Media centre


Press releases


Official statements

Fact sheets

Q&As and Commentaries


Photo stories

The OneMinutesJr



Contact information


Poor sanitation and hygiene a dirty and costly reality in East Asia

© UNICEF Cambodia
Cambodian children with a water pump in Stung Treng province

BEPPU CITY, Japan, 30 November 2007 – Ministers and leaders from 14 East Asian countries will gather for two days of talks here today aimed at tackling the huge problem of poor sanitation that is harming health and hurting social and economic development, even as the region booms.

Almost half the population of East Asia lacks access to adequate sanitation, such as pit latrines with slabs or composting toilets. This harsh reality – affecting almost 800 million people – has spawned disease and deprivation on a massive scale, reinforced a vicious cycle of poverty among the marginalized, and widened disparities between urban and rural, rich and poor households.

“The region is enjoying steady economic growth of 6-10 per cent a year while trade has tripled in the past decade, yet there is a massive lack of basic household sanitation and hygiene,” said Ede Ijjasz-Vasquez, Program Manager, Water and Sanitation Program (WSP) of the World Bank.  “Governments may not realize that unsafe sanitary practices translate into economic costs in the tens of billions of dollars, threatening future progress, but the fact is sanitation has not been high on the political agenda. We have a chance now to change that.”

The East Asia Ministerial Conference on Sanitation and Hygiene 2007 (EASan) is the highest-level gathering of its kind ever to be held in this region. More than 170 delegates are attending, including ministers and senior government officials. The focus is on nine countries: China, Cambodia, Indonesia, Lao PDR, Myanmar, Mongolia, Timor-Leste, the Philippines and Viet Nam. In addition, representatives are attending from Brunei Darussalam, Japan, Malaysia, Singapore and Thailand.

The conference, ushering in the UN International Year of Sanitation 2008, seeks to expose the costs of inadequate sanitation, the untapped benefits of improved sanitation, and flag immediate actions that governments, the public and private sectors need to take for large-scale progress.  On the concluding day, ministers are expected to reach consensus on a list of concrete commitments.

“We will make it clear in Beppu City that sanitation and hygiene need to sit in the top league beside the major development imperatives, with funding and policies to match,” said Anupama Rao Singh, Regional Director of UNICEF East Asia and the Pacific. “We can no longer brush aside the arguments against doing more when we know that the costs of inaction are staggering.”

Faced with competing social demands, bigger vote winning issues and the consistent belief that sanitation is the private concern of the family, governments have rarely given sanitation and hygiene the priority they deserve.  This has translated into low investment and budgets for sanitation services and programmes, leaving homes, hospitals, schools and other key infrastructure woefully under-served. 
Sanitation experts, part of a large civil society and private sector presence at the conference, will give voice to why sanitation is so crucial. The list is long.

To start with, sanitation is vital for human health.  Fecal contamination resulting from poor sanitation and hygiene is a major cause of diarrhea, a leading child killer in East Asia. In addition, poor sanitary conditions lead to a host of other diseases, including dysentery, cholera, hepatitis A, and trachoma.


A simple and low cost toilet in Lao PDR

"Just imagine how many children's lives can be saved with simple low cost interventions like latrines and hand-washing. These interventions have the potential to reduce by half the 190,000 deaths per year that occur due to diarrheal diseases in East Asia, most of them in children under five, ” said Dr. Linda Milan, Director, Division of Building Health Communities and Populations, World Health Organization, Western Pacific Regional Office.  “Improvements in sanitation and hygiene can also reduce the incidence of worm infestation in children and other infectious diseases, improve children's nutritional status and their personal growth and development."

Sanitation and water are catalytic entry points for achieving most of the 2015 Millennium Development Goals, such as those to reduce poverty and hunger, child and maternal mortality, to promote gender equality and manage and protect natural resources. Insufficient moves on sanitation will stall progress towards fulfillment of the other MDGs.

Poor sanitation impairs social development through its conveyance of low status, harassment, inconvenience and discomfort, particularly for women and girls, who tend to be highly conscious of social factors. It results in missed educational opportunities, especially for girls. It pollutes the environment by generating vast amounts of uncollected and untreated human waste and waste water each year.

And, a fact that is often not widely understood: poor sanitation acts as a drag on economic growth. A recent World Bank study estimates that poor sanitation and hygiene in Cambodia, Indonesia, the Philippines and Viet Nam incurs collective economic losses of around $9 billion per year for these countries, equivalent to 2 per cent of gross domestic product. If these are representative of the wider losses across East Asia, then the 9 EASan focus countries could be shouldering economic losses approaching $40 billion per year.  These costs are due to many factors, including the costs of treating sanitation-related illnesses, lost income through illness and premature death, higher water treatment bills because of fecal contamination, and reduced income from tourism.
Conversely, it is estimated that every dollar spent on improving sanitation generates economic benefits that far exceed the investment.  The annual investment needed in East Asia to achieve universal access to both safe water supply and basic sanitation by 2015 is estimated at around $8 billion – barely 20% of the estimated economic losses incurred through inaction. 

East Asia and the Pacific as a whole is poised to meet the MDG target on sanitation, although there are large differences in how individual countries are faring. But even meeting this milestone will still leave 640 million people without basic sanitation facilities, with many or even a majority likely to be the most impoverished in the hardest-hit areas.

There are many barriers to universal sanitation. They include entrenched sanitation and hygiene habits, low demand for latrines/toilets from householders, and a culture where open defecation goes un-remarked. However, affordable and practical solutions are at hand. And there are plenty of sanitation success stories, whether of an individual community or an entire country – proving change at a fast clip is possible.


Note to editors/broadcasters:  Information about the conference is available on the website:  Broadcast quality footage is available free of charge. The conference is co-organized by the Water and Sanitation Program of the World Bank, UNICEF and the World Health Organization. It is hosted by the Asia-Pacific Water Forum Summit, to be held at Beppu Convention Center in Beppu City on 3-4 December 2007.

For further information or to arrange an interview with an expert, please contact:

Yosa Yuliarsa, WSP Jakarta, Japan mobile:(81) 90 5008 4057,
Vandana Mehra, WSP New Delhi, Japan mobile: (81) 80 1387 1828,
Marilu Lingad, WHO Manila, Japan mobile: (63) 918 9181094,
Tani Ruiz, UNICEF Bangkok, mobile (66) 89 204 3453




 Email this article

unite for children