Advocating With Passion


How Investing in Sanitation, Hygiene Pays Back Well



Christopher W. Williams (PhD) is an eloquent advocate of water supply, sanitation and hygiene. As Executive Director of the Water Supply & Sanitation Collaborative Council (WSSCC), the lone international institution with a United Nations mandate to work on sanitation, he is busy selling the agenda and the best ways to achieve improvements, within global development circles. Before being appointed to lead the Council, Williams worked with UN-Habitat at various senior levels. Trained in economics, sociology, public policy and political science, Williams is well versed with all of them and easily switches between them in evidencing his arguments. In this exclusive interview with GETACHEW T. ALEMU, FORTUNE’S OP-ED EDITOR, held at the sidelines of the Third Financing for Development (FfD) Conference, Williams shares his thoughts about the political rationale for investing in sanitation and hygiene, and how a convincing business case could be made from opportunities inherent in informal undertakings.


Christopher W. Williams (PhD) is an eloquent advocate of water supply, sanitation and hygiene. As Executive Director of the Water Supply & Sanitation Collaborative Council (WSSCC), the lone international institution with a United Nations mandate to work on sanitation, he is busy selling the agenda and the best ways to achieve improvements, within global development circles. Before being appointed to lead the Council, Williams worked with UN-Habitat at various senior levels. Trained in economics, sociology, public policy and political science, Williams is well versed with all of them and easily switches between them in evidencing his arguments. In this exclusive interview with GETACHEW T. ALEMU, FORTUNE’S OP-ED EDITOR, held at the sidelines of the Third Financing for Development (FfD) Conference, Williams shares his thoughts about the political rationale for investing in sanitation and hygiene, and how a convincing business case could be made from opportunities inherent in informal undertakings. Excerpts:

 

Fortune: The whole process of policymaking on water supply and sanitation started from a lower base, in general. The world seems to have so many challenges in the area. But 15 years from the start of the Millennium Development Goals (MDGs) process, how do you evaluate the whole progress in terms of policymaking as well as practically bringing solutions to the problems?

Christopher W. Williams: I think what has happened, the improvement over the last 15 years, is that there has been recognition of the importance of sanitation as part of the package of water and sanitation provision – which is good. People, particularly governments, are addressing the imbalance – all water and less sanitation. That was not the case 15 years ago.

Another thing is that the approach to improving sanitation has shifted from infrastructure to behaviour change. If you look at the policies of most of the countries of sub-Saharan Africa, of South Asia, Southeast Asia, you will see that they explicitly talk about software and behaviour change- software meaning not heavy infrastructure, but working at the household level to get people to appreciate the connection between sanitation and health and the importance of hygiene – that shift, at the Federal level, the central government level, was not there 15 years ago. People thought they should just spend government money to build toilets – so that is a big shift.

Yet another shift I think is that many governments have got smarter and they realise that they need to, not only have policy, but they need to have strategies.

How are they going to achieve this? How are they going to improve the situation?

And they have also established targets. It is one thing to have the MDGs targets but many countries – 30 countries in particular, have set aside, as part of national policy, to end open defecation in the country. They call it an open defecation free (ODF) country by 2018, 2019 or 2020. That is exciting. It shows they have committed themselves politically.

  1. Can we say that people like you who are engaged in advocating for better water supply and sanitation within the developmental sphere are happy about this progress?

Even more! These people are happy that we exist. Fifteen years ago, they would say this is not what we are doing. So the fact that they have made this a policy priority, they have targets and they even have committed themselves to a particular approach means they have now taken the thing upon themselves.

Q: Much of the financing in terms of social development at national level still goes to education, health, mainstream housing issues and rural infrastructure. Water supply and sanitation is still an overlooked or sidelined issue. Where do you think is the major problem?

I would agree with you that it is not well-funded. The positive steps over the last five years are awareness of the issue, policy position, strategy, as well as targets that they want achieve, particularly to end the practice of open defecation and improve sanitation.  That is all the good news. The bad news is that they have not put their money where their mouth is.

Q: Why is that?

I think there are competing priorities and also, the governments are not comfortable with the justification for the funding. They know it is important but they know other issues are also important – education, health, food security.

Q: But the preference seems to always go in the direction of populism and adapting to electoral cycles?

Let me answer your question both on political rate of return and financial rate of return, to use those two terminologies. What the Global Sanitation Fund (GSF) does is to help establish an implementation strategy and actually achieve results in three to four years. This is very powerful for ministers of finance that are making resource allocation decisions, because we are able to show in roughly three to four years  that a modest investment of one million dollars a year, over five years, can improve sanitation and hygiene for 250,000 households – about 1.5 million people.

