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In followup to the University of North Carolina’s Water and Health Conference, which took place October 26-30, we've rounded up a number of tweets from conference presenters and participants. The conference covered a number of issues including drinking water supply, sanitation, hygiene, and water resources with a strong public health emphasis.

Were you at the conference? Share your own highlights in the comments below!

Editor’s Note: The post below is authored by John Garrett, Senior Policy Analyst at international water and sanitation NGO WaterAid, and Sarah Hénon, Analyst with Development Initiatives, an organization that works to end absolute poverty by making data and information on poverty and resource flows transparent, accessible and usable. This post is based on a recent report, Essential Element: Why international aid for water, sanitation, and hygiene is still a critical source of finance for many countries.

As the world turns its attention to the implementation of the Global Goals for Sustainable Development, making good, early progress towards Sustainable Development Goal 6 -- achieving universal access to water and sanitation -- will be essential for all developing countries. This requires ensuring the necessary resources are put in place, and the 2015 Addis Ababa Action Agenda provides an important platform for this, but a recent report released by WaterAid, based on analysis by Development Initiatives, suggests that current financing volumes and trends are not adequate to reach this goal for many countries, and that aid will continue to play a vital role in the implementation of Agenda 2030.  

Recent decline in share of aid to the sector

Aid flows to water and sanitation reached US$6.6 billion in 2013, a 10-year high in 2013, following steady growth from 2007.[1] This aid has played an important role in financing improved access to water and sanitation and allowing the world to meet the MDG water target. But the UN Water Global Analysis and Assessment of Sanitation and Drinking-Water (GLAAS) 2014 survey of 94 developing countries found that a majority (80%) of developing countries had insufficient current finance to meet MDG targets for drinking water and sanitation.[1]

WF Chart

Despite the increase in aid in 2013, there are some troubling underlying trends. Between 2011 and 2013 aid to water and sanitation grew by only 2.5%, falling behind the pace of overall aid, which grew by 10.7%. In line with these trends, the share of aid going to water and sanitation decreased between 2012 and 2013. In 2013, the share of aid to the sector dropped to only 3.9% of overall aid, falling below 4% for the first time since 2009. To achieve universal access to water and sanitation, countries that lack financing to meet MDG targets will experience an even greater gap. External financing from aid donors has a vital role to play to support countries' progress to universal access, particularly for countries with low levels of domestic revenue.

Aid to water and sanitation is increasingly delivered as concessional loans

International aid is composed of both grants and loans. During the ten year period between 2003 and 2013, aid loans to water and sanitation increased steadily from US$1.1 billion in 2003 to US$3.3 billion in 2013. This is an increase of 205%, compared with a 123% increase for grants over the same period. Thus, the increasing total volume of aid to water and sanitation is driven by aid loans.

The share of loans in aid to the sector has increased, from less than a third in 2005 to over half of aid since 2011. In 2013, 50.2% of aid to the water and sanitation sector came as loans. Compared with other social sectors, this is a very large share. The health sector receives only 6% of aid as loans, and the education sector receives 14%.

Within the water and sanitation sector, aid loans go mainly to large system projects.[2] Between 2011 and 2013 large systems projects received on average two-thirds (64%) of all aid loans. This increase in aid loans to the sector, although helping to address financing gaps, nevertheless reduces already constrained fiscal space in low-income countries and contributes to risks around debt sustainability.

Most aid in the sector goes to water projects

Since 2010, data on aid flows to the water and sanitation sector can be broken down into aid to water-only projects and sanitation-only projects.[3] For both water and sanitation, aid to basic supply and aid to large systems can be tracked. A total of US$1.9 billion of aid to water and sanitation could be disaggregated between water and sanitation spending in 2013. Of this, aid to water received two thirds (65%). A large share went to large water systems (43%), while basic water received just over a fifth (22%).

Aid to sanitation represented just a third of aid to the sector that can be disaggregated (35%). Basic sanitation received the least at 7%, while aid to large sanitation systems was 28%. Given that the MDG sanitation target was not met, accelerating investments in sanitation are required.

Small but increasing levels of foundation grants

According to data from Foundation Center, foundation funding for water and sanitation has increased in recent years, reaching US$181 million in 2012, delivered through 340 projects. The largest donor was the Bill & Melinda Gates Foundation (US$119 million), followed by the Coca Cola Foundation, the Stone Family Foundation and the PepsiCo Foundation. While the objectives of funds are to be lauded, the volume of their financial contribution matched against the scale of the challenge of achieving universal access suggests the need for careful selectivity, with choices based on maximising impact beyond those immediately reached.  

Key recommendations from WaterAid:

  • A credible Sustainable Development Goal for universal access to water and sanitation will require increased aid to the most vulnerable and under-resourced countries, with a strong focus on equity, sustainability and strengthening systems.
  • Aid to water, sanitation and hygiene should at least double from current levels by 2020, with an emphasis on grant financing, effective targeting and addressing the neglect of sanitation and hygiene. A reassessment of progress and financing gaps should take place in 2020.
  • National governments and donors—including private foundations—should act decisively to improve aid effectiveness and strengthen country systems: through increased transparency, pooling of resources, more technical assistance, and aligning and harmonising all stakeholder inputs behind national processes.

