'Improved' or 'Adequate'?

We all know that some 2.6 billion people lack access to a toilet or a latrine. Even if you do know this horrific fact, it still shocks − here we are in 2008 and this vast number of people have nowhere decent “to go”. Just appalling. Actually, it’s probably even worse than this. WHO and UNICEF, and their Joint Monitoring Programme, use the term ‘improved’ sanitation, which they take to mean connection to a sewer or septic tank or having a pour-flush toilet or a simple or a ventilated improved pit latrine. A healthy spanner was put in the works by UN-Habitat in its 2003 report ‘Water and sanitation in the world's cities: Local action for global goals’ by claiming that ‘improved’ sanitation was not necessarily ‘adequate’ sanitation, with adequacy of provision being defined as “good quality provision in the home (eg, the toilet), the immediate surrounds (eg, connection to a sewer, pit or septic tank that does not contaminate the groundwater or other people’s water) and the neighbourhood (provision to ensure no human contact with excreta and to make sure that wastewater is removed safely)”. The resulting figures for those without access to adequate sanitation are much, much greater than for those lacking access to improved sanitation, at least in urban/periurban areas. In the year 2000 in Africa, for example, there were reckoned to be around 46 million people without improved sanitation in urban/periurban areas, but some 150−180 millions without adequate sanitation; in Asia the figures are 297 millions vs. 600−800 millions, and in Latin America and the Caribbean 51 millions vs. 100−150 millions. This means that, even if we achieve the sanitation target of the Millennium Development Goals and/or the WHO/UNICEF goal of universal coverage by 2025, many hundreds of millions of people will still not have adequate sanitation. We’ve certainly got our work cut out! And then remember that almost all population growth in the world over the next 50 years or so will be in urban/periurban areas of developing countries!