Tackling Toilet Loss
The hidden economic andsocietal cost of neglecting
school toilets

Supported by

Tackling Toilet Loss2

Contents
3

Foreword

4

About the report

6

Executive summary

16 Unpacking the what, why and how
27 The current state of Toilet Loss
35 A pathway to full sanitation coverage in schools
52 Conclusion
58 Appendix: Country data summary©Economist Impact 2023

Tackling Toilet Loss3

Foreword
Many people are fortunate enough not to give the humble toilet much thought. But next time you sit
on a fully-functioning, clean toilet, just take a moment to think about the millions of school children
around the world who go to school without one.
The first toilet was built in around 3000 BCE, and the first flushing toilet in 1596. But what is one ofhumanity’s most important inventions is easily—and rightly—taken for granted. The uncomfortable
truth, however, is that one in three, or 539 million, school children do not have a toilet in school that is
fit for use. They can’t take the toilet for granted. That this is happening in 2023—a year of missions tothe sun, tourists flying into space and AI going mainstream—makes it even more shocking. This has tochange.
Without up-to-date, relevant data, we make decisions in the dark and risk doing the same things while
expecting different outcomes. We need clear, actionable, new data to solve old problems. This is why
we’ve commissioned the Toilet Loss report to help us understand why the SDG 6.2 target of universal
access to adequate and equitable sanitation has stayed resolutely out of reach—a gap in access thatnever closes despite the Herculean efforts in building toilets over the past decade.
What has emerged from the report is simple behavioural economics, specifically the economics ofloss aversion. Loss is felt more keenly than a gain. And the problem isn’t that we’re building toilets
too slowly, it’s that we’re losing toilets too frequently. The toilets exist but, without a plan to maintainthem, they fall into disrepair and become unusable—like they never existed.
This report quantifies the scale and cost of Toilet Loss, starting with schools, where the impactof lost toilets means that an urgent change is required. Toilet Loss is holding back a generation ofschool children whose education has already been unjustly impeded by the global pandemic. This
report shows the value of investing in school toilets, and the economic impact of improved learning
outcomes alongside more prosperous economies. More than US$1.9 billion is lost across four countries
alone because toilets are built without a plan to maintain them. If we want to achieve universal accessby 2030, the solution is not simply to build more toilets—the most cost-effective strategy is to direct
investment first towards maintaining existing toilets.
The humble toilet is something worth protecting. A value that’s understood as universally as gold.
Our Unilever brand, Domestos, is the world’s leading toilet cleaning brand and believes exactly that.
To date, Domestos has helped 29 million people get access to a clean, safe toilet through its 10-year
partnership with UNICEF and its school toilet operation and maintenance programme, ‘Cleaner Toilets
Brighter Futures’.
Together with its partners, including UNICEF and GIZ, Domestos is committed to helping 100 million
people get improved access to sanitation by 2030.
This is not a fight we can win alone. Many experts from the public and private sector have contributed
to this report and their voices are heard in it. So just as we came together to develop it, we must cometogether to act on it.
Our hope is that this report shines a light on the overlooked and undervalued issue of the operationand maintenance of school toilets; ignites new discussions and decisions to inform policymaking andfunding; and frees all schools and pupils to have their needs met so they can focus on what matters:
their education. Toilet Loss is an unnecessary drag on our education systems, and only by knowing it’shappening—having the data to show it—can we work together to stop it. If we get it right, every childborn today will have access to a clean, safe toilet by the time they start school. And I sincerely hopeeach of them takes it for granted.
Eduardo Campanella, Chief Marketing Officer, Home Care, Unilever©Economist Impact 2023

Tackling Toilet Loss

4

About the report

This report, supported by Unilever, presents findings from research conducted by Economist Impact
to assess the costs of failing to provide all children with access to clean, safe and usable toilets intheir schools and to identify the most effective investment pathway to close the gap. The findings are
based on insights gathered from a literature review, expert interviews and a custom economic impact
model developed by Economist Impact. Economist Impact bears sole responsibility for the content
of this report. The findings and views expressed do not necessarily reflect the views of the sponsor.
This report was produced by a team of researchers, writers and editors including:• Katherine Stewart—senior project advisor• Shivangi Jain—project director• Dina Alborno—project manager• Deni Portl—lead analyst
The report was designed by Marina da Silva.
Our thanks are due to the following people for their time and invaluable insights
through interviews and consultations throughout the programme (listed alphabeticallyby surname). Support provided to the programme’s development does not imply
endorsement (in part or in full) of the research approach or findings.
• Brian Arbogast, director of Water, Sanitation and Hygiene
Program, Bill & Melinda Gates Foundation• Habib Benzian, research professor, WHO Collaborating Center, New York University;
global health research fellow, Institute of Advanced Study at Stellenbosch University• Sophie Boisson, sanitation and WASH epidemiologist, World Health Organisation (WHO)• Claire Chase, senior economist, World Bank
• Christie Chatterley, Fort Lewis College; independent consultant
with WHO/UNICEF Joint Monitoring Programme• Antoine Delepière, senior programme manager, Stockholm International Water Institute• Josh Garn, assistant professor, University of Nevada School of Public Health• Kate Holme, strategic partnerships director, WaterAid• Guy Hutton, independent consultant, senior economist andfinancing specialist in WASH (previously UNICEF)• Md Tahmidul Islam, technical lead, WaterAid Bangladesh• Rick Johnston, co-lead of the WHO/UNICEF Joint Monitoring Programme, WHO• Liliane Kente, principal sanitation specialist, African Development Bank
• Jan Libera, project coordinator, German Agency for International Co-operation (GIZ)©Economist Impact 2023

