According to the WHO/UNICEF Joint Monitoring Programme for water supply, sanitation and hygiene (JMP), as of 2022, 72 million people do not have access to basic sanitation services. This number includes 9.9 million who continue to practice open defecation, mostly in rural areas. Inequalities in access are large between urban and rural areas, socioeconomic status and countries in the region. In addition, measuring progress in sanitation services is hindered by limited data in most countries in the region.

The Latin American Sanitation Conference (LatinoSan) was held this year in Bolivia with the theme “Sanitation: a call to action”. SEI sanitation researchers participated and presented their work as part of the Bolivia WATCH program. The aim of LatinoSan was to position sanitation as a priority in the region and secure access to quality and sustainable sanitation for urban, peri-urban and rural areas with their links to health and climate change in mind. The human right to water and sanitation was part of the agenda, together with circular economy approaches, post-pandemic finance, cooperation and research, information and transparency, as well as Integrated Water Resources Management (IWRM).

The conference provides a platform for discussing progress and stimulating regional commitments for action to achieve SDG 6 on clean water and sanitation. Reflecting on the issues discussed at the conference, here are the key points on improving sanitation in the Latin America and the Caribbean region that policymakers and sector practitioners should consider.

Four takeaways from the LatinoSan conference:

• Advance action towards social inclusion and gender equality aspects in sanitation services

Although social inclusion and gender equity were considered part of the LatinoSan agenda, there was a greater interest on technical aspects, innovations and financing mechanisms, revealing that there is still a long way to go to bring attention to social and gender considerations in the region’s sanitation sector. This is even more pronounced when current gender and social inclusion approaches tend to focus on increasing participation of women and vulnerable populations in terms of numbers and not so much on meaningful participation and decision-making power.

With the official declaration of this year’s LatinoSan pledging to “move forward in the duty of the States to gradually expand water and sanitation services, particularly in rural and marginalized urban areas, taking into account particular needs of indigenous populations, local communities, women, girls and boys…and this way reduce existing gaps and gradually eliminate inequalities”, there is a greater need to advance research and practice on this topic in the region to commit to this statement.

• Apply circular economy approaches to rural sanitation

The circular economy and resource recovery from sanitation systems were also prominent on the LatinoSan agenda, focusing mainly on the productive management of sludge and wastewater from conventional systems. Given that only a minor part of nutrient resources in sanitation systems end up in the sludge of conventional septic tanks and wastewater treatment plants in combination with the challenges of reusing discharged wastewater, it would have been interesting to see more examples of alternative sanitation solutions. These include source separating systems such as separate management of blackwater (only urine, faeces and minimal flush water) or urine-diverting systems, which enable a more complete and often safer resource recovery, but need more research and piloting to refine technologies and gain traction and acceptance.

SEI contributed with a report on the prospects for more sustainable sanitation in the Bolivian city of Montero, including governance capacity, user preference and demand for reuse products. UNICEF and Montero’s utility also presented the experience of urine-diverting dry toilets with a collection service for more than 300 families. Separately, AguaTuya in Bolivia showcased decentralized treatment plants for wastewater in the city of Cliza, with 100% coverage and strong focus on wastewater reuse in maize plantations around the city.

Rural sanitation received little attention, although it lags behind in several countries, especially in Bolivia, where only 42% have access to basic sanitation in rural areas. SEI had two presentations on the potential of resource recovery and how the Clean and Green implementation framework can support more productive sanitation in rural areas. However, urbanization has now reached around 80% in Latin American countries, higher than most other regions of the world, which also explains why urban sanitation challenges and more conventional solutions dominated LatinoSan conference.

• Improve data and knowledge management about sanitation services

There is a clear need to collect more data about sanitation services in the region. Most Latin American and Caribbean countries report data about coverage of water and sanitation services, but there is no information about their quality in terms of acceptability, availability, safety, affordability and sustainability, nor it is disaggregated. To respond to this gap, the Knowledge and Development Network of the Observatory of Latin America and the Caribbean for Water and Sanitation (RID-OLAS), of which SEI is a member, was created. RID-OLAS also participated at LatinoSan and aims to enable collaboration between researchers, practitioners and policymakers through promoting sharing scientific evidence about water and sanitation in the region. Providing robust evidence of sanitation services can contribute to improved planning and policies that move from traditional approaches emphasizing infrastructure to ones that consider a human rights and environmental sustainability perspective to the provision of services.

• Consider sanitation as part of Integrated Water Resources Management (IWRM) and climate change resilience approaches

LatinoSan included several sessions on IWRM, but the main emphasis was on stepping up efforts for better watershed planning to ensure water quantity and quality for human use. However, throughout IWRM plans, sanitation and climate change should be given equal priority and considered in order to ensure water quality and quantity in the watershed.

Safely managed decentralized sanitation systems can play an important role in decreasing organic pollution to water bodies (including groundwater) through safe reuse of wastewater and nutrients recovered from wastewater or faecal sludge. At the same time, these systems promote efficient water use such as dry toilets, especially in areas of the watershed where water and sewer networks are not available.

The need to consider the short-term impacts of water-related hazards such as floods and droughts and long-term climate change impacts in water availability when planning and implementing sanitation services has also become more evident. Although climate change was part of the agenda, it was only mentioned in two of the 16 agreements in the official declaration.

Both topics were part of the sessions during the conference and SEI presented part of its work on integrating sanitation and watershed management in the Bolivia WATCH project. How to effectively integrate sanitation in IWRM and incorporate a climate-resilience approach remains a challenge.

Current challenges hindering the integration of sanitation in Integrated Water Resources Management include:

• incompatible mathematical models (IWRM vs WASH)
• different scales and disaggregation in available data (mainly regarding sanitation data in the watershed)
• difficulty in including information from dispersed communities into the watershed scale
• shortage of water, sanitation and hygiene (WASH) mathematical models
• lack of communication on common terms between sectors (IWRM vs WASH).

The state of sanitation in Latin America and the Caribbean demands action towards improving systems and services while reducing inequalities at the same time. To achieve this, the sanitation sector will need to move beyond large-scale investments and technologies for conventional systems that tend to dominate the region and focus also on making the invisible visible. These include effectively integrating sanitation in IWRM and climate change, highlighting how safely managed sanitation can help reduce groundwater pollution, investing in non-conventional systems with a resource recovery approach in rural areas, advancing practices to substantially improving social inclusion and gender equality and last but not least, increasing efforts to improve data and knowledge to inform better policies.