalities are real and averages don’t tell the real story”. Monitoring Indicators should reveal inequalities in access to sanitation affecting vulnerable and marginalised groups.
  • Civil society have a key role to play in monitoring equity and ensuring implementation of the human right to sanitation.
  • Youths should be involved in the implementation as well and management of sanitation programmes, and targeting young people is key to behavioural change.
  • Why transparent budgeting is critical, tracking and monitoring sanitation expenditures is also key to good WASH governance.
  • Most water and sanitation policies do not connect access to safe water and hygiene with maternal and infant health.
  • Most women and young girls do not have access to safe sanitation during their menstrual periods, emphasising the need to break the taboo and secrecy on menstruation and promote Menstrual Hygiene Management (MHM)


The conference ended with declarations by both the civil society, and Ministers AMCOW.

The African Civil Society Network on Water and Sanitation (ANEW) in a statement signed by its Chairman, Leo Atakpu expressed concern that ‘implementation and financing’ of sanitation commitments are ‘still lagging behind and compromising universal access’, and pledged to continue to play its role as ‘watchdog to hold duty bearers accountable to right holders’.


African Ministers responsible for sanitation and hygiene on their part issued the ‘Ngor (a wolof word for dignity) declaration’, admitting that while an estimated 133 million people living in Africa gained improved sanitation since 1990, the level of progress has not kept pace with demograpic change; many countries do not have adequate high-level leadership, financial and human resources to implement existing policies, fail to tackle equity, do not build, manage or maintain sanitation system and services, or create the large-scale hygiene behaviour change;


The Ngor declaration reaffirmed the human right of safe drinking water and sanitation for all; welcomed  the aspiration of the draft Sustainable Development Goals which include an explicit target to “by 2030, achieve access to adequate and equitable sanitation and hygiene for all and an end to open defecation, paying special attention to the need of women and girls and those in vulnerable situations” committing to integrating these in national policies and plans;  and recommitted themselves to achieve universal access to adequate and sustainable sanitation and hygiene services and eliminate open defecation by 2030; and establishing  sanitation and hygiene budget lines that consistently increase annually to reach a minimum of 0.5%GDP by 2020.

Image result for AFRICASAN4

They also called on the Civil society in Africa to forge a cohesive, coherent and transparent vision and strategy to work with all stakeholders to achieve the  Ngor Declaration; the private sector to increase its engagement in the entire sanitation and hygiene value chain to improve innovation and efficiency;  and development banks, donors and partners to increase their support to government led efforts for universal access to sanitation and hygiene and to match this financial support with responsible accountable engagement.


 Babatope Babalobi +248035897435  is Chairman, Water and Sanitation Media Network Nigeria


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