Tackling Toilet Loss

5

• Bernd Loewen, chief financial officer and member of the executive board, kf W
• Marvin Marquez, monitoring and evaluation coordinator, GIZ• Kate Medlicott, team leader, sanitation and wastewater, WHO• Ed Mitchell, chief executive, Water & Sanitation for the Urban Poor
• Bella Monse, senior advisor, Fit for School, GIZ• Ana Virginia Mujica, programme officer, Stockholm International Water Institute• Heather Murphy, associate professor and Canada researchchair in One Health, University of Guelph• Ubo Pakes, consultant, GIZ• Ian Ross, assistant professor (health economics), London School of Hygiene & Tropical Medicine• Kevin Roussel, regional co-ordinator Africa, Sanitation and Water for All• Oliver Schmoll, programme manager, water and climate, WHO
European Centre for Environment and Health• Hugh Sharma Waddington, assistant professor, London School of Hygiene & Tropical Medicine• Jitendra Kumar Singh, water supply and sanitation specialist, Asian Development Bank
• Tom Slaymaker, senior statistics and monitoring specialist, UNICEF• Bryony Stentiford, director of the growth hub, IRC Wash
• Ann Thomas, senior WASH advisor, UNICEF©Economist Impact 2023

Tackling Toilet Loss

6

Executive summary
Context
Chances are, if you are reading this report, you take access to a usable toilet for granted.
That is, until one is not available when you need it most. Lucky for you, reader, this problem
is most likely rare and only a temporary inconvenience.
But imagine you are a child in school and the only toilet in your school is out of order—and has
been since the start of the school year. Imagine trying to focus on lessons while living in fear of
nature’s call on a daily basis.
Sadly, this is the reality for at least 539 million school children around the world (equivalent to one inevery three school children) who do not have access to a usable toilet at school.1 Almost half of thesechildren have no toilet in school at all. For the other half, a toilet may exist but have become unusable
through a lack of basic maintenance.2 These children suffer the impact of Toilet Loss daily.
These statistics on toilet access across schools capture only a specific moment in time. The reality, in fact,
is constantly evolving and can shift in a matter of hours when a toilet is left unmaintained and anotherchild is left without a usable toilet.
Addressing Toilet Loss for school children is necessary to meet two of the UN Sustainable Development
Goal (SDG) targets: 4.a—to provide safe and effective learning environments for all—and 6.2—toensure equitable access to safe sanitation and hygiene.3 It is also necessary to fulfil a basic humanright—the right to physical and affordable access to sanitation (including toilets), that is safe,
hygienic, secure, socially and culturally acceptable and that provides privacy and ensures dignity.4

Toilet Loss is the economic and societal cost of neglected
toilets. Toilets can become unusable through neglect from:a) lack of investment in operations and maintenance;b)lack of appropriate school-level management policies, or
implementation capacity, to enable toilet use (e.g. safety
policies, school policies on routine O&M); andc) lack of provision of essential resources (for example,
water and sanitary products).

539 million

school children globally without accessto a usable school toilet (2021)

240 million

299 million

have no access to any
school toilet

impacted by
Toilet Loss

Source: WHO/UNICEF Joint Monitoring Programme,5Economist Impact analysis

1
2
3
4
5

https://data.unicef.org/wp-content/uploads/2022/08/JMP-WASH-in-schools_2022.pdf
Economist Impact estimates based on data from the WHO/UNICEF Joint Monitoring Programme (washdata.org/data/school#!/)unstats.un.org/sdgs/metadata/?Text=&Goal=6&Target=6.2
https://digitallibrary.un.org/record/821067
Economist Impact estimates based on data from the WHO/UNICEF Joint Monitoring Programme©Economist Impact 2023

Tackling Toilet Loss

7

The existence of a school toilet is not enough. Toilets also need to be safe, clean and maintained if
children are to use them. The WHO/UNICEF Joint Monitoring Programme for Water Supply, Sanitationand Hygiene ( JMP) is the most widely used and reputable source for measuring access to usable
school toilets.6
The JMP ladder for sanitation in schools
Throughout this report, we refer to the terminology used by the WHO/UNICEF Joint Monitoring
Programme (JMP) in classifying sanitation services in schools.7
No service

Required toilets are not available in schools, or they are unimproved

Limited service

Improved toilet facilities exist in schools but they are not single-sex or usable

Basic service

Improved toilet facilities exist in schools that are single-sex and usable

Advanced service

To be defined by countries at the national level. National-level definitions
to include consideration of additional requirements for use including
cleanliness and accessibility for all users, among others

Improved services are defined as those that receive waste management to remove excreta fromhuman contact.
Usable services are defined as toilets that are accessible to students (doors are unlocked or a
key is available), functional (not broken or blocked, and water is available), and private (lockable
doors with no large gaps in the structure).

Building on JMP data (see “Interpreting the JMP data” below), Economist Impact, supported by
Unilever, has measured the scale, scope and cost of Toilet Loss and developed an investment pathway
to ensure every school child has access to a clean and safe basic toilet. Specifically, we focus on fivecore questions:8• How many safe basic school toilets have been lost through neglect?9• What is the cost—or Toilet Loss—of not providing all children with access to basic school toilets?
• How much will countries need to invest in both building new toilets and maintaining existing andnew ones to close the gap?
• How much will countries and their economies gain from doing so?
• What is the most effective investment pathway to ensure that all children have a basic toilet inschool by 2030?

