“Global monitoring efforts have resulted in an underestimation of the urban sanitation crisis and the risks to public health, the economy, and the environment.” Studies of 15 cities in the global South (where 106M people live) showed that on average, 62 per- cent of sewage and fecal sludge is unsafely managed somewhere along the sanitation service chain. The number of urban residents who lack safely managed sanitation has increased from 1.9 billion in 2000 to 2.3 billion in 2015. 77% of those living in the South Asian cities studied did not safely manage sewage and fecal sludge. These conditions negatively affect public health, impedes economic growth and degrades the natural environment.
Sewers are the preferable sanitary option. However, there are many informal settlements in cities in which sewers don’t exist. On-site sanitation options are difficult to maintain. City governments should work with community organizations, nongovernmental organizations, and federations to improve and extend sanitation to informal settlements and address affordability.