19 November 2015: A panel discussion organized by UN-Water and the Permanent Mission of Singapore, on the occasion of World Toilet Day, focused on ‘Toilets and Health: Better Sanitation for Better Nutrition.’ Participants highlighted that the lack of access to clean drinking water and sanitation, along with the absence of good hygiene practices, are among the underlying causes of poor nutrition.

Deputy Secretary-General Jan Eliasson said the Sustainable Development Goal on water (SDG 6) makes clear that access to water, sanitation and hygiene (WASH) is essential, and highlighted that WASH has a strong impact both on SDG 2 on ending hunger and SDG 3 on health. Noting that the lack of appropriate sanitation leads to malnutrition – through diarrhea or intestinal worm infections – and is both responsible for 45% of child deaths and has strong negative effects on children’s cognitive development, by causing stunting, he stressed the need to create multi-stakeholder partnerships to meet the differentiated needs of men, women and children.

Mogens Lykketoft, President of the UN General Assembly (UNGA), underlined the need to complete the unfinished business of the Millennium Development Goals (MDGs) and to reach those people that the MDGs left behind: 2.4 billion people still do not use basic toilets; 1 in 7 people worldwide practice open defecation; and 50% of people living in rural areas lack improved sanitation facilities, compared to only 18% of people in urban areas. Lykketoft added that access to sanitation and hygiene is not just related to SDG 2 and 3 but also to SDG 15 (environmental sustainability), SDG 9 (sustainable infrastructure), SDG 10 (reducing inequalities), SDG 5 (through reducing violence against women and girls) and SDG 4 on education (by empowering women and girls with greater access to education and job opportunities).

Geeta Rao Gupta, UN Children’s Fund, said the lack of access to sanitation disproportionately affects women and girls and the most vulnerable groups of the society – the poor, the rural, migrants, and those in areas affected by conflict – and is a clear sign of inequality. “We put toilets in space, so shame on us if we cannot put toilets on earth,” she added.

Karen Tan, Permanent Representative of Singapore, expressed Singapore’s commitment to work on achieving the goal of ending open defecation, while Tanveer Aslam Malik, Minister of Housing, Urban Development and Public Health Engineering, Punjab, Pakistan stressed the need for cross-sectoral collaboration for WASH and nutrition.

Robert Chambers, Institute of Development Studies, University of Sussex, noted that open defecation itself is responsible for 54% of stunting, and underscored the necessity to map the “hotspots” in the world where it really impacts malnutrition. He noted it causes 65% of malnutrition in some places with high population density, and called for addressing, through public information campaigns, the under-estimation of fecal transmitted infections.

Jean Lapègue, Action Contre La Faim and Senior Advisor WASH, said work on malnutrition has traditionally been more focused on treatment, but now a paradigm shift is happening, with WASH and prevention also being taken into consideration. He underscored the need to treat at scale and highlighted that nutrition security depends on: health security – improving the conditions in health facilities; infrastructure; environmental security – need for environmental sanitation; feeding practices; and the stimulation of children. He also underlined the necessity to work on mothers and children as couples, in order to catalyze long-term behavioral change.

A representative of Unilever said the company will commit to helping 25 million people gain access to safe sanitation by 2020 and, in calling for an indicator on hygiene, underscored the need for indicators to address the cross-cutting linkages between nutrition and WASH.

The UN General Assembly designated 19 November as World Toilet Day in 2013. World Toilet Day 2015 focused on the links between sanitation and nutrition, drawing attention to the importance of toilets in supporting better nutrition and improved health [Website UN High-Level Water and Sanitation Days 2015] [Website World Toilet Day 2015] [IISD RS Sources] [IISD RS Story on World Toilet Day] [IISD RS Story on High-Level Water and Sanitation Days]