6
7
8
9

washdata.org/monitoring/schools
https://washdata.org/monitoring/schools
See technical annex for further detail on the methodology
Estimated as the number of limited service toilets in schools. See technical annex for further detail on the methodology©Economist Impact 2023

Tackling Toilet Loss8

Our research shines a light on the urgent need for countries to collect and provide systematic
data not only on levels of access to school toilets, but also the quality of this access. We now havea good sense of whether children have a toilet in their school in principle, but we continue toremain in the dark on whether these toilets are sufficient, clean and usable in practice. Without
data on this, we will be unable to fully grasp the scale of the challenge that lies ahead.
Our analysis focuses on four countries, selected to gain geographic coverage across a rangeof contexts and levels of development: Ecuador, India, Nigeria and the Philippines. It reveals
key findings for the pathway to closing the gap in basic sanitation access across schools.

Estimating Toilet Loss and the costs and benefits of addressing it

Number of toilets (basic and limited service).
Number of children with basic/limited
service sanitation in school*

Number of pupils per toilet**Number of toilets lost.
Number of school toilets built(basic and limited service)***Number of usable toilets(basic service)***Social and economic cost of Toilet Loss.
Healthcare
expenditure***Family income
loss***

Economic output
loss***

Investment in construction and O&M to close basic access gap.

* Data from JMP

Construction
cost

Number of school toilets
needing construction***Cost of school toilet
construction***O&M cost

Number of school toilets
needed for population***Cost of annual O&M perschool toilet***** Based on WHO guidelines*** Economist Impact analysis©Economist Impact 2023

Tackling Toilet Loss

9

Key findings:

1

Across the four countries considered in this study, 1.2 million school toilets
constructed since 2015 have been “lost” through lack of maintenance, equivalent
to a loss of US$1.9 billion.

These losses have been most extreme in India and Nigeria, where 0.6m and 0.4m constructed
toilets have respectively been lost. In Nigeria and Ecuador, the losses amount to nearly 20% of
all investment in school sanitation since 2015—in other words, for every US$5 invested in school
toilets, US$1 has been lost.

FIGURE
3. Toilet
FIGURE
1. Toilet
Loss loss

Ecuador

US$120 million
17% of investment
Nigeria

India

US$990 million
3 % of investment
Philippines

US$580 million

US$250 million

18% of investment

10% of investment

Total Toilet Loss(four countries)

US$1.9 billion©Economist Impact 2023

Tackling Toilet Loss10

2

If toilet construction had been supported by operation and maintenance (O&M),
the countries in this study could be 10% closer to full coverage of basic toilets
across schools. Prioritising O&M is critical to preventing Toilet Loss.

While constructing new school toilets is necessary to reach full school sanitation coverage,
construction without O&M results in a significant and rapid loss of the newly built toilets. In Ecuador,
US$120m has been lost from building new school toilets that have not been maintained. If this money
had been put towards maintaining existing toilets instead, access to basic school toilets in the country
could be 69% instead of 59%.

FIGURE 2. What could have been

FIGURE 4. What could
havebeen services in school, actual (2021) vs hypothetical*
Share ofbasic sanitation
Share of basic services (2021)

Gap in access to basic services (2021)

Gap in access closed with investment in O&M

India

Nigeria2%

Ecuador

59%

86%

10%

38%

7%
Philippines

74%

9%* Note: The hypothetical share of basic sanitation services is estimated by assessing how many additional school toilets could bemaintained using the investment made in constructing unusable (limited service) school toilets

Maintaining a toilet: estimating the costs
Increasing access to basic sanitation services in schools means investing not only inconstructing toilets, but also in maintaining those toilets over their lifetime. A toilet built
without a plan for O&M leads to Toilet Loss.
This analysis quantifies the costs of operating and maintaining toilets in schools using abottom-up approach at a country level. These costs include:• Operation costs: day-to-day regular costs incurred in ensuring that toilets have theresources required for use (for example, toilet paper, handwashing soap, water supply)and operations (for example, cleaning tools and resources, including personnel for regularcleaning and minor repairs).
• Maintenance costs: semi-regular costs incurred in the maintenance and upkeep of toilets
over time (for example, pit emptying and minor infrastructure repair, including required tools
such as hammers and paint).10
Rehabilitation costs are not included in this analysis. These costs are incurred if existing toilets
are left unmaintained or decommissioned for an extended period of time and, therefore, require
more extensive work to bring them to a basic service level before they are available for use again.
The existing data does not allow for an assessment of how many toilets require rehabilitation. As
a result, the estimated cost for closing the sanitation gap is underestimated.

10

Some of the costs included within this analysis go beyond those required to achieve basic sanitation levels in schools based on the JMP definitions.
For example, pit emptying is not a basic service requirement. However, these costs are marginal (less than 1%) of the total estimated costs.
©Economist Impact 2023

Tackling Toilet Loss

11

3

Increased O&M spending could have avoided large healthcare expenditure,
reduced family income and lost economic output of over US$10 billion
across the countries studied in 2015-21.

