Water Currents: World Toilet Day 2020


On November 19, celebrate World Toilet Day 2020. This year’s theme—sustainable sanitation and climate change—explores the way flooding, drought, and rising sea levels can damage any part of a sanitation system, such as toilets, pipes, tanks and treatment plants, which leads to the spread of raw sewage. Sustainable sanitation systems keep untreated human waste out of the environment.

USAID prioritizes safely managed sanitation services that improve health outcomes and reduce pollution that comes from improper treatment and the spread of diseases. This entails a focus on not only containment, but also the emptying, transport, treatment, and safe disposal of waste. Any USAID investment in management of fecal waste must account for the final destination of the waste and take measures to ensure waste is not illegally dumped in the environment.

This issue features recent USAID sanitation publications as well as studies on COVID-19 and sanitation, sanitation financing, resource recovery, and other topics.

In Focus

World Toilet Day 2020: Sustainable Sanitation and Climate Change – World Toilet Day is a United Nations Observance that celebrates toilets and raises awareness of the 4.2 billion people living without access to safely managed sanitation. The celebration day encourages action to tackle the global sanitation crisis and achieve Sustainable Development Goal 6: water and sanitation. The website provides a ToolkitSocial Media Resources, and campaign materials.

Recent USAID Technical Guides and Resources
USAID Water and Development Technical Series. These technical briefs provide guidance on important topics for developing and implementing water and sanitation activities in support of the U.S. Government Global Water Strategy and USAID’s plan under the strategy. Technical Briefs on sanitation include:

  • Rural SanitationUSAID, September 2020. This technical brief provides an overview of the important factors to consider in rural sanitation programming, including information on how to address governance, financing, markets, and behaviors for sanitation.
  • Urban Sanitation ServicesUSAID, September 2020. This technical brief provides an overview of the important factors to consider in USAID's urban sanitation programming.

Policy Diffusion in the Rural Sanitation Sector: Lessons from Community-Led Total Sanitation (CLTS)World Development, December 2019. This paper uses a qualitative approach to analyze the reasons and processes that drove the wide diffusion of CLTS. The article was produced under USAID’s Water, Sanitation, and Hygiene Partnerships for Learning and Sustainability (WASHPaLS) project.

Enterprise Viability Case Study: A Retrospective Analysis of Rural Sanitation Enterprises in Bihar, IndiaUSAID WASHPaLS, March 2020. This case study examines the experience of sanitation enterprises that were supported by Population Services International's Supporting Sustainable Sanitation Improvements intervention in Bihar, India.

Webinar: Designing for Sustainability: Bringing Citywide Inclusive Sanitation to Debre Birhan, EthiopiaUSAID SWS, March 2019. SWS held a webinar on March 28, 2019, to discuss efforts to improve sanitation infrastructure and service delivery in the rapidly growing town of Debre Birhan, Ethiopia.

Water Service Provider COVID-19 Financial Stress Testing and MitigationUSAID WASH-Finance (WASH-FIN), July 2020. This technical brief discusses how Kenya emergency directives amplified the financial effects of the pandemic on water service providers (WSP). Based on consultations with WSPs, WASH-FIN found that COVID-19 increased financial stress because the WSPs took on new tasks they had not performed prior to the pandemic, and also faced a sharp decline in revenue collection.

Customer Service Reform for Water and Sanitation Service Providers: The Cape Town ExperienceUSAID WASH-FIN, March 2020. This case study illustrates the lessons learned from the City of Cape Town’s post water-crisis reform experiences. The city undertook important measures to improve its water and sanitation department’s customer relationship management systems, with assistance from USAID.

Financing Water, Sanitation and Hygiene in COVID-19 Era: Lessons from KenyaSanitation and Water for ALL Blog, October 2020. The WASH-FIN program in Kenya undertook assessments that revealed water service providers across Kenya saw a 50 percent drop in revenue collection, limiting their ability to meet operational costs for electricity, chemicals, staff costs, and statutory obligations. The assessment concluded that by July 2020, WSPs in Kenya owed US$2.8 million in unpaid electricity bills.

