Recent efforts

Over the past five years many external support agencies and some national governments have made increased efforts to promote sanitation and seek ways to create political will in support of sanitation programmes. Others have evaluated existing sanitation projects and programmes to determine what lessons have been learned from their successes or failures. These efforts have contributed to sector thinking on principles and best practices, particularly as they relate to community and household-based approaches to sanitation.

Many external support agencies and selected national and sub-national governments have also implemented and documented pilot sanitation projects that have demonstrated the effectiveness of a particular programming approach, technology, or management model. Progress has also been made in improving the connection between lending institutions and NGOs who operate at the local level - an important advance because scaling up has often failed due to a disconnection here.

Despite these efforts the recent Global Water Supply and Sanitation Assessment 2000 Report showed that sanitation coverage still lags far behind water supply coverage throughout the developing world, particularly in Africa and Asia. In addition, coverage in rural areas is less than half of that in urban areas. The majority (80%) of those lacking adequate sanitation services live in rural areas.

Significant, and in many cases growing, numbers of rural and urban poor families are living in unhealthy environments because they lack access to adequate sanitation and have not been made aware of appropriate hygiene practices.

It is increasingly recognized that health risks in urban areas are often greater than in dispersed rural areas. Many of the pilot projects have targeted these families, but increasingly it appears that the successful sanitation pilots are not being replicated elsewhere in the country, much less scaled up to a national level.