India and Nigeria suffered the greatest losses, of US$5.1bn and US$4.4bn respectively. The
greatest contributor to these losses is healthcare expenditure to treat infections in children—in
India, healthcare expenditure constitutes two-thirds of the total loss. Losses in the longer term
could be substantially higher than estimated, as learning losses drive wider economic impacts aschildren grow older, from reduced access to skilled labour and decreased overall productivity.
Construction without O&M leads to societal losses of over

US$10 billion
across Ecuador, India, Nigeria and the Philippines from:Higher healthcare costs
from more diarrheal
infections in children

4

Lost family income throughabsenteeism from work or
increased childcare spending

Lost economic activity andemployment in O&M

Globally, at least 20m more basic service toilets are needed across schools
to reach 100% coverage by 2030. Meeting this target requires a six-foldacceleration in the progress made since 2015.

Between 2015 and 2021, the number of basic service toilets in schools increased from 36m to 38m.
By 2030, 58m toilets will be needed across schools. To achieve this goal, our analysis estimates that:– 12m more toilets need to be newly constructed and subsequently maintained;– an additional 8m existing toilets need to be rehabilitated and receive subsequent regular O&M; and,– the remaining 38m need continued O&M.

FIGURE 3. Accelerating progress in providing sanitation in school
Global access to basic sanitation services in schools (number of basic toilets, millions)

Required growth: acceleration
to meet targets

36 million
2015

Historic growth

38 million
2021

Projected growth:
continuation of historic paceof growth

58 million
Sanitation service
gap across schools

41 million

2030©Economist Impact 2023

Tackling Toilet Loss

12

5

An additional cent in every dollar of education spending per child each year
will allow most countries to achieve full basic sanitation coverage in schools
through investment in the construction and O&M of school toilets by 2030.11

Investing both in building (and then maintaining) new school toilets and maintaining existing ones is
the most equitable solution to reach 100% coverage of basic school toilets and provides the greatest
benefits to society. Additional estimated annual spending of US$2-11 per child is needed to achieve
this across the four countries studied. Nigeria is the only country among those studied where more
substantial increases in spending—equivalent to 23% of current education spending per child—will beneeded for full basic coverage. This level of investment is a result of lower baseline education spendingin Nigeria and much larger gaps in basic toilet coverage in schools. Across all countries, additional
investment will be needed beyond those estimated to achieve advanced service levels in schools,
particularly in terms of sanitation software such as training, and the implementation of monitoring andevaluation systems.12

FIGURE 4. Getting to full coverage: additional investment needs
Additional annual spending needed per child to achieve full coverage of basic service toilets in schools

US$ additional
spending per child
Percentage ofeducation spending

11

12

Ecuador

India

Nigeria

Philippines

US$7 =
0.9%

US$2=

US$10.5 = US$4 =

0.5%

23%

0.7%

Investments in school sanitation do not come entirely or partially from education budgets in all contexts. These numbers are intended to put thescale of requirements to meet full coverage into perspective and to promote increased education sector ownership and responsibility for WASH in
Schools.
https://www.ircwash.org/sites/default/files/Peal-2010-Hygiene.pdf©Economist Impact 2023

Tackling Toilet Loss

13

6

In a budget constrained environment, prioritising O&M investment tomaintain existing school toilets is the most cost-effective strategy—inNigeria, this strategy delivers social returns of US$2.6 for every US$1 invested.

Achieving the SDG targets will ultimately require investing in both construction and O&M, but, in a
fiscally constrained environment, countries may not have the capacity to substantially increase theirinvestment in school sanitation. Investing first in maintaining existing toilets is the most cost-effective
and feasible strategy, delivering the highest social returns for every dollar invested (see Figure 5).
These returns arise from reduced healthcare expenditure, higher family income and increased
economic activity. In the longer term, as more funding is unlocked, greater investment can be directed
towards building and maintaining new toilets to close the access gap.

FIGURE 5. Returns on investment
Returns (US$) for every US$1 invested in school sanitation, by sanitation strategy
Construction alone

O&M alone

Construction and O&M

Every US$1 invested returns:

Ecuador

0.4
1.27
1.08
0.78

India

1.66
1.38

Nigeria

0.41

2.59
1.76

Philippines

0.39
1.76
1.44

©Economist Impact 2023

Tackling Toilet Loss

14

Based on insights gathered through interviews with experts, published research and learning fromcountries leading the way towards sanitation for all children, we identify a three-point plan as abaseline for developing local strategies to close gaps in sanitation access in schools. Accelerating
progress towards achieving the goal of eliminating Toilet Loss will require system-level change in
how sanitation services in schools is planned, delivered and managed. Central to this change will bepolitical commitment across international, national and sub-national levels.

A three-point plan for eliminating Toilet Loss across schools
Accelerate future planning
No school toilet built
without a plan and budget for
operations and maintenance

Political
commitment
Better monitoring
Collecting systematic
data against clear
guidelines to measureand monitor theavailability of and accessto basic sanitation
services in all schools

Prioritise school
sanitation acrossinternational, national
and local policy levels

Clear governanceClarifying roles andresponsibilities for all
stakeholders providing
sanitation services in schools©Economist Impact 2023

Tackling Toilet Loss

15

The remainder of this paper explores these findings in greater depth, concluding with key
steps that stakeholders can take to urgently accelerate the sanitation agenda in schools.
Interpreting the JMP data
Our analysis makes a number of assumptions in interpreting the WHO/UNICEF Joint
Monitoring Programme ( JMP) data on basic, limited and no sanitation services in schools.
It assumes that:• toilets defined as “basic service” both exist and are usable;• toilets that are defined as “limited service” exist but are not usable, because they have notreceived sufficient and regular O&M; and• toilets defined as “no sanitation services” have not been constructed and do not exist. In
reality, these toilets may also exist despite being unusable, meaning that some construction
expenditure has been incurred.
Interpreting basic, limited and no sanitation services
Basic sanitation services

Limited sanitation services

No sanitation services

The infrastructure for
improved facilities exists andis single-sex and usable.

