The Skoll Foundation has published a blog on WSUP’s highly successful project in Visakhapatnam and how its experiences can inform future work towards achieving universal access to sanitation in India.
By Neil Jeffery, Chief Executive, Water & Sanitation for the Urban Poor (WSUP)
Half of the one billion people in the world who still defecate in the open live in India. Poor sanitation in India is not just a rural issue: at least 157 million urban poor Indians lack access to decent toilets and one in 10 deaths in India are related to poor sanitation.
The port city of Visakhapatnam, also known as Vizag, is the largest city and an industrial center in the southern Indian state of Andhra Pradesh.
Water & Sanitation for the Urban Poor (WSUP) has just completed a three-year programme in this city, funded by USAID, which has made a major difference to the lives of 250,000 residents and created a model for how cities in India can make rapid strides to improve sanitation.
Learn more about WSUP Advisory
At World Water Week in Stockholm, WSUP will talk about the conclusion of this highly successful project and how its experiences can inform future work towards achieving universal access to sanitation in India.

Ending Open Defecation and Improving Services
Open defecation – the practice of going to the toilet outside – pollutes water supplies; diminishes people’s dignity and safety, and leads to the spread of diseases such as cholera and dysentery. This, in turn, can lead to malnutrition, child stunting, and even death.
The solution to this complex problem is not just about building toilets and raising public awareness. People need to change centuries-old behaviors and be prepared to pay for and regularly use toilets.
But improving sanitation for residents also goes beyond eliminating open defecation. To reduce the risk of disease spreading, a key challenge is to ensure the safe management and treatment of waste from toilets that are not connected to sewers.
Success in Visakhapatnam
From 2015-2018, WSUP worked with the city of Visakhapatnam, as part of India’s Swachh Bharat Mission, an ambitious national programme led by Prime Minister Narendra Modi. As a result of the partnership, the city eliminated open defecation in 2016 and improved access to a toilet for 250,000 people. The city rose from 44th to the third cleanest city in India in 2017. It has become a city that other states want to emulate.
We found that the following components were crucial for a successful programme:
- Leadership from city authorities
The Greater Visakhapatnam Municipal Corporation was fully behind the program, with strong leadership and guidance from the Commissioner. His leadership, in our experience, is an essential element for citywide change and to ensure the change will be sustainable for the long-term.
- Mobilising community groups
WSUP worked with local communities to design and implement new methods for eradicating open defecation.
Rather than try and cover the whole city at once, our team developed a unique ward-by-ward approach to stop open defecation. The programme tapped into existing community groups to better understand sanitation needs and promote behavior change.
Read more about WSUP’s ward-by-ward approach.

- Seeing people as consumers, not beneficiaries
Rather than view residents as passive beneficiaries, we took a consumer-led approach, recognizing the importance of developing services and products which people actually want – and will pay for.
This resulted, for example, in public toilets being redesigned with better lighting, accessibility, and separate entrances for men and women.
- Strong involvement from the private sector
Many of the vacuum tankers which empty waste from toilets are private sector operated, and improving these services was a vital part of the program. As a result, standards for adequate services rolled out and operators were trained in safe practices. Licensed operators are now allowed to dump their waste in city disposal points rather than in drains or rivers as they were doing before – reducing environmental pollution and improving water quality.

Other states are now looking to Visakhapatnam to learn more about the model that WSUP Advisory—our consultancy arm—developed with city authorities. The Indian government’s Ministry of Housing and Urban Affairs has now adopted many of the guidelines and policies produced by the project as good practice to help drive forward the national Swachh Bharat initiative.
Read the blog on the Skoll Foundation website.
This programme was implemented by WSUP Advisory
Learn more about WSUP’s work in India.
Top image: Community engagement in one of Visakhapatnam low-income areas