Speech by the Prince of Orange, Chairman of the United Nations Secretary-General’s Advisory Board on Water and Sanitation (UNSGAB), at the World Toilet Summit and Expo, Macau, 4 November 2008
Your Excellencies, Distinguished Guests, Ladies and Gentlemen,
It is my great pleasure to be here with you again today and to be part of this year's World Toilet Summit in Macau. It was only one year ago that I stood before you in New Delhi at the 2007 Summit. At that time we stood on the threshold of the International Year of Sanitation and I asked you to join me in the battle to get the Millennium Development Goal's sanitation target on track. A lot has been achieved but there still is a worldwide sanitation crisis going on right now. You know it, and I know it. It might not be the most noticed crisis of this particular moment, but nevertheless it is the naked truth for the 2.5 billion fellow citizens who suffer from it every day.
I cannot and will not accept the fact that 7500 people die every day of avoidable causes. I cannot and will not accept that so many poor, young girls still have to relieve themselves in unhygienic, hazardous places where they run the risk of getting sick or being raped.
The International Year of Sanitation has enabled us to fight the political indifference, public ignorance and cultural stigma that all contribute to inaction. It has proved to be an effective advocacy tool and we have made real progress. And yet, as the Year draws to a close, it is critical that we keep focused and even intensify our efforts on the ground.
Everyone here today understands that this battle must be fought on all fronts and we share in the belief that we cannot afford to lose. We now have only six years to halve the number of people without sustainable access to basic sanitation and we still have a long way to go. Water and sanitation-related diseases remain among the world's biggest killers, especially of children. But sanitation is about more than just building toilets. It starts with basic hygiene and personal care.
I celebrated Global Handwashing Day, October 15th , with the children of Atteridgeville, a former township near Pretoria, now a middle class town. On this day children from all over the world learned about the importance of hygiene and sanitation. Over 75 countries participated and more than 250 million children washed their hands in various parts of the world. This kind of global educational campaign should be repeated in the future. Also in so called developed nations! In the Netherlands a recent study of the Inspector of Public Health found that the reason many patients were getting infected in operating theatres with drug resistant bacteria was simply because the doctors and staff were not adequately washing their hands!
We cannot overstate the crucial role that sanitation and hygiene play in sustainable human development in health and with dignity.
In India, I saw first hand the positive results of the Total Sanitation Campaign, which is an excellent example of social innovation and is being implemented by the Indian government. This community-led approach works to end 'open defecation' while promoting the use of latrines. By 2012 the campaign should provide all of rural India with some form of adequate sanitation.
Bangladesh is now also implementing this comprehensive campaign, which combines community pressure with government rewards. There has been incredible progress in Bangladesh: the country is becoming a champion for developing sanitation and it will reach the MDG not by halving, but by possibly eliminating, the number of people without access to sanitation.
You are the people with the market-based solutions, technological innovation and cultural understanding to bring the world within reach of the MDG on sanitation.
Indeed, providing sanitation has a dramatic impact on social development and enormous economic benefits. Appropriate sanitation infrastructure can improve water quality and have a positive effect on the environment. It is often impossible to obtain clean drinking water supplies unless adequate attention is given to sanitation: human excreta remain one of the most serious causes of drinking water contamination.
The focus needs to be on demand-driven approaches that promote the benefits of installing household toilets. Too often in the past, facilities have been built and then left abandoned.
Possible ways to create demand include hygiene education at school, mass-media campaigns, demonstration latrines and exploiting community pressure and community dynamics to eliminate defecation out in the open.
We still have to reach those 2.5 billion women, children and men without access to adequate sanitation. And ladies and gentlemen: you can make a difference!
We have already created momentum. This World Toilet Summit, in support of the International Year of Sanitation, is proof of the remarkable progress under way in the field of sanitation.
It is truly remarkable what has been achieved in a year. We have succeeded in getting sanitation on the agenda of many organisations and at many levels. Regional Sanitation Conferences in South East Asia, South Asia, Africa and Latin America and the Caribbean have yielded incredible results. A highly significant milestone was the African Union Declaration on Water and Sanitation, which was adopted unanimously by African Heads of State and Government in Sharm el Sheikh in July.
What impressed me about that declaration was the balance struck between political commitment and practical, sensible recommendations, such as ensuring that one senior, accountable institution takes the lead on sanitation, and establishing specific budget lines to accommodate future allocations of public spending for sanitation and hygiene.