The infrastructure for improved
facilities exists, but it is not
single-sex and/or usable

The infrastructure for toilets or
latrines does not exist, or the facilities
that exist are unimproved

Constructed
toilets

Regular
O&M

Constructed
toilets

No
O&M

No
construction

No
O&M

However, these assumptions are likely to overestimate current levels of access in two ways:
1. The number of existing toilets is overestimated in our analysis. We assume
that WHO guidelines on student-to-toilet ratios—one toilet per 25 girls, and one
toilet and one urinal per 50 boys13—are met in all schools that have access to“basic services”; however, the JMP assigns “basic service” levels to any school thathas at least one toilet facility each for boys and girls. By imposing ratios on the
JMP definitions we, therefore, are likely to overestimate the access to toilets.
2. The number of usable toilets is also overestimated in our analysis. We assume
that all “basic service” facilities are usable in practice. The JMP’s definition of “basic
service” accounts for school toilets being accessible, functional and private. Other
measures of usability—such as cleanliness—are captured in “advanced services”
for which data are not yet collected at the country level. Therefore, the analysis
does not distinguish between “basic” and “advanced” levels of service.
As a result, it is likely that we have underestimated the infrastructural and financial
requirements to close access gaps to basic sanitation services—as well as the benefits that
could arise from doing so.

13

https://apps.who.int/iris/bitstream/handle/10665/44159/9789241547796_eng.pdf?sequence=1&isAllowed=y©Economist Impact 2023

Tackling Toilet Loss

16

Unpacking the what, why and how
The goal: sanitation for all children, starting with schools
The goal is set for 2030: all children should have access to a basic toilet. We are over halfway throughthe 15-year period to achieve the SDGs. How far are we away from the goal of universal access toa basic toilet? One of the places where we can measure and monitor toilet access for children is inschools, and today 539 million children around the world still do not have basic access at school.14
The UN Sustainable Development Goals (SDGs), established in 2015, serve as a call to action
for all countries to implement policies that promote prosperity for both people and theplanet.15 SDG target 4.a specifically aims to provide safe and effective learning environments
for all. Providing all children with access to a safe and usable toilet at school is crucial toenhancing the learning environment.16 This goal is complemented by SDG target 6.2, whichseeks to ensure equitable access to safe sanitation and hygiene for all by 2030.17

FIGURE 6. Global access to basic toilets in school
Percentage of children without access to usable basic toilets in school, by region

Northern America

0%Western Europe

0.06%

Eastern Europe

0.5%

Asia

26.7%

High levels ofaccessLow levels of access

Latin America and the Caribbean

20.6%

Sub-Saharan Africa

56.0%

Middle East
& North Africa

20.4%

Global average: 30%
Source: WHO/UNICEF Joint Monitoring Programme, Economist Impact analysis
Note: Regional assessment is based on JMP definitions
14

15
16
17

The WHO/UNICEF Joint Monitoring Programme defines a usable school toilet as one that is accessible to students (doors are unlocked or a key is available),functional (not broken or blocked, and water is available) and private (lockable doors with no large gaps in the structure).
sdgs.un.org/goals
www.globalpartnership.org/blog/how-can-toilets-promote-education
unstats.un.org/sdgs/metadata/?Text=&Goal=6&Target=6.2©Economist Impact 2023

Tackling Toilet Loss17

Half of these children have no toilet in school at all. For the other half, a toilet may exist, but it has become
unusable through a lack of basic maintenance.18 These children suffer the impact of Toilet Loss.

FIGURE 7. Comparing toilet access with usability
Breaking down the shares of children with no usable toilet access* in school, by region (2021)% of children with no access to a toilet in school*% of children impacted by Toilet Loss**

15.3%

Global average

30%

14.7%
39.9%

Sub-Saharan Africa

16%

55.9%

26.7%

Asia

8.90%

17.8%

Latin America
and the Caribbean

10.8%

9.8%

20.6%

Middle Eastand North Africa

9.40%

11%

20.4%

Eastern Europe

0.20% 0.30%

0.50%

Western Europe

0.06%

North America

0%

0.06%

* The WHO/UNICEF Joint Monitoring Programme ( JMP) definition of toilet usability in schools means that at least a single toilet existsthat is accessible to students, functional and private.
** Using JMP data on “no service” access*** Using JMP data on “limited service” access
Source: WHO/UNICEF Joint Monitoring Programme, Economist Impact analysis

The what: defining Toilet Loss
Toilet Loss arises when toilets are constructed but become unusable. This results in costs:
to governments and others who have invested in building infrastructure that cannot be
used, and costs to societies from poorer health, educational and economic outcomes.
Toilet Loss is the economic and societal cost of neglected toilets. Toilets can become unusable
through neglect from:a) lack of investment in operations and maintenance (O&M);b) lack of appropriate school-level management policies, or implementation capacity, to enable
toilet use (e.g. safety policies, school policies on routine O&M); andc) lack of provision of essential resources (for example, water and sanitary products).

