Costs, climate and contamination: Three drivers for city-wide sanitation investment decisions

Significant progress is needed, in both large cities and small towns, to meet the ambitious targets set at international and national levels relating to universal access to safely managed sanitation. There has been increased recognition in the urban sanitation sector that in rapidly growing cities, there is unlikely to be a single centralized sanitation solution which can effectively deliver services to all demographics, and that heterogeneous approaches to urban sanitation are required. At the same time, due to competing investment priorities, there is a greater focus on the need for sanitation investments to address multiple objectives. However, calls for more informed sanitation planning and a more dynamic and disaggregated approach to the delivery and management of sanitation services have had limited impacts. This is in part due to the complexity of the drivers for sanitation investment, and the difficulties involved in identifying and addressing these multiple, often conflicting, goals. This paper examines three potential drivers of citywide sanitation decision-making – public health, sustainability and economic performance – via the three proxies of contamination, climate change and costs. It examines the importance of each driver and proxies, how they are considered in investment decisions, the current state of knowledge about them, and priority aspects to be included in decisions. At present, while public health is a common driver for improving sanitation, there are significant gaps in our understanding of fecal contamination spread and exposure, and how to select sanitation solutions which can best address them. Climate change is sometimes seen as a low priority for the sanitation sector given the immediacy and scale of existing challenges and the uncertainty of future climate predictions. However, potential risks are significant, and uninformed decisions may result in greater costs and increased inequalities. Cost data are sparse and unreliable, and it is challenging to build robust cost-effectiveness analyses. Yet these are needed to compare citywide options based on least-cost over their full life cycle. This paper provides insights into how existing evidence on contamination, climate change and costs can inform decisions on sanitation investments and help chart a sustainable way forward for achieving citywide services