title: Does global progress on sanitation really lag behind water? An analysis of global progress on community- and household-level access to safe water and sanitation.
abstract: Safe drinking water and sanitation are important determinants of human health and wellbeing and have recently been declared human rights by the international community. Increased access to both were included in the Millennium Development Goals under a single dedicated target for 2015. This target was reached in 2010 for water but sanitation will fall short; however, there is an important difference in the benchmarks used for assessing global access. For drinking water the benchmark is community-level access whilst for sanitation it is household-level access, so a pit latrine shared between households does not count toward the Millennium Development Goal (MDG) target. We estimated global progress for water and sanitation under two scenarios: with equivalent household- and community-level benchmarks. Our results demonstrate that the "sanitation deficit" is apparent only when household-level sanitation access is contrasted with community-level water access. When equivalent benchmarks are used for water and sanitation, the global deficit is as great for water as it is for sanitation, and sanitation progress in the MDG-period (1990-2015) outstrips that in water. As both drinking water and sanitation access yield greater benefits at the household-level than at the community-level, we conclude that any post-2015 goals should consider a household-level benchmark for both.
authors.affiliation: Department of Disease Control, Faculty of Infectious Tropical Disease, London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors.forename: Oliver
authors.initials: O
authors.lastname: Cumming
authors.affiliation: Department of Civil, Construction and Environmental Engineering, University of Alabama, Tuscaloosa, Alabama, United States of America; Water Institute, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.
authors.forename: Mark
authors.initials: M
authors.lastname: Elliott
authors.affiliation: Water Institute, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.
authors.forename: Alycia
authors.initials: A
authors.lastname: Overbo
authors.affiliation: Water Institute, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.
authors.forename: Jamie
authors.initials: J
authors.lastname: Bartram
mesh_terms: D002947:Cities / Q000706:statistics & numerical data; D060766:Drinking Water; D006040:Goals; D006297:Health Services Accessibility; D006798:Housing / Q000706:statistics & numerical data*; D006801:Humans; D038622:Internationality; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012424:Rural Population / Q000706:statistics & numerical data; D012449:Safety; D012499:Sanitation / Q000706:statistics & numerical data*
chemical_list: D060766:Drinking Water