The forgotten right to sanitation

The forgotten right to sanitation | Photo: Daniel Cheung

Published on 11 July 2026 at 00:58 GMT

By Editorial Team SDG6

Sanitation is one of the foundations of public health, but it is often discussed only when systems fail. Toilets, sewers, septic tanks, drainage, handwashing facilities and wastewater treatment determine whether human waste is safely contained or allowed to contaminate homes, streets, soil and water. The human right to sanitation is therefore not a secondary development concern. It affects whether people can attend school, use public space, manage menstruation, receive safe health care and live with privacy and dignity.

UN-Water, which coordinates the United Nations system’s work on water and sanitation, defines the right to sanitation as access to facilities that are safe, hygienic, secure, affordable, socially acceptable and capable of providing privacy. The United Nations General Assembly recognised safe drinking water and sanitation as a human right in 2010. This recognition established an important principle: sanitation should not depend entirely on income, geography, gender, disability or social status.

Yet political attention frequently concentrates on water supply while sanitation remains less visible. A new water point can be photographed and counted. The sanitation chain is more complicated. It begins with access to a suitable toilet, but it also includes the collection, emptying, transport, treatment and safe disposal or reuse of waste. A toilet does not provide safely managed sanitation when its contents leak into the environment or are discharged untreated elsewhere.

The WHO/UNICEF Joint Monitoring Programme for Water Supply, Sanitation and Hygiene is the main international system for tracking progress. It distinguishes between different levels of service, including facilities shared by households, basic sanitation and safely managed systems. This approach matters because the presence of a toilet alone says little about what happens after it is used.

The public-health consequences are substantial. The World Health Organization (WHO) states that inadequate sanitation and untreated human waste can contaminate groundwater and surface water used for drinking, irrigation, bathing and domestic activities. Poor water, sanitation and hygiene services are associated with preventable illness and wider damage to well-being, livelihoods and community resilience.

Sanitation policy is therefore inseparable from SDG 6 (clean water and sanitation). Target 6.2 calls for adequate and equitable sanitation and hygiene for all, an end to open defecation and particular attention to the needs of women, girls and people in vulnerable situations. The word equitable is central. National progress can conceal major differences between wealthy and low-income households, urban and rural areas, formal neighbourhoods and informal settlements.

In many rapidly growing cities, sanitation systems have not expanded at the same pace as the population. Residents of informal settlements may live beyond sewer networks, in areas where roads are too narrow for waste-removal vehicles or where insecure land tenure discourages public investment. Households may rely on shared toilets, makeshift facilities or pits that are difficult to empty safely.

Informal legal status should not be used to deny essential services. Governments may fear that providing infrastructure will appear to recognise unauthorised settlements. However, withholding sanitation does not resolve disputes over land. It instead exposes residents and surrounding communities to health and environmental risks. Contamination does not remain within administrative boundaries.

Conventional sewer systems are not the only answer. They can be expensive, water-intensive and difficult to extend in dense or remote areas. Depending on local conditions, decentralised treatment, properly managed septic systems, communal facilities or other forms of inclusive urban sanitation may be more practical. The important test is whether the entire service chain protects users, workers and the environment.

Shared and public toilets are particularly important for people who work in markets, transport hubs, streets and other public spaces. They also affect older people, children, pregnant women and people with medical conditions. A city cannot claim to be inclusive when basic bodily needs can be met only by purchasing food or entering a private commercial building.

Availability alone is not enough. Public toilets must be clean, affordable, well lit, accessible to people with disabilities and designed to provide privacy. Opening hours, locks, water, soap, disposal facilities and regular maintenance all influence whether a toilet can be used safely. Dignity in public facilities is created through ordinary operational decisions, not simply through construction.

Gender shapes the experience of sanitation. Women and girls may face longer queues, greater privacy requirements and safety risks when facilities are distant or poorly designed. Care responsibilities can also mean accompanying children, older relatives or family members with disabilities. These realities should influence the number, location and layout of facilities.

Menstrual health makes the connection between sanitation, education and gender equality especially clear. A suitable school or workplace requires private toilets, water, handwashing facilities and safe methods for changing and disposing of menstrual materials. Information and affordable products are also necessary. UNICEF notes that poverty, gender inequality and social taboos can prevent menstrual health needs from being met.

The absence of these conditions can restrict participation in school and public life. Menstruation is not itself a sanitation problem, but inadequate facilities can turn a normal biological process into a source of anxiety, exclusion or missed learning. Menstrual health and hygiene should therefore be included in education budgets, building standards and school management rather than treated as a private matter for individual students.

This connection supports SDG 4 (quality education) and SDG 5 (gender equality), even though SDG 6 remains the primary framework. Students cannot benefit equally from education when school facilities do not meet their basic needs. Sanitation policy consequently affects attendance, concentration, safety and the ability of students to participate without embarrassment or avoidable disruption.