Toilets need to exist. They also need to be safe, clean and maintained if they are to be
used. Operations and maintenance (O&M) is critical for the sustainability and longterm functioning of toilets.19 O&M includes daily cleaning to ensure that toilets can beused, and regular maintenance to ensure that toilets do not fall into disrepair.20

Economist Impact estimates based on data from the WHO/UNICEF Joint Monitoring Programme (washdata.org/data/school#!/)www.ircwash.org/sites/default/files/Muellegger-2011-Operation.pdf
20
programme.worldwaterweek.org/Content/ProposalResources/PDF/2017/pdf-2017-6723-10-04%20GIZ%20-%20DPP%20O&M%20Guide.pdf
18

19©Economist Impact 2023

Tackling Toilet Loss

18

With O&M, a well-installed school toilet can be used without replacement for over 20 years.21
However, without investment in O&M, toilets rapidly deteriorate, becoming dysfunctionaland hygienically unsuitable for use. Rehabilitating a dysfunctional toilet can require
costly renovations. Resource constraints, lack of clarity on ownership and responsibilities
across stakeholders, and competing budget priorities can all cause Toilet Loss.

FIGURE 8. Lifecycle of a toilet
End ofasset
life

Investment in regular O&M

Constructionof school toilet

Toiletneglect: No
investment inregular O&M

Toilet neglect:
No investment inregular O&M

Restorationof neglected
toilets

Decreasing
returns on
sanitation
investment

End ofasset
life

Restorationof neglected
toilets

End ofasset
life

Toilet lifetime
Days/weeks

Up to
20 years

20 years“Toilets that aren't properly maintained inschools become unusable very quickly.
The cost of neglecting to clean andmaintain toilets is very high and we often
fail to recognise this. Children are the ones
who suffer as a result.”
Guy Hutton, independent consultant, senioreconomist and financing specialist in WASH

21

pdf.usaid.gov/pdf_docs/PNAAM278.pdf©Economist Impact 2023

Tackling Toilet Loss

19

Implementing O&M initiatives in schools: roles and responsibilities

Case study

Water, Sanitation and Hygiene (WASH) in Schools (WinS) is a global effort dedicated toenhancing WASH services within schools. In the context of sanitation, WinS emphasises therole of O&M to ensure that school toilets both exist and are usable, to minimise Toilet Loss.22
Implementing WinS requires the collective engagement of teachers, parents, students
and community members.23 In particular, education ministries play a key role in managing
and co-ordinating WinS programmes, while relying on local authorities and schools for
implementation.
India’s Ministry of Education launched the Swachh Bharat: Swachh Vidyalaya (SBSV; Clean
India: Clean Schools) programme in 2014 to advocate for enhanced WASH services. These
included the need for regular O&M of school toilets and separated toilets for boys and girls.24
In 2016 the ministry instituted the Swachh Vidyalaya Puraskar (Clean Schools Award) to reward
best practice under the SBSV initiative.25 The introduction of the award created a mechanism
and incentive for schools to collect and share data on their WASH practices. Data are collected
at the school level through a survey, which includes questions on the frequency of cleaning
school toilets, the materials used in cleaning, and responsibilities for the supervision ofcleaning and maintenance.26
Liberia also joined the WinS efforts to help combat its Ebola outbreak in 2014-16.27 The Ministryof Education published Guidelines for the implementation of the Liberia WASH in Schools
in 2015, in which it established clear WASH objectives. The guidelines state that all schools
should have adequate, clean, functional, accessible, private and safe toilet facilities.28 Clear
roles and responsibilities are outlined for different stakeholders, overseen by the Ministryof Education, including the Ministry of Public Works, Ministry of Health and Social Welfare,and local and international NGOs. The guidelines emphasise the importance of O&M, withrecommendations for school authorities to assign daily cleaners to all school toilets and forfunds to be set aside for maintenance and repairs.29

The why: the need to address Toilet Loss
Beyond loss of infrastructure, not investing in school toilet O&M creates additional
real and tangible losses both to individuals and to societies more broadly.
When toilets are clean and well-maintained, children have an incentive to use them.30 But
when they are not, children avoid them. Even in middle- and high-income countries, children
avoid dirty school toilets—a recent study in Denmark found that over 50% of children are
dissatisfied with the toilets in their schools and 25% postpone toilet visits as a result.31

programme.worldwaterweek.org/Content/ProposalResources/PDF/2017/pdf-2017-6723-10-04%20GIZ%20-%20DPP%20O&M%20Guide.pdf
programme.worldwaterweek.org/Content/ProposalResources/PDF/2017/pdf-2017-6723-10-04%20GIZ%20-%20DPP%20O&M%20Guide.pdf
swachhvidyalayapuraskar.com/about
25
dsel.education.gov.in/sites/default/files/2022-12/SVP_Coffee_Table_Book_5.pdf
26
www.education.gov.in/sites/upload_files/mhrd/files/upload_document/Swachh_Vidyalay_Puraskar_Guidelines.pdf
27
oxfamilibrary.openrepository.com/bitstream/handle/10546/345841/tb-wash-in-schools-ebola-recovery-liberia-020315-en.pdf;jsessionid=2BEF20566D313A602C58FFC48D6D1890?sequence=128
reliefweb.int/attachments/e0a42c7b-3eb7-3056-bd35-dfe3af1a2e55/liberia_wins_quick_implementing_guidelines_v1_0.pdf?_gl=1*1nn2jwm*_
ga*OTc3MDk0MjgzLjE2OTQxODE3OTg.*_ga_E60ZNX2F68*MTY5NTg0MDk0OS4yLjEuMTY5NTg0MTA3NC42MC4wLjA.
29
www.humanitarianresponse.info/sites/www.humanitarianresponse.info/files/documents/files/annex_8_liberia_wins_guidelines_and_tor_0.docx
30
programme.worldwaterweek.org/Content/ProposalResources/PDF/2017/pdf-2017-6723-10-04%20GIZ%20-%20DPP%20O&M%20Guide.pdf
31
link.springer.com/article/10.1007/s00431-021-04111-1
22
23
24