Jeff Albert and Jesse Shapiro on Researching Best Practices for WASH Service Delivery and Sustaining Behavior ChangeGlobal Waters Radio, April 2020. Jesse Shapiro is a senior WASH advisor at USAID and Jeff Albert is WASHPaLS’ deputy director, and they share insights on how this initiative has been identifying, researching, and sharing best practices for WASH service delivery and sustaining WASH behavior change, with a special emphasis on the program’s work related to sanitation.

Measuring Systems Change in WASH Programming: A Practical Application of Two ToolsUSAID Sustainable WASH Systems Learning Partnership (SWS), August 2020. SWS built a complexity-aware monitoring approach to measure changes in local WASH systems as part of its performance management framework that includes outcome mapping and sustainability scorecards.

State of the World’s SanitationUNICEFWHO, November 2020. The report State of the World’s Sanitation: An Urgent Call to Transform Sanitation for Better Health, Environments, Economies and Societies, will be launched on World Toilet Day and available on this page. The report brings together the data on sanitation coverage and investment, and how it impacts health, economies, and the environment.

Contributions of Recycled Wastewater to Clean Water and Sanitation Sustainable Development Goalsnpj Clean Water, April 2020. This paper discusses the potential of recycled wastewater to become a significant source of safe water for drinking purposes and improved sanitation in support of the Sustainable Development Goals.

Evaluation of User Experiences for the Clean Team Ghana Container-Based Sanitation Service in Kumasi, GhanamedRXiv, October 2020. While one product or service does not fit the needs of all customers, this evaluation supports the growing body of evidence that container-based sanitation provides a service valued by users and acceptable to policymakers in dense urban settlements.

Poor Sanitation is the Shittiest Consequence of Climate ChangeIRC WASH, November 2019. Sanitation services are essential for human health, but their technologies and their management systems are indeed potentially vulnerable to climate change, yet in contradiction they also play a significant role in pollution and greenhouse gases.

Evaluating the Circular Economy for Sanitation: Findings from a Multi-Case ApproachScience of The Total Environment, November 2020. This research identifies the main barriers and enablers for circular sanitation business models to succeed.

Review of Frameworks and Tools for Urban Strategic Sanitation Planning: Considering Technology Innovations and SustainabilityJournal of Water, Sanitation and Hygiene for Development, September 2020. This study provides a historical review of frameworks for strategic sanitation planning and compares how 15 tools address the current urban sanitation challenge.

Sanitation and COVID-19
COVID Financial Impact Assessment Tool for Water and Sanitation Providers User GuideWorld Bank, June 2020. This is a financial planning tool to help water and sanitation providers quantify the financial impact on their operations and make evidence-based justifications for additional funding as a response to the pandemic.

Tracking SARS-CoV-2 in Sewage: Evidence of Changes in Virus Variant Predominance during COVID-19 PandemicViruses, October 2020. This article concludes that viral RNA sequences found in sewage closely resemble those from clinical samples and that environmental surveillance can be used in monitoring SARS-CoV-2 transmission, tracing virus variants, and detecting virus importations.

Rethinking Wastewater Risks and Monitoring in Light of the COVID-19 PandemicNature Sustainability, August 2020. Converging evidence from the current pandemic, previous outbreaks, and controlled experiments indicate that SARS-CoVs are present in wastewater for several days, leading to potential health risks via waterborne and aerosolized wastewater pathways.

Tracking COVID-19 with WastewaterNature Biotechnology, September 2020. Wastewater testing captures the rise and fall of novel coronavirus cases in New Haven, Connecticut, a mid-sized metropolitan region.

SARS-CoV-2 in River Water: Implications in Low Sanitation CountriesScience of the Total Environment, November 2020. This is the first report of SARS-COV-2 in river waters highly impacted by sewage.

SARS-CoV-2 from Faeces to Wastewater Treatment: What Do We Know? A ReviewScience of the Total Environment, November 2020. This review aims to understand the viral load of SARS-CoV-2 in feces and sewage and its fate in wastewater treatment plants.

Sanitation Financing
A Review of the Financial Value of Faecal Sludge Reuse in Low-Income CountriesSustainability, October 2020. The most common form of reuse in practice is agricultural composting, which is also the lowest value product. Few cases were able to achieve more than $5/person/year from sludge reuse, therefore, other drivers are needed to promote proper human waste disposal.