Those are real numbers that we can share with you. And we have them substantiated, confirmed, verified by third parties so it is not us making it up. And this is the kind of evidence that ministries of finance need, to show that there is value for money and this is actually the data that I’m preparing for your state minister of finance. He asked me for it. He was shocked that this was actually happening in his country. He was not aware of it.

Q: How about the political rate of return?

The political rate of return is very powerful, because imagine 1.5 million people, in four regions of the country. That is very visible. You have 250,000 households that associate improved sanitation and improved health, and in many cases improved education, because the kids are not sick, they are going to school, if they associate that, with a government-sponsored programme, they are going to be happy about that government.

Q: Organisations like your Council have been doing so much in terms of creating awareness on the importance of water supply and sanitation, especially in the process of crafting these Sustainable Development Goals (SDGs).  Are you happy about the magnitude of focus that the water supply and sanitation issue has actually gained in the SDGs process?

Yes. I think it is fantastic and the reason that it has gained this kind of attention – you have two things happening. You have this groundswell, 15 countries that are actually doing sanitation. They are not talking about it. They are improving the lives of 250,000 households, in some cases 2.5 million people, per country. At the same time, the international community, led by the United Nations Secretary-General Ban Ki-moon and a number of key UN Member States have said, we cannot have these SDGs if we have not finished the MDGs. How can we get up in front of the world and establish a whole other set of targets if we have not even succeeded in achieving the first set?

So for the last three years there has been enormous focus on sanitation, because it is the target that has done the worst. Of all the 21 targets of the MDGs, sanitation was the worst of all of them. So the Secretary-General and the Deputy Secretary-General decided to really focus on that and say how can we draw attention because the whole exercise of global declarations with targets becomes a joke if we cannot reach the targets. So they realised that they had to focus on the targets that were not being met. They could celebrate the targets that were being met, but they had to focus very much on the weaker targets and sanitation was one of them.

This led to a lot of work over the last two or three years.  The Deputy Secretary-General launched a call to action on sanitation, where he brought the private sector, Member States and various international organisations together, a group of us, organisations like ours – 35 organisations and he said, I do not want to establish a programme but I want to elevate this issue so that you can do your work better – so that your work gets more visibility.

The Secretary-General picked that up and made sanitation one of his seven priorities. He has got hundreds of priorities but he made sanitation one of the seven top priorities. So the issue is local and global. We have got to work on both levels to promote this.

Q:  Was the process as deliberative and as inclusive as it needs to be?

Well it was much more inclusive than preparation of the Millennium Development Goals (MDGs) – huge difference in terms of the process, the involvement of different stakeholders – there were four or five different processes that converged into one.

At the end of the day, it is a Member State driven process because the Member States are committing themselves to a set of targets and will honour those commitments over the next 15 years. It is good to have multi-stakeholders involved in the process, but at the end of the day, Member States are the ones that are signing this Declaration in September, and they are the ones that are held accountable to all of us, to achieve them.

Q: What is your evaluation of Ethiopia’s performance in light of the institutional setup for water supply and sanitation, and the progresses made?

Ethiopia is unique in Africa because of its Health Extension Programme (HEP) and 38,000 health extension workers. That is a foundation with which many things can be done, such as sanitation and hygiene. So doing sanitation hygiene in a place like Ethiopia is much easier because the country has already made the investment of the HEP, which is a model. People come here every two months to look at that programme.

People from Tanzania, West Africa, Southern Africa, they say, how do you guys do this?

So you see it is also an indicator of importance when you get visitors. So Ethiopia has backbone for it. Ethiopia is among the first country to establish basket funding on water, sanitation and hygiene (WASH). They have created a mechanism within the Ministry of Finance & Economic Development (MoFED) to get money from the World Bank, the British Government, other international organisations that can be pooled into one place, and availed to the MoFED to then disburse to the Ministry of Health (MoH) and the Ministry of Water, Irrigation & Energy (MoWIE) to do sanitation and hygiene.

The problem is coordination. This often happens. For the first time, the MoH has more money for sanitation and hygiene than it is ever had. The Minister said to me, “you know we have had money for HIV and AIDS for years, so we have built the structures that allow us to support that”.

For sanitation and hygiene, he told me, “We never had this before so we have to adjust the departments, the human capital, and how it relates to the regions. We have to build up the human capacity to implement – to be in a position to use this money”. It works.

