'No protection from human excreta = unimproved sanitation.' 6 out of every 10 people on Earth still do not have access to flush toilets or other adequate sanitation that protects the user and the surrounding community from harmful health effects. Graphic: Baum, et al., 2013

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20 February 2013 It may be the 21st century, with all its technological marvels, but 6 out of every 10 people on Earth still do not have access to flush toilets or other adequate sanitation that protects the user and the surrounding community from harmful health effects, a new study has found. The research, published in ACS’ journal Environmental Science & Technology, says the number of people without access to improved sanitation is almost double the previous estimate. Jamie Bartram and colleagues explain that the current definition of “improved sanitation” focuses on separating humans from human excrement, but does not include treating that sewage or other measures to prevent it from contaminating rivers, lakes and oceans. Using that definition, 2010 United Nations estimates concluded that 4.3 billion people had access to improved sanitation and 2.6 billion did not. The new estimates used what the authors regarded as a more realistic definition from the standpoint of global health, since untreated sewage is a major cause of disease. They refined the definition of “improved sanitation” by discounting sewage systems lacking access to sewage treatment. They concluded that about 60 percent of the world’s population does not have access to improved sanitation, up from the previous estimate of 38 percent.

Six in 10 people worldwide lack access to flush toilets or other adequate sanitation

ABSTRACT: Progress toward the sanitation component of Millennium Development Goal (MDG) Target 7c was reassessed to account for the need to protect communities and the wider population from exposure to human excreta. We classified connections to sewerage as “improved sanitation” only if the sewage was treated before discharge to the environment. Sewerage connection data was available for 167 countries in 2010; of these, 77 had published data on sewage treatment prevalence. We developed an empirical model to estimate sewage treatment prevalence for 47 additional countries. We estimate that in 2010, 40% of the global population (2.8 billion people) used improved sanitation, as opposed to the estimate of 62% (4.3 billion people) from the WHO/UNICEF Joint Monitoring Programme (JMP), and that 4.1 billion people lacked access to an improved sanitation facility. Redefining sewerage-without-treatment as “unimproved sanitation” in MDG monitoring would raise the 1990 baseline population using unimproved sanitation from 53% to 64% and the corresponding 2015 target from 27% to 32%. At the current rate of progress, we estimate a shortfall of 28 percentage points (1.9 billion people) in 2010 and a projected 27 percentage point shortfall in 2015.

Sanitation: A Global Estimate of Sewerage Connections without Treatment and the Resulting Impact on MDG Progress