©Economist Impact 2023

Tackling Toilet Loss

20

Toilet avoidance can bring severe health risks. Lack of adequate sanitation is associated withthe transmission of diseases such as worms and diarrhoea.32 In the worst cases, these diseases
can lead to death—globally, 90% of deaths from diarrhoeal diseases in children under the ageof five are linked to lack of sanitation, contaminated water or inadequate hygiene.33,34
For those who survive, inadequate sanitation impacts more than health. It can impede access to
education—studies have shown impacts on both school enrollment and attendance, with more
pronounced impacts for girls.35,36 Research shows that children’s perception of their physical school
environment is associated with academic achievement.37 Adequate sanitation at school is
critical to creating a health-promoting environment in which children can thrive. In SouthAsia, one in three girls miss school days every month owing to toilet facilities that lack wateror privacy.38 In some cases, this also leads to school drop-out.39 The resulting implications for achild’s learning outcomes impact on their employment opportunities and earning potential.
The negative impacts on health and education outcomes—through increased disease transmission or
lower school attendance—translate into wider impacts across communities and societies. In the shortterm, sanitation-related diseases create a burden both on health services and on individuals, families
and governments through higher healthcare costs. In the longer term, deaths caused by sanitationrelated diseases and worse education outcomes result in a smaller and less productive workforce,
contributing to reduced economic activity and an overall loss of economic value (see Figure 9).40

www.ncbi.nlm.nih.gov/pmc/articles/PMC4889767/
www.unicef.org/mena/press-releases/lack-of-toilets-dangerous-for-everyone
reliefweb.int/report/world/children-dying-daily-because-unsafe-water-supplies-and-poor-sanitation-and-hygiene
35
www.mdpi.com/1660-4601/9/8/2772
36
iwaponline.com/washdev/article/8/1/53/38065/Sanitation-and-water-supply-in-schools-and-girls
37
www.frontiersin.org/articles/10.3389/fpsyg.2022.959259/full#:~:text=Regression%20analysis%20indicates%20that%20students,significantly%20
related%20to%20academic%20achievement.
38
www.wateraid.org/uk/media/young-children-most-at-risk-from-lack-of-water-sanitation-and-hygiene-in-schools#:~:text=A%20recent%20WaterAid%20and%20Unicef,disposal%20options%20for%20sanitary%20pads.%E2%80%9D
39washmatters.wateraid.org/publications/women-and-wash-water-sanitation-and-hygiene-for-womens-rights-and-gender-equality-201340
www.wateraid.org/us/media/economic-report-unlock-trillions-of-dollars-with-clean-water-decent-toilets-and-hygiene
32
33

34

©Economist Impact 2023

Tackling Toilet Loss

21

“It’s poorly understood that lack of access tosanitation really undermines the achievement of
any of the other SDGs. We can’t achieve any ofthem, arguably, without access to sanitation.”
Heather Murphy, associate professor and Canada researchchair in One Health, University of Guelph

FIGURE 9. Impacts of inadequate sanitation in childhood

Loss of societal
employment
opportunities

Loss ofsocietalincomeReducedeconomic
demandHealthcareburden on
families

Inadequate
sanitation inchildhoodPresence andtransmissionof diseases

Reducedschoolenrollment
and/orattendance

Reducedlearning
outcomes

Loss of humandignity

Reducedself-worth

Reduced future
employment
opportunities

Reducedeconomic
outputReducedfuture earningpotential

Reducedproductivity

Societal impacts

Individual impacts
Short-term impacts

Loss of labour
supplyDeathLong-term impacts

Through the impacts it has on individual children, lack of access to basic sanitation
services directly hinders the achievement of SDG target 4.a (to provide effective learning
environments for all) and target 6.2 (to provide adequate and equitable access to sanitationand hygiene for all). Beyond these direct impacts, the wider implications for societies andeconomies at large also indirectly prevents progress on other SDGs including goal 3 (ensuring
healthy lives and wellbeing for all), goal 4 (ensuring inclusive and quality education for all),and goal 8 (promoting inclusive and sustainable economic growth), among others.

©Economist Impact 2023

Tackling Toilet Loss22

“By not investing in WASH, policymakers
jeopardise their efforts in providing
effective learning and proper education.”
Oliver Schmoll, programme manager, water and climate,
WHO European Centre for Environment and Health

