Perspectives: Sanitation in a world of 7 Billion

On October 31st, 2011 the world’s population was predicted to have hit a major milestone.  Somewhere on this planet, the 7th billion person joined an increasingly crowded populace. Based on some figures, 2.6 billion of them are without adequate sanitation[i]. As part of the Millennium Development Goals, the United Nations set a target to reduce, by half, the number of people facing this situation by 2015; a number they have recently announced was no longer achievable at the current pace. Some progress has been made in this area, but the UN reports that it has largely evaded the poor, and rural populations remain at a distinct disadvantage in a number of regions[ii].

Across the world, particularly in developing nations, instituting proper sanitation measures remains a challenge. For instance, it is estimated that as much as 1.1 million litres of raw sewage are dumped into India’s Ganges River every minute, carrying with it parasites, bacteria and viruses[iii]. These practices contribute greatly to the spread of water-borne diseases, such as typhoid, cholera, hepatitis A, and diarrhea. According to the World Health Organization (WHO), more than 3.5 million people die each year from water-related diseases worldwide. Diarrhea alone claims as many as 1.5 million lives every year; most of them are children under the age of five[iv]. These problems can become intensified in areas that are hard hit by severe climate or catastrophic events. Consider Haiti, which was struck by a magnitude 7.0 earthquake in January 2010 and continues to suffer from a serious cholera outbreak. The bacterial disease is spread from person-to-person through contaminated food and water. Before the earthquake, no cases of cholera had been seen on Haiti for more than a century[v].

In addition to the dumping of waste and polluting of waterways, another issue that persists in many countries is the lack of basic washroom facilities. Without this access, people are forced to go to the bathroom outside, often in close proximity to rivers and other bodies of water. These same rivers frequently serve as the water supplies for drinking, cooking and bathing, further facilitating the spread of disease.The World Health Organization cautions that personal health and safety is also a concern in situations where there is an absence of proper washroom facilities, particularly for women. Lack of adequate cover can put women at risk of sexual assault[vi]. Other women, who avoid relieving themselves to avoid assault, are at higher risk of developing bladder infections.

The health and social impacts of poor sanitation can also become an economic burden, resulting in direct medical costs associated with treating sanitation-related illnesses and lost income through reduced productivity. Globally it is thought that 4.1 per cent of the total Disability Adjusted Life Years (a measure of overall disease burden, expressed as the number of years lost due to ill-health, disability or early death) is due to diarrhea alone; 88 per cent is due to unsafe drinking water[vii]. It is estimated that meeting the UN goals of halving those without adequate sanitation could cost up to $20 billion dollars a year[viii]. But the return on investment is estimated at 5 to 28 dollars for every dollar spent[ix]. Potential initiatives to meet the UN goals would include point-of-use disinfection, improved water quality, and regulated piped-in water and sewage connections.

These issues are not exclusively found in the developing world either. The Cape Breton Regional Municipality made headlines in November 2011 because it continues to defy federal mandates by dumping sewage directly into the harbour[x]. In fact, effluent from wastewater systems represents one of the largest sources of pollution, by volume, in Canadian waters[xi]. As recently as 2004, it was estimated that as much as 200 billion litres of raw sewage – six per cent of Canada’s total output – is dumped untreated into Canadian waterways[xii].

Human sewage is a high source of organics and nutrients, which means that beyond the increased pathogen loads, the pollution can decrease available oxygen in the water. A drop in oxygen can result in fish kills and cause other environmental issues. It can also result in an eutrophication of the water and a build-up of algae and plants. 

So how then does the planet cope with sanitation in a reality of over 7 billion people? The WHO has developed guidelines for the safe use of wastewater, excreta (waste matter), and grey water (wastewater generated from domestic activities such as laundry, dishwashing, and bathing) to help reduce some of the environmental impacts related to poor sanitation. Initiatives are also underway to find ways to deal with Canada’s raw sewage, including workshops by the World Health Organization, International Development Research Centre, and the Food and Agriculture Organization on the “Non-treatment options for safe wastewater use in poor urban communities.”

The Government of Canada is also anticipated to pass the Wastewater Systems Effluent Regulations in the coming months, which have been developed under the Fisheries Act and would fulfill a commitment under the Canadian Council of Ministers of the Environment (CCME) Strategy for the establishment of national effluent quality standards. These standards represent a secondary level of wastewater treatment or equivalent. Environment Canada estimates the total cost for upgrades across the country at $5.9 billion, the majority of which will fall to the municipalities[xiii].

[i] United Nations, The Millennium Development Goals Report 2011,

[ii] United Nations, The Millennium Development Goals Report 2011,

[iii] World Health Organization, 10 facts on Sanitation

[iv] World Health Organization, 10 facts on Sanitation

[v] BBC, March 15, 2011

[vi] World Health Organization, Poor Sanitation Threatens Public Health,

[vii] WHO (n.d.) Water Sanitation and health – Burden of disease and cost-effectiveness estimates

[viii] The French Water Academy, 2004. The Cost of Meeting the Johannesburg Targets for Drinking Water

[ix] Hutton and Haller, 2004. Evolution of the Cost and Benefits of Water and Sanitation Improvements at the Global Level,

[x] CBC November 21, 2011. Cape Breton leaders defy sewage rules,

[xi] Government of Canada, Regulatory Impact Analysis Statement,

[xii] MacLean’s Magazine, 2009. Many cities still dump raw sewage,

[xiii] Government of Canada, Regulatory Impact Analysis Statement,

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