Neil Jeffery, CEO, Water & Sanitation for the Urban Poor

Central Lusaka has the air of a city on the rise – well-organised streets with brand new buildings, and shopping malls springing up all over the place. The Zambian capital, which I visited last October, is a typical rapidly growing African city.

But step outside of the central zone, into Lusaka’s peri-urban areas, and the picture looks quite different. In low-income communities such as Kanyama and Chazanga, people live in squalor. Without access to clean water and safe sanitation, illnesses such as diarrhoea – the second biggest killer of children in developing countries – spread fast.

In Livingstone, a rapidly growing city next to Victoria Falls, it’s a similar story. Tourists staying in the smart centre would not guess that just a few miles away, tens of thousands of people live in informal settlements with limited basic services.

During 2016, our understanding of the connectivity between the poor, hidden areas of a city and the richer central districts moved forward. I sit on the advisory board of SaniPath, a research tool supported by Emory University in Atlanta and Bill & Melinda Gates Foundation. The tool tracks how faecal matter can contaminate a city, and I was fascinated to hear emerging results at a session at World Water Week in August.

In Maputo, Mozambique, the SaniPath team have applied their tool as part of a wider health impact evaluation led by the London School of Hygiene & Tropical Medicine and Georgia Tech, looking at the impact of new shared sanitation blocks we constructed. Emerging – not final – results are suggesting that because faecal contamination spreads so widely in a city, new toilets in just one part of a city may not be sufficient in themselves to improve the health of the residents that are using the toilets.

At first this seems like a depressing insight – that improved sanitation may not have as much of an impact on health as we thought. But even if improving toilets doesn’t immediately improve health, the investment is still a necessary step along the way to achieving eventual health impact. And even if there is no health impact, toilets still generate huge benefits in terms of dignity, women and children’s safety, privacy and convenience.

For me, the message it sends is clear: if we want to reduce the public health risk posed by poor sanitation, then we need to address sanitation on a citywide level. Policymakers are often tempted to focus on the higher profile central districts, but this approach has to change. Poor sanitation in low-income urban areas is contaminating entire cities.

So that’s why in 2017, all of us at WSUP are very clearly focused on one thing: stepping up our efforts to promote systemic, citywide transformations to water and sanitation.

We can’t do this without the support of partners and in Zambia, for example, we’re working closely with the Lusaka Water & Sewerage Company as well as some forward-thinking supporters who back our work, including Bill & Melinda Gates Foundation, The Coca Cola Africa Foundation, Comic Relief, Stone Family Foundation, UK Department for International Development, and Wasser fuer Wasser.

I’d like to take this opportunity to thank all of our supporters for embracing our vision of a world in which all urban dwellers enjoy affordable, safe water and sanitation services.