The IYS has also generated a positive response from civil society and the private sector. Sanitation is now seen not purely as a technical problem, but as a nuanced and complex issue that impacts health, education, gender equality and, perhaps most insidiously, the economy.
Ladies and gentlemen, in many countries we have the political support we need, the technology is available and the information campaigns are well advanced. I am delighted to see that a great resurgence of interest and effort is under way. But that does not mean that the problem of sanitation is already solved.
I have noticed that once a strong, high-level political declaration is in place, some people think that the work is done. Unfortunately this is not the case. The real work is about to begin! The primary aim of UNSGAB is to put as many people as possible on the sanitation ladder, and to do so we need more technological, social and financial innovation.
The 2008 World Toilet Summit offers an important platform for sharing experiences, exchanging ideas on sanitation services, and finding solutions together. All of you are stakeholders: government and UN agencies, NGOs, local bodies, financial institutions, designers, town planners and manufacturing industries. You are exactly the people we need. Your input is crucial to solving the sanitation crisis.
We had a similar opportunity to share ideas at the recent Stockholm World Water Week, where I spoke about ecologically sound re-use options like urine-diversion toilets which enable the collection and safe re-use of human excreta. It seems there is also a need for cheaper small-bore sewer systems, pit-emptying facilities, low-cost septic-tank sludge treatment methods and biogas technologies which could help provide many households with energy. Of course, the technology required changes according to the density of the community. Serving the increasing numbers of urban dwellers poses particular challenges in terms of infrastructure and design.
But let me stress that technology alone is not enough. Maggie Black and Ben Fawcett make that very clear in their book 'The Last Taboo'. They argue that: 'Even the best manuals cannot teach an engineer to be sensitive to the needs of an impoverished community'.
Too often in the past, people in the developing world, whether urban or rural, have been presented with immaculately engineered toilet facilities, and then have not used them. We simply cannot afford to let this happen. We need to understand the community context and generate demand for toilets while promoting behavioural change.
Jack Sim always reminds us that when we talk about sanitation we are talking actually about a market of 2 .5 billion people. He also says that today's market is dysfunctional, mainly due to muted demand and low priority among individuals. A market-based approach is needed to address the problem on a large scale, at the grassroots level. This is known as the 'bottom of the pyramid' approach. That phrase: 'bottom of the pyramid' was first used by US president Franklin D. Roosevelt in his April 7, 1932, radio address, The Forgotten Man, in which he said: 'These unhappy times call for the building of plans that rest upon the forgotten, the unorganized but the indispensable units of economic power [...] that build from the bottom up and not from the top down, that put their faith once more in the forgotten man at the bottom of the economic pyramid.' The contemporary usage of the phrase 'bottom of the pyramid' refers to the world's four billion people with less than 3000 US$ local equivalent in purchasing power and who live in relative poverty.
Fortunately, these days more and more businesses, governments and donor agencies are changing their view of poor people as victims and instead starting to see them as resilient and creative entrepreneurs as well as value-demanding consumers. There are tremendous benefits for multi-national companies who choose to serve these markets in ways that respond to their needs. After all, today's poor are tomorrow's middle class. Like Atteridgeville, the town where I joined the celebrations of Global Hand Washing day, went from township slum to middle class village, many so called informal settlements will follow that route. And there will also be poverty-reducing benefits if the private sector works with civil society organisations and local governments to create new local business models. A good example of the 'bottom of the pyramid' approach in action is the growing microfinance market in South Asia, especially in India, not coincidently the same country that came up with the rural Total Sanitation Campaign that I mentioned before already.
Ladies and gentlemen, there are three pillars on which the total sanitation concept is based.
1) It considers latrine users as individual customers with varying needs, instead of employing a top-down approach that provides one type of latrine for everyone.
2) It stimulates a dynamic private sector to produce and sell latrines as a business.
3) It creates demand using intelligent social mobilisation so that villagers 'awaken' and then exert the social pressure needed to make things happen.
Total sanitation is a public good in the public health domain. It needs strong support from governments, civil society and the international donor community.
I am sure there are many people in this room with a wealth of knowledge and experience. Use it, share it, and make sure that this conference generates conclusions and recommendations, but above all actions, that will make a difference to those 2.5 billion people who do not yet have access to a simple, clean toilet.
I would like to conclude by sincerely thanking the organisers and I wish you all a successful conference that yields useful and practical outcomes. Let us redouble our efforts! I can assure you that doing so would multiply many times over the output in terms of health, dignity and development for those who need it most.
Now it is my honour to declare this World Toilet Summit 2008 opened.
Thank you.