[1] All figures on financial flows are in 2012 prices. Data refers to gross disbursements from all donors. Unlike net ODA, gross ODA disbursements do not take into account ODA loan repayments from recipient countries. Disbursements correspond to the release of funds or the purchase of goods or services for a recipient. All figures based on OECD DAC Creditor Reporting System, data accessed May 2015.

[2]  ‘Large systems’ is a sub-sector of aid the water and sanitation sector. ‘Water supply – large systems’ includes: potable water treatment plants; intake works; storage; water supply pumping stations; and large scale transmission/conveyance and distribution systems. ‘Sanitation – large systems’ includes: large scale sewerage including trunk sewers and sewage pumping stations; domestic and industrial waste water treatment plants. Other sub-sectors are: waste management and disposal; basic drinking and sanitation; systems support. For more information, see

[3] This presents some challenges, in particular that improved donor reporting under these purpose codes may skew trends analysis. The ability of donors to disaggregate reporting using these purpose codes depends on their internal management information and reporting systems.

Following up from World Water Week, we’ve rounded up a number of tweets from the annual global meeting in Stockholm. This year’s theme, “Water for Development”, allowed for the exploration of number of WASH topics -- from financing and the Sustainable Development Goals, to gender issues, climate change, and water management.

The author on the road in Chadiza District. Photo Credit: Sarah Fry of WASHplus, FHI 360

The author on the road in Chadiza District. Photo Credit: Sarah Fry of WASHplus, FHI 360

Editor’s Note: This guest post was authored by Sarah Fry, WASHplus activity manager for the USAID-funded project, SPLASH, which works to ensure that proper WASH facilities and hygiene education exist in schools. As the project nears its end, Sarah describes a surprise visit she took to SPLASH sites in Zambia’s Eastern Province and details a number of positive changes she witnessed, particularly in regards to engagement and ownership around WASH -- both within the schools as well as the broader communities. This post originally appeared here on the WASHplus Blog.

That’s literally, not figuratively, building bridges. Two weeks ago I would not have been able to even understand that question, but today I have a story to share with you. First of all, hello from Zambia. As the WASHplus activity manager for the USAID funded activity called SPLASH (Schools Promoting Learning Achievement through Sanitation and Hygiene), I have been here since early July working with our team to see this activity to its end on September 30th.

SPLASH began in early 2012, and since then has built over 3,000 school toilets, drilled, equipped or rehabilitated over 400 water points for schools, provided permanent handwashing and drinking water stations, and worked with teachers, the national government and local government to ensure that good hygiene practices and stronger systems for operating and maintaining school WASH facilities are put in place, and will stay in place. These activities have taken place in Zambia’s Eastern Province.

Before SPLASH started, Chief of Party Justin Lupele and I went on a “Road Show” out to the districts, where we introduced SPLASH to the government officials and local committees and started to build ownership and participation. The last three years have been a whirlwind of activity -- construction, training, community mobilizing, monitoring, publicizing, documenting. Justin and I thought that as the project nears its end, it would be good to go on another grand tour to get a solid sense of what has happened, what has changed, and maybe, what does it all mean. The only requirement we set was to not alert any schools that we were coming to visit.

Zambia is a vast, not densely populated country. Visiting schools requires spending a lot of time in vehicles riding on rough and dusty country roads. These distances impressed upon me how much staff and building contractor time and effort it took to reach the schools to carry out SPLASH activities. Bumping along, I had a chance to think and look forward to what we would find. I certainly expected to see positive changes and improvements at SPLASH schools. However, nothing prepared me for the sea of change that unfolded before us as we made our way to about 20 schools, mostly rural, but a few urban ones as well.

A school in Chipata. Photo Credit: Sarah Fry of WASHplus, FHI 360

A school in Chipata. Photo Credit: Sarah Fry of WASHplus, FHI 360

In 2012, we heard many complaints from schools about how communities were misusing their boreholes and denying any responsibility when they broke down. Now, every school has active WASH committee and pupil WASH Club and all are engaged in some form of joint school-community fundraising for maintenance and repair of the borehole. Handwashing after toilet use and before eating was a nearly universal practice by pupils, a habit acquired even if group handwashing hadn’t been inaugurated yet.

A major achievement was the presence of soap at almost all handwashing stations -- stealing soap is a thing of the past, we were told, because pupils want and like to wash their hands. Through the WASH Clubs peer education, they feel that the stations and the soap belong to them. Going beyond peer education, some WASH Clubs are visiting local health centers and performing hygiene skits and poems for women gathered for pre-natal and under-five clinics. In addition, Teachers were delighted with drinking water stations close to the classrooms because time away from lessons was reduced.

Possibly the biggest change was the universal acceptance of Menstrual Hygiene Management (MHM) as a necessary and welcome part of the school program. Zambia, like many African countries, has taboos, myths and restrictions around menstruation, which is almost never discussed openly. Facilities and support for menstruating girls in schools is nearly absent, causing girls to stay home and miss weeks of lessons during the school year. Girls at SPLASH schools were thrilled with their beautiful washrooms -- shower/toilet structures built to accommodate MHM.