Thus, there is a problem with human capital and capacity and coordination. But the ministers and the civil servants are getting there. These things take time.

Q: In many of the panels in the Third Financing for Development (FfD) conference, the issue of having quality data has been repeatedly mentioned as one of the challenges. If there is an area where this problem is severe, it is water supply and sanitation. What do you think should be done to improve this situation?

One is that we need to be very careful how we define open defecation. Governments need to establish a definition so that they know what they are measuring. You can have one village that says we are Open Defecation Free (ODF) and another village that says the same, but when you look at them, they are totally different.  So we need consistency. We need a national definition of ODF.

Another issue is that we need to have a definition of improved sanitation. This is hotly debated and it is amazing – every country is different. UNICEF and WHO developed a framework of standards and guidelines to help countries develop tools to measure ODF and improved sanitation. So it is not like there is no information on this. It is available. It is just political will.

Governments have to make those decisions – to make the definitions. The first step is to have verification. We have to verify the ODF status.  And we have to be able to verify improved sanitation. The second step is to increase the capacity of, particularly the health workers, to be able to monitor the implementation of the sanitation programmes. The third level is good information technology. Once that information technology is available, the data that is being generated, by the health extension workers, does not have to be generated manually. It can be generated digitally.

Hence, putting in place information technology is another crucial issue in the whole process. And yet another thing that is necessary is human capital. You need to build people in the private sector, in the public sector – maybe partnerships. There are a lot of creative Ethiopians – lot of very smart people in this country – to try to increase the capacity of central government and regional governments to use information and analyse it and use it as the basis of policy. So those are the four things.

Q: Challenges remain in multiple fronts in order to actually push the progress on water supply and sanitation forward; as a showcase, for instance, here we are in a city where sanitation is really poor and public toilets are a rarity. Are you an optimist about the future of water, sanitation and hygiene? 

At the global level yes.

Q: How about on policy formulation and implementation?

I am very optimistic. My concern is actually urban sanitation. Urban sanitation is very different from what we have been discussing so far. You just alluded to it in your statement about the case in Addis and it is difficult. Urban sanitation requires urban planning. It requires land tenure and security. And it requires really good financing mechanisms, with accountability. Those three things are not needed in rural sanitation.

You can do behaviour change in rural areas. Once you move that to dense urban areas, you need the land tenure, really good governance systems and financing.

None of those things exist in most urban centres in sub-Saharan Africa. None of them! So I am of the view that what is necessary is to use the SDGs on cities (by the way it is for the first time we have cities. We did not have cities in the MDGs) as a great opportunity to host water and sanitation. On land tenure issues, urban planning, financing – we can be able to pull many different actors together, to address this issue.

Q: How about making the business case for the private sector to invest?

In urban areas you have scales, so you have a market for both the services of the safe disposal of waste, everybody needs it and they are willing to pay for it. It has to be priced correctly. Because there is a revenue stream of people willing to pay for that service, there is a business opportunity.

If more and more people are using toilets, and they are using hygiene products also – the sale of those will be very high and there is a market for that. So there are markets that are untapped and markets that are growing because of urbanisation that the private sector can tap into.

What is necessary, is very creative people, who are able to draw on informal arrangements. If you go around this city, you will find that there is actually a system of sanitation, removal and delivery. It is just informal.

There are scavengers, there are people recycling bottles, people that are actually removing waste from the local slum, to the outside of that slum – and they are getting paid for that. It is not much, but it is a survival skill. So there are things that are happening on an informal basis right now that smart private entrepreneurs could use as the basis for developing a business venture.

These informal networks have been able to reach markets and they are able to make money by providing a service. Maybe a poor service, there may be levels of exploitation, that are not appropriate but it is the basis for which a smart entrepreneur would come in and begin to develop services.

So there’s a huge business opportunity – that is before you get to the whole city. Then once you get to the whole city, once you figure out sludge management and organic waste management, you have actually saved the city billions of dollars. Because right now the city is filling up landfills with things that can easily be used for composting because there is no system for separation of waste.

So there is a whole new conversation about urban sanitation. But I want to emphasise two points. Once you talk about urban sanitation, you have to talk about other things – planning, security, tenure, financing, good governance, and you have to deal with the waste question. I would think that in all of those, there is great opportunity for businesses to thrive, if they are smart and tap into what is happening informally within these services.



Published on Jul 27,2015 [ Vol 16 ,No 795]


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