The impact of school sanitation: Evidence from Tanzania

Case study

Tanzania has made significant efforts to expand access to WASH services across schools inrecent years, delivering tangible benefits for children.41 In response to the pressing need for
improved school sanitation, the Tanzanian government initiated the Sustainable Rural Water
Supply and Sanitation Programme (SRWSSP) in 2018.42
The SRWSSP aimed to construct and upgrade sanitation and hygiene facilities, referred to as“School-WASH” or SWASH, in public primary schools. A key focus was on building separate
sanitation blocks for girls and boys, and ensuring that toilets are lockable and private.43 Schools
participating in SRWSSP also introduced menstrual health and hygiene initiatives, such aschanging rooms for girls stocked with sanitary towels.
At programme inception, an estimated 57% of schools lacked functional handwashing facilities,
nearly 40% had no on-site water supply and over 60% had no proper disposal mechanism forsanitary pads. Additionally, more than half of the installed toilets did not have a door, exposing
students to the risk of violence, including gender-based violence.44
The introduction of improved sanitation facilities brought about transformative changes.
World Bank findings demonstrate that the interventions led to increased retention andparticipation of students in schools, particularly among adolescent girls, who were encouraged
to attend school even during menstruation. The overall attendance rate for girls has surged
from an average of 70% to 90% since the introduction of these initiatives.45

www.worldbank.org/en/news/feature/2022/06/14/school-toilets-in-rural-tanzania-a-performance-game-changer
projects.worldbank.org/en/projects-operations/project-detail/P163732
www.worldbank.org/en/news/feature/2022/06/14/school-toilets-in-rural-tanzania-a-performance-game-changer
44
www.worldbank.org/en/news/feature/2022/06/14/school-toilets-in-rural-tanzania-a-performance-game-changer
45
www.worldbank.org/en/news/feature/2022/06/14/school-toilets-in-rural-tanzania-a-performance-game-changer
41

42

43

©Economist Impact 2023

Tackling Toilet Loss

23

The how: building a pathway for stopping Toilet Loss
To begin to develop a road towards meeting the SDG targets on sanitation in schools, national
policymakers, local authorities and school districts need to understand current gaps in access, what thismeans for gaps in infrastructure, and how much money will need to be invested to close these gaps.
The WHO/UNICEF Joint Monitoring Programme ( JMP) provides a starting point to measureaccess to basic school toilets. It is currently one of the most comprehensive databases onsanitation services across countries and is widely used to inform policy-level decisions.
The Joint Monitoring Programme is a joint initiative by the World Health Organisation(WHO) and UNICEF to provide estimates of country, regional and global progress on targets
for drinking water, sanitation and hygiene across households, schools and healthcare facilities.

With regards to sanitation services in schools, the JMP collects data on access at three levels:46• Basic services: infrastructure for improved sanitation facilities exists and is single-sex and usable• Limited services: infrastructure for improved sanitation facilities
exists, but is not single-sex and/or usable• No services: infrastructure for sanitation facilities does not exist
The JMP’s definition of usable within “basic services” in schools means that at least a single toilet
exists that is accessible to students (doors are unlocked or a key is available), functional (not broken
or blocked, and water is available), and private (lockable doors with no large gaps in the structure).47
A fourth level of service—advanced services—incorporates additional elements such as student-pertoilet ratios, facilities for menstrual hygiene management and toilet accessibility for all users. However,while the JMP has developed a framework for advanced services, national-level requirements have notyet been defined by countries, and data are not currently collected consistently across schools.

“To allocate government or public sector budgets effectively,
whether at the national or local level, it is crucial tounderstand context-specific needs and plan accordingly.
Ideally, investment plans should be informed by dataobtained through monitoring and evaluation processes.”
Ana Virginia Mujica, programme officer, Stockholm International Water Institute

Building on the JMP data on access levels to basic and limited sanitation services in schools, this study
measures the scale, scope and cost of Toilet Loss and develops an investment pathway to ensure
every student has access to a clean and well-maintained school toilet. Specifically, we quantify:

46
47

washdata.org/monitoring/schools
washdata.org/monitoring/schools©Economist Impact 2023

Tackling Toilet Loss24

• the number of school toilets lost through neglect;• the cost—or Toilet Loss—from not providing all children with access to basic school toilets;• the level of investment needed in both building new toilets and maintaining existing and new ones
to close the access gap; and• the gains for societies and economies from doing so.
Creating these data allows us to answer the question: what is the most effective investment pathway
to ensure that all children have a basic toilet in school by 2030?
To convert access data from the JMP into estimates of the availability and requirements for toilets, we
make assumptions on the interpretation of the existing data. We assume that school toilets defined as“limited service” exist, but have not received sufficient O&M to remain usable. In other words, these
toilets are lost. School toilets defined as “basic service” both exist and are usable.
In reality, toilets defined as “no sanitation services” may also exist despite being unusable,
meaning that some construction expenditure has been incurred; however, we assume that noconstruction has been made.
Our analysis deep-dives into four countries, selected to gain broad geographic coverage across a rangeof contexts and levels of development: Ecuador, India, Nigeria and the Philippines.

“With the current JMP data, we’re not monitoring toilet use but
whether a toilet is usable—these are two different things. The
basic services indicator is based on survey data and only looks
at if a school has at least one toilet in it which is single-sex,
functional and private. It’s a low bar to report on. Some countries
collect data on the cleanliness of toilets and the particularbarriers that children face, but there is a lack of standardisation
on measuring these indicators of use.”
Tom Slaymaker, senior statistics and monitoring specialist, UNICEF

FIGURE 10. Interpreting the JMP data

Basic sanitation services

Limited sanitation services

No sanitation services

The infrastructure for
improved facilities exists andis single-sex and usable.

The infrastructure for improved
facilities exists, but it is not
single-sex and/or usable

The infrastructure for toilets or
latrines does not exist, or the facilities
that exist are unimproved

Constructed
toilets

Regular
O&M

Constructed
toilets

No
O&M

No
construction

No
O&M©Economist Impact 2023

Tackling Toilet Loss25

Why a focus on schools?
While the JMP collects data on sanitation in the contexts of households and healthcare
facilities, in addition to schools, the focus of this