Health-care facilities provide another critical test. Toilets, water, hand hygiene, cleaning systems and safe waste management are necessary for infection prevention. A clinic without adequate sanitation places patients, health workers and surrounding communities at risk. The WHO identifies water, sanitation and hygiene as essential components of safe and effective health services, including during emergencies.

Sanitation also depends on a workforce whose contribution is frequently overlooked. Workers empty pits and septic tanks, clear sewers, transport waste, clean public toilets and operate treatment facilities. They provide an essential public service but may face unsafe conditions, social stigma, inadequate equipment and insecure employment. The WHO has warned that sanitation work often comes at the expense of workers’ own health, safety and dignity.

Mechanisation, protective equipment, training, fair contracts and enforcement of labour standards are necessary parts of sanitation worker safety. A system cannot be described as safely managed when it protects users by transferring danger to workers. Public authorities and private contractors should be accountable for conditions across the entire sanitation chain.

Wastewater is another neglected part of the debate. Untreated discharges can damage rivers, coastal ecosystems and groundwater, while poorly controlled industrial waste may introduce additional hazards. Treatment requires land, energy, technical knowledge, maintenance and stable financing. Infrastructure that is built without budgets for operation can deteriorate long before the end of its expected life.

At the same time, treated wastewater and recovered nutrients may have productive uses where health and environmental safeguards are strong. Resource recovery can reduce pollution and support more circular urban systems. It should not, however, become a justification for weak regulation or unsafe exposure. Wastewater treatment and reuse must be based on monitoring and public-health standards.

Climate change is placing additional pressure on sanitation systems. Flooding can overwhelm sewers, spread waste and damage toilets, while drought can reduce the water available for conventional systems. Sea-level rise threatens infrastructure in coastal settlements. Resilient sanitation planning must account for these risks instead of relying solely on historical weather patterns.

Displacement and humanitarian emergencies create even more difficult conditions. Temporary camps and informal shelters require rapidly installed facilities, but emergency sanitation must still consider privacy, lighting, accessibility, menstrual needs and protection from harassment. Facilities that are technically present but unsafe to reach cannot be treated as adequate.

Financing remains one of the largest barriers. Sanitation infrastructure is expensive to construct and maintain, while many of its benefits appear as avoided illness, cleaner environments and greater participation rather than direct financial returns. This can make it less attractive to investors than services capable of producing predictable revenue.

Public funding is therefore unavoidable, particularly for low-income communities and systems serving schools, clinics and public spaces. Tariffs may contribute to operational costs, but charges must not make essential sanitation unaffordable. Governments need transparent subsidies and financing arrangements that prioritise those facing the greatest barriers rather than concentrating investment in already well-served areas.

Accountability is equally important. Responsibilities are often divided among ministries, municipalities, utilities, health authorities and private providers. When maintenance fails, each institution may claim that another is responsible. Clear service standards, public data, independent regulation and channels for complaints are necessary to turn formal rights into practical access.

Community participation can improve planning, particularly when facilities are intended for groups whose needs are frequently ignored. Women, people with disabilities, sanitation workers, tenants and residents of informal settlements should be involved before designs and locations are finalised. Consultation cannot replace government responsibility, but it can reveal why technically sound projects sometimes remain unused.

Sanitation is easily forgotten because successful systems remove waste from sight. That invisibility is a sign of functioning infrastructure, but it can also weaken political commitment. The consequences become visible only through polluted water, overflowing drains, closed school toilets or unsafe working conditions.

The right to sanitation requires more than counting toilets. It requires universal access to safe sanitation, reliable management of waste, inclusive public facilities and respect for the people who use and maintain them. Progress under SDG 6 will depend on whether governments treat sanitation as essential public infrastructure rather than a private household problem.

A safe toilet represents something larger than a piece of equipment. It allows a child to remain at school, a worker to participate in public life, a patient to receive safer care and a community to protect its water and environment. Sanitation may be among the least discussed development issues, but it remains one of the clearest measures of whether public systems recognise everyday human dignity.

Further information:

* UN-Water, the United Nations coordination mechanism for water and sanitation and an official source on SDG 6 and the human rights to water and sanitation. https://www.unwater.org/

* WHO/UNICEF Joint Monitoring Programme for Water Supply, Sanitation and Hygiene, the custodian of global data on household, school and health-care WASH services. https://washdata.org/

* World Health Organization, an official source on sanitation, wastewater, public health and the working conditions of sanitation workers. https://www.who.int/health-topics/water-sanitation-and-hygiene-wash

* UNICEF, an official source on WASH services for children, schools and menstrual health and hygiene. https://www.unicef.org/wash

* WaterAid, an international civil society organisation working on water, sanitation and hygiene access and public accountability. https://www.wateraid.org/