The second WTO

The World Toilet Day of the WTO is in 10 days. Why do we have a World Toilet Day? It is nothing to celebrate. It is a reminder that more effort is needed to provide 2.6 billion people without access to sanitation with a toilet. Whereas a lot of progress has been made in the last decades to supply people around the world with access to safe drinking water, little or no progress has been made to provide them with adequate sanitation. But if we belief the health literature, adequate sanitation is as (if not more) effective to reduce child morbidity and mortality as safe water access (a recent literature review can be found on the website of 3ie). A recent Lancet’s editorial even argued that “adequate sanitation is the most effective public health intervention the international community has at its disposal” (The Lancet Editorial, 2007).

If the health impacts of improved sanitation are as large, why are still so many without it?  There are several economic reasons I can think of, why this might be the case: first, the direct health benefits of improved sanitation – involving invisible bacteria and parasites – are hard to understand and internalize, especially for populations with little or no formal education. Improved water access – in contrast – has in addition to health benefits often direct economic benefits in form of large time savings to collect water. Second, with high initial costs of sanitation facilities and (uncertain) health benefits that might only occur in the far future, individuals with limited access to credit and/or high discounting rates will generally under-invest in precautionary health care measures. Third, with disposal of human feces in public areas as a natural alternative to sanitation facilities, the social benefits of proper sanitation are likely to exceed the private ones: positive externalities of sanitation might lead to underinvestment.

But despite possible sub-optimal market outcomes, public investments remain low. Most donors focus their water and sanitation policies on water supply at the expense of sanitation and investments in adequate sanitation are usually not high on the policy agenda of domestic governments. The cynical observer might argue that sanitation, or the disposal of human waste, is an unpopular subject, which might not be appealing for both international aid agencies and national governments. But I can also think of two other closely linked reasons. First, there is still a lack of clearly defined solution strategies – not from an engineering but from a social science point of view – and second, and directly linked to the first point, the lack of research in social sciences on sanitation is striking. Being an economist, I did a quick economic literature review. Research on sanitation barely exists beyond cost-benefit analysis. Between 1970 and 2009 only ten articles with a focus on sanitation were published in 100 of the top economic journals. And the situation is probably not much different in political science…