Our Vision: Enable widespread use of safely managed, sustainable sanitation services, contributing to positive health, economic, and gender equality outcomes for the world’s poorest.

The Challenge

In This Page The Challenge





At A Glance up In the developing world, an estimated 4.5 billion people practice open defecation or use facilities that do not safely dispose of human waste. Inadequate sanitation and hygiene are estimated to have caused more than half a million deaths from diarrhea alone in 2016. Safe sanitation is essential to a healthy and sustainable future for developing economies. The foundation focuses on accelerating innovations in non-sewered sanitation technology and service delivery, particularly in densely populated areas of South Asia and Sub-Saharan Africa. Our Water, Sanitation & Hygiene strategy is led by Brian Arbogast and is part of the foundation’s Global Growth & Opportunity Division. down

Unsafe sanitation is a massive problem that is becoming more urgent as our global population increases and trends like water scarcity and urbanization intensify. About 4.5 billion people—more than half the world’s population—either practice open defecation or use unsafe sanitation facilities and services. To be effective, sanitation must be carefully managed at all stages, from the point that waste is collected and contained to how it is transported and treated. If there are gaps or breaks at any stage, then harmful human waste flows into surface waters and fields where children play and people of all ages live, eat, drink and bathe.

Poor sanitation, which is widely accepted as a chief contributor to waterborne diseases, is the cause of more than 1,200 deaths of children under five-years-old per day, more than AIDS, measles, and tuberculosis combined. Inadequate sanitation and hygiene were the cause of more than half a million deaths from diarrhea alone, in 2016. Despite the indisputable connection between poor sanitation and human health risks, sanitation models and services aren’t improving quickly enough. According to the World Health Organization and UNICEF, sanitation rated as “safe for people” increased by only three percent worldwide over the last five years.

Creating sanitation infrastructure and public services that work for everyone and keep human waste out of the environment is difficult—and it isn’t a one-size-fits-all proposition. The toilets, sewers, and wastewater treatment systems that made sense in the past aren’t necessarily the best solutions for the future, especially in poor countries. These types of systems require vast amounts of land, energy, and water and are extremely expensive to build, maintain, and operate, even by western standards. They are particularly difficult to introduce, as new infrastructure, into dense urban settings and informal settlements, where the impact of unsafe sanitation on people is the greatest.