The sanitation sector, one of the worst performing of the “basic services” sectors, could hold the key to understanding how the world can achieve the United Nations’ Sustainable Development Goals (SDGs). The SDG sanitation target requires universal access to safely managed toilets and hygiene practices by 2030—a tall order for the sector, which faces trajectories suggesting it will not reach this target in Africa or South Asia for at least another century. How is it possible, then, to turn around this laggard sector? And could its past successes provide lessons for how to achieve other SDG goals?
WaterAid—an international non-profit organization working to improve access to safe water, hygiene, and sanitation—researched whether any country had ever accomplished rapid transformation in the sanitation sector in a timeframe consistent with the 15 years set by the SDGs. The research focused on several public policy and political “drivers” in Singapore, South Korea, Malaysia, and Thailand, and analyzed how these drivers translated into universal access to toilets and helped shift the public’s attitude toward hygiene practices. The findings identified not only how these states achieved universal access to sanitation within two decades, but also distinguished the conditions needed to help developing countries achieve other SDGs.
The research emphasized the importance of a state’s leadership in changing the nation’s norms and the structures necessary to deliver universal access to sanitation, particularly in terms of maintaining political will and overcoming implementation challenges.
Authorities presented sanitation, hygiene, and public cleanliness as the necessary trappings of modernity that would lead to national success. Sanitation was repeatedly articulated as a necessary condition for attracting foreign investment and building a regional economic competitive advantage. The idea of sanitation as a public good was critical in the early stages of these countries' post-colonial nation-building projects. The public viewed sanitation, and the accompanying changes in social attitudes toward toilet use, as a social contract between the state and its citizens, particularly as leadership promoted adherence to the contract as the hallmark of good citizenship. The state promised to deliver public goods in exchange for citizens adhering to normative standards of civic behavior, such as ending open defecation.
Indian Prime Minister Modi should take note of this method in executing his flagship sanitation policy, Swachh Bharat Mission (or “Clean India Mission”). As it stands, the policy focuses too heavily on meeting targets relating to the construction of household toilets while neglecting the equally important changes that need to place in societal behavior.
East Asian governments also worked diligently to understand and overcome implementation challenges that are instrumental to success. They did not restrict themselves to speeches and high profile declarations; rather, they promoted a progress-focused approach through ongoing engagement with the institutions and governance that delivered the governance reforms. As noted by Malaysian Deputy Prime Minister Abdul Razak Hussein, political elites driving at wholesale transformation must become “breakers of bottlenecks.”
Without a blueprint to guide them, leaders instructed authorities to identify sanitation implementation obstacles and formulate public policy and technocratic remedial responses. Rapid cyclical monitoring allowed leaders to reward performance improvements and to raise sanitation services standards. Bureaucratic incentives rewarded infrastructure and policy innovations that responded to the implementation challenges. Every two years, for example, South Korea’s then President Park Cheung Hee issued a new Presidential Decree urging improvements in the delivery of sanitation and hygiene practices. This included, for instance, requiring household investments in building village drainage and sanitation infrastructures, which allowed sanitation reforms to take effect immediately.
In addition to swift implementation, WaterAid’s research also demonstrated that widespread, large-scale change requires multiple levels of performance monitoring and coordination between different sectors at all tiers of the implementation chain. Malaysia’s Deputy Prime Minister said development teams “must also, at least once a week, have... ‘morning prayers,’ where all departmental officers get together and, instead of writing tedious minutes on files to each other, they settle their departmental differences together, in a coordinated way, in front of the maps in their operations rooms.”
In the case of sanitation improvements, this type of organization requires simultaneous cooperation between education, housing, environmental health, public media, water, and drainage departments. It must also include tough sanctions for non-compliance. Public health and education outlets in the four East Asian countries also ran campaigns identifying open defecation as a “backward practice.” In Singapore, the government imposed punitive sanctions and fines for those engaging in unsanitary toilet practices, discouraging unhygienic behavior.
Ongoing monitoring and adaptive management could be the pillars for success in delivering quality services in other SDG sectors. Although they should not be viewed as fixed models for addressing other sustainable development issues, East Asian states have created an instructive outline for other countries to use when designing programs to meet SDG targets.
However, several questions remain regarding whether the historical contexts and specificities of the East Asian countries’ political economies were the key determinants of sanitation improvements, rather than the processes and mechanisms WaterAid’s research identified as critical. The “initial conditions” in East Asia were wholly different from those faced by contemporary Sub-Saharan African and South Asian countries. However, the research found that reaching a threshold of national wealth was not a key determinant in the leaderships’ resolve to achieve universal access to sanitation, an encouraging statistic for today’s Least Developed Countries (LDCs). The figures in Table 1 (below) show that setting the course for achieving universal access to sanitation has little to do with GDP per capita.
When newly independent East Asian states were in their most formative stages of development, they set a course for universal access to sanitation as part of a larger nation-building project. They did so with per capita incomes and aid receipts comparable to, and sometimes even lower than, those of their African counterparts—suggesting that prioritizing universal access to sanitation does not depend on achieving a particular income threshold.
Caution should be applied to extrapolating East Asia’s experience to present-day, lesser-developed, lower-middle-income countries. Nevertheless, for fragile states grappling with the challenge of meeting challenging SDG targets and achieving “escape velocity” from low progress trajectories across a range of sectors, the sanitation lessons of East Asia highlight the importance of investing political capital in monitoring and cyclical reforms. Countries must significantly invest in the structures necessary to achieving these goals, as well as build the capacity to identify and respond to systemic weaknesses. This approach is critical, potentially not only in countries’ efforts to improve sanitation and hygiene, but also to achieve human development gains across all the SDGs.
This article is based on WaterAid’s research and synthesis paper – Achieving Total Sanitation and Hygiene coverage within a generation – lessons from East Asia (WaterAid - Jan 2016) by Henry Northover, Tim Brewer, and Shin Rue Kyu.