WaterAid and sanitationToday, over 2.3 billion people do not have a safe and private toilet, and a billion have no choice but to defecate in the open. This is a deadly crisis. Where people don’t have safe water and adequate sanitation, disease spreads fast. Over 500,000 children die every year from diarrhoea as a result. For women and girls, no access to a toilet means no dignity, no privacy and no safety – they often wait until dark to find a quiet place to defecate, increasing the risk of attack or rape. Without toilets in schools, children are left to defecate in the open. This makes them vulnerable to diarrhoeal illnesses and causes them to miss lessons. Girls in particular are affected by a lack of private toilets, and often drop out completely when they start their periods. Recruiting teachers into schools without decent sanitation is also difficult. The knock-on effects are considerable. In many countries, the economic cost of poor sanitation and hygiene amounts to more than 5% of their GDP. Despite commitments by many governments, and the UN’s recognition of sanitation as a human right, it remains neglected and the most off-track of the Millennium Development Goals (MDGs). For the life-changing impacts of safe water and hygiene to be delivered, everyone, everywhere must have access to safely managed sanitation. This is why toilets continue to be at the centre of our work.