Integrating Savings and Income-Generating Activities into Community Health Clubs for Improved SanitationPRO-WASH, September 2020. A qualitative study was undertaken to better understand barriers and motivators to latrine construction and how, and if, the integration of these activities with Community Health Clubs improved uptake of latrine construction. This learning brief shares key study findings along with additional lessons from implementation.

Financing Water Supply and Sanitation in a Changing ClimatePacific Institute, October 2020. This report examines the energy and greenhouse gas implications of expanding access to safely managed water and sanitation, presents the current understanding of the climate impacts affecting water resources and built water systems, and assesses these impacts in the context of specific water supply and sanitation interventions.

When Pits Fill Up: Supply and Demand for Safe Pit-Emptying Services in Kisumu, KenyaPLoS ONE, March 2020. To determine the degree to which market forces can promote safe fecal sludge removal in low-income neighborhoods of Kisumu, Kenya, researchers compared household willingness-to-pay for formal pit emptying with the prices charged by service providers.

Costs, Climate and Contamination: Three Drivers for Citywide Sanitation Investment DecisionsFrontiers in Environmental Science, August 2020. This paper provides insights into how existing evidence on contamination, climate change, and costs can inform decisions on sanitation investments and help chart a sustainable way forward for achieving citywide services.

Sustainable Sanitation and Gaps in Global Climate Policy and Financingnpj Clean Water, May 2020. The authors describe gaps in how sanitation is being addressed in mitigation and adaptation, discuss how this results in little inclusion of sanitation in climate policy and financing at the global level, and explore implications of these gaps for different sanitation systems and geographic regions.

Resource Recovery
Advancing Sustainable Sanitation and Agriculture through Investments in Human-Derived Nutrient SystemsEnvironmental Science & Technology, June 2020. This research makes a case for supporting innovative sanitation strategies and the development and financial support of human-derived fertilizer markets in areas with poor fertilizer and sanitation access.

Re-Envisioning Sanitation as a Human-Derived Resource SystemEnvironmental Science & Technology, August 2020. The authors developed a framework that offers a shared vision for sanitation as a human-derived resource system, where people are part of the resource cycle.

From Waste to Resource: Shifting Paradigms for Smarter Wastewater Interventions in Latin America and the CaribbeanWorld Bank, March 2020. This report summarizes the work of the World Bank’s initiative "Wastewater: From Waste to Resource," launched to raise awareness among decision-makers regarding the potential of wastewater as a resource.

Comparative Analysis of Sanitation Systems for Resource Recovery: Influence of Configurations and Single Technology ComponentsWater Research, November 2020. The authors developed five recommendations for the optimization of resource recovery. Two of these are to prioritize short systems that close the loop at the lowest possible level and to separate waste streams as much as possible, because this allows for higher recovery potentials.

Global and Regional Potential of Wastewater as a Water, Nutrient and Energy SourceNatural Resources Forum, January 2020. This study provides insights into the global and regional potential of wastewater as water, nutrient, and energy sources. Facilitating and expediting implementation of resource recovery innovations is particularly needed in low- and middle‐income countries where most municipal wastewater still goes into the environment untreated.

Exploring the Use and Appeal of Playpens to Protect Infants from Exposure to Animals, Animal Feces, and Dirt in Rural EthiopiaAmerican Journal of Tropical Medicine and Hygiene, November 2020. The authors conclude that playpens alone cannot protect infants from environmental contamination, but results support further exploration of the potential benefits and commercial viability of scaling up use of playpens in rural, agricultural households.

Regulating Citywide Inclusive SanitationIWA, October 2020. Panelists on this webinar share their experiences from Latin America, Africa, and Asia and address how they are using regulatory tools and instruments to incentivize investment and innovation in underserved areas.

Women Are More Likely to Expect Social Sanctions for Open Defecation: Evidence from Tamil Nadu IndiaPLoS ONE, October 13, 2020. Open defecation practices are known to cause psychosocial stress among women due to their experiences with sanitation insecurity. Results highlight the need for gendered intervention strategies when sanitation programs leverage social influence for behavior change.

Technical Brief on Water, Sanitation, Hygiene (WASH) and Wastewater Management to Prevent Infections and Reduce the Spread of Antimicrobial Resistance (AMR)FAOWHO, 2020. This technical brief on WASH and wastewater management to reduce the spread of AMR provides a summary of evidence and rationale for WASH and wastewater actions within AMR national action plans.


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