A tale of clean cities: Strong local leadership key to solving urban sanitation challenge, says new WaterAid research

1 Sep 2016

New research from WaterAid has identified the ingredients of success for tackling the ever-growing sanitation challenge caused by uncontrolled urbanisation across the developing world, with strong leadership being key to effecting change.

With over half (54%) of the global population now living in urban areas, city infrastructure is struggling to keep up in many countries, leaving millions without access to clean water and toilets, increasing the risk of disease. However, progress is being made.

A tale of clean cities: insights for planning urban sanitation from Ghana, India and The Philippines explores ‘what works’ by examining how three cities have made significant strides in ensuring access to sanitation services for all urban dwellers.

Strong local leadership proved vital to success in all three cases, be it from the mayor or the head of the waste management department. While rapid urbanisation poses huge challenges, the pressure it causes can actually be positive, driving demand for services to be provided. Efforts were also driven by financing opportunities, commercial competitiveness or tourism, and even by crises, such as outbreaks of disease.

Findings also showed uneven progress along different parts of the sanitation chain, such as access to toilets, emptying septic tanks, and treating the faecal waste. Meanwhile, inadequate financing and a lack of coordination between municipal departments are frequent obstacles. Furthermore, the urban poor and those who live in challenging areas are being left behind.

Innovative solutions that have been shown to work range from public toilets managed through public-private partnerships, to public campaigns on cleanliness to create tourist-friendly spaces, and from decentralised sanitation wastewater treatment to centralised pit emptying services.

WaterAid’s report, released this week at Stockholm World Water Week, provides guidance for municipal authorities, national governments, donors and development agencies to support the UN Global Goal to ensure improved sanitation for everyone everywhere by 2030.

All three cities are success stories in their own ways and provide useful insight to learn from:

  • Rapid urbanisation in Visakhapatnam, India, led to almost half the population living in slums. The strain on resources resulted in water scarcity and problems with sewage and open defecation. The desire to transform the once small fishing village into the financial capital of the state of Andhra Pradesh inspired political buy-in, which drove initial investments in sewers and the treatment and reuse of wastewater but failed to reach poor neighbourhoods. Sanitation efforts have recently received a significant boost from the launch of Prime Minister Modi’s Swachh Bharat (Clean India) Mission. The city has now committed to become free of open defecation and is striving to provide services to those not connected to sewers.
  • Although Ghana is making significant strides in development, the lack of progress in water and sanitation is holding it back. However, the country’s second-largest and fastest-growing city, Kumasi, has bucked this trend, almost eradicating open defecation and so helping prevent outbreaks of disease, such as cholera. Demand from an influx of traders, transient workers, and migrants for proper toilets, drove the city to invest in pay-per-use public toilets. These are managed through public-private partnerships, ensuring sustainability, but can present issues as quality of service is very low in many poor neighbourhoods.
  • San Fernando, La Union, in the Philippines is lined with beautiful beaches, making it popular with tourists, fueling demand to keep the water clean and ensure good sanitation provision. Through strong leadership from the Mayor, the city has rolled out environmentally-friendly strategies where sanitation was a key component, even introducing a sanitation tax. They have used various approaches to address the needs of the different areas of the city, resulting in an improvement in city-wide sanitation. Legislation and public awareness campaigns have been key ingredients of success.

NGOs such as WaterAid have an important role to play in providing financial support, stimulating greater accountability, and building capacity.

Andrés Hueso, Senior Policy Analyst for sanitation at WaterAid, said:

“Fifty-four per cent of the world’s population now live in cities putting major strains on city planners to extend drinking water and sanitation services to all.

“Our research shows there is no one size fits all when it comes to ensuring sustainable sanitation services in urban areas. However, the ingredients to success include strong leadership, with key drivers being national political influence, economic motives, and the pressure posed by rapid urbanisation. City sanitation planning is important, but is not a silver bullet. Planning must be adapted to the specific context and phase of sanitation development, and be linked to financing opportunities to avoid it being treated as a tick box exercise.

“One worrying shortfall identified is that the needs of the urban poor are rarely a top priority. WaterAid believes we must always aim to reach the poor and most excluded people, ensuring sanitation services reach everyone everywhere by 2030.”


Read the full report >

Download photos of city sanitation >

For more information or to arrange interviews please contact Laura Crowley, Senior Media Officer, on [email protected] or 0207 793 4965, or Carolynne Wheeler, News Manager, at [email protected]. Or call our after-hours press line on 07887 521 552 or email [email protected].

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Notes to editors:

About WaterAid

WaterAid’s vision is of a world where everyone has access to safe water and sanitation.  The international organisation works in 37 countries across Africa, Asia, Central America and the Pacific Region to transform lives by improving access to safe water, hygiene and sanitation in some of the world’s poorest communities.  Since 1981, WaterAid has reached 23 million people with safe water and, since 2004, 21 million people with sanitation.  For more information, visit, follow @wateraid or @WaterAidPress on Twitter, or visit us on Facebook.

  • Around 315,000 children die each year from diarrhoeal diseases caused by dirty water and poor sanitation. That’s nearly 900 children each day, or one child every two minutes.
  • Over 650 million people (around one in ten) are without safe water
  • Over 2.3 billion people (around one in three) live without improved sanitation
  • For every £1 invested in water and sanitation, an average of £4 is returned in increased productivity.
  • Just £15 can help provide one person with access to safe water.
  • For details on how individual countries are keeping their promises on water and sanitation, please see our online database,