Clean Water and Sanitation

Why access to safe water and toilets has large economic and health benefits, and what India's Swachh Bharat Mission achieved.

Access to clean water and safe toilets is basic to health and dignity. It is also important economically: poor sanitation spreads disease, harms children’s growth, and costs time and income.

The global picture

According to the WHO and UNICEF Joint Monitoring Programme, around 2 billion people still lacked safely managed drinking water and several billion lacked safely managed sanitation in recent years. Diarrhoeal diseases linked to unsafe water and sanitation kill hundreds of thousands of people a year, many of them young children.

Economic costs

Health costs: illness reduces work and increases medical spending.
Stunting: repeated infections in early childhood are linked to stunted growth, with lasting effects on learning and earnings. Research by Dean Spears and others linked open defecation in India to children’s height.
Time: collecting water, often done by women and girls, takes hours each week.
Education: girls may miss school without private toilets.

The WHO has estimated that investments in water and sanitation bring economic returns several times their cost.

Swachh Bharat Mission

India launched the Swachh Bharat Mission in October 2014, aiming to end open defecation by building toilets and changing behaviour. Over 100 million household toilets were built in rural areas. In 2019, the government declared rural India open-defecation free. Independent surveys found large increases in toilet access and use, though some people continued to defecate in the open, showing that building toilets and changing habits are both needed.

The Jal Jeevan Mission, launched in 2019, aims to provide piped water connections to every rural household.

The value of a tap at home

A woman who spends two hours a day fetching water from a distant well gains those hours when a tap is installed at home. She can use the time for paid work, rest or her children's education. Her family also faces less risk of illness from contaminated water.

Challenges

Maintaining water supply systems, ensuring toilets are used and safely managing waste remain challenges. Sanitation also depends on social norms, which can take time to change.

Thinking building infrastructure is enough

Toilets and pipes only help if they are maintained and used. Behaviour change, community involvement and ongoing funding for upkeep are as important as construction.

Key takeaways

Billions of people still lack safely managed water or sanitation.
Poor sanitation causes disease, stunting and lost time, especially for women and girls.
India's Swachh Bharat Mission built over 100 million rural household toilets from 2014.
Maintenance and behaviour change are as important as building infrastructure.