However, no one had anticipated the envy of the boys, who are now demanding their own washrooms to clean up after sports. MHM has entered into the vocabulary and into the culture, to the point where one WASH Committee was holding pad making parties for the girls, but then headed out into the community to distribute them to women in need. The taboos around menstruation seem to have melted away.

While the news from schools is very good -- and we will soon be able to quantify what kind of effect SPLASH had on the schools -- we encountered even more good news during this visit, outcomes that I can only call “unexpected consequences” of WASH in schools, and that frankly, I was unprepared for. The big apparent message is that WASH in schools can lift an entire community up and can bring about changes that were previously not possible.

Classroom before SPLASH in Mambwe District. Photo Credit: Sarah Fry of WASHplus, FHI 360

Classroom before SPLASH in Mambwe District. Photo Credit: Sarah Fry of WASHplus, FHI 360

Launching SPLASH with School Led Total Sanitation “triggering” shifted social norms in surrounding communities around open defecation practices to such a degree that we heard of headmen ordering all households to build latrines or pay a fine! Over a thousand household latrines have been built as a result.

In one school receiving a water point, a new classroom block was built where previously there was only a thatched shelter. Teachers’ houses have gone up, and a new water source at another school enabled a clinic to be built nearby.

Every single school stocked soap and toilet paper -- a miracle right there -- and consequently local shops were seeing a rise in sales of hygiene products. Some schools have a “one child one bottle” policy, leading local businesses to stock up on drinks to satisfy the demand for bottles.

New classroom block built after SPLASH provided access to a new water source. Photo Credit: Sarah Fry of WASHplus, FHI 360

New classroom block built after SPLASH provided access to a new water source. Photo Credit: Sarah Fry of WASHplus, FHI 360

One of the best “unexpected outcome” is the engagement of artisans in building the latrines and washrooms, and who, in the process, have gained marketable skills.

They have found work on road crews (may the work be speeded up!) and other local construction projects and in one case were solicited by a health center next to a school that has decided to build an exact replica of a SPLASH toilet.

Leading the parade of successful new entrepreneurs is the ex-SPLASH artisan who proved so competent that once the latrine construction was done, he was hired to oversee the building of a new bridge. And that’s what WASH in schools and building bridges have in common!

Attending World Water Week? Submit a Blog Post to WASHfunders!

Are you planning to attend World Water Week later this month in Stockholm? WASHfunders is currently accepting blog submissions and is interested in publishing content related to this year’s conference. Whether you’re organizing a workshop, involved with an exhibition, or are interested in covering a plenary, we’d love to feature your blog post describing highlights from the event.

Even if you won’t be attending the conference, we always welcome blog post contributions around critical issues of water, sanitation, and hygiene.

Posts should be about 800 words, written in an accessible style, and may cover a wide range of subjects related to WASH.

To contribute to the WASHfunders blog – around World Water Week or another topic – contact us at for more information. 

Webinar: Using Data for Learning and Sharing

This August 11th, join WASH Advocates, Global Water Challenge, IRC, and Aquaconsult for the third and final webinar in the 3-part webinar series, What Can Your Data Do For You? Moving Beyond Reporting, which outlines the ways to turn your data into action. 

The webinar, focused on applying data for learning and sharing in the sector, will feature presentations by Brian Banks from Global Water Challenge, Ivan Birungi from the Ministry of Water and Environment in Uganda, and Nompumelelo Ntshalinthsali from the Department of Water Affairs in Swaziland.

For more information or to register, please click here. To see past webinars in the series, visit the webinar page on  

Pit Emptying and Marketplace Development: A Mucky Business from Water For People on Vimeo.

Market development in sanitation is, both literally and figuratively, a mucky business. A recent video from Water For People thoughtfully illustrates the different approaches and limitations the organization has experienced in its attempts to establish a city-wide market for pit emptying services in Kampala, Uganda.

After identifying transportation costs as a main constraint to the scaling of the city’s pit emptying sector, Water For People helped to establish Sanitation Solutions Group with the aim of growing the market for this service. The Group leases vehicles and equipment to the best performing businesses already existing in the informal sector and supports pit emptiers in becoming franchisees, helping to professionalize an industry to which few aspire.

Watch the video and share your own insights and lessons learned for market-based solutions in the WASH sector in the comments!

The Water Institute at UNC is now accepting abstracts for their annual conference, which will focus on the theme “WaSH in emergencies and outbreaks”.  The conference, which will take place October 26-30, will explore this theme in the context of this year’s earthquake in Nepal, several cholera outbreaks throughout the work, and other global emergency situations which have resulted in critical WaSH concerns.

Submissions will be accepted through July 31 and selected abstracts will be offered poster presentations at the conference.  

To submit an abstract, use the Submit or Edit an Abstract link, where you will be prompted to log in to or create your user account. There is no limit to the number of submissions you may make, and you may return later to edit previously-created submissions. The Institute asks that abstracts be limited to 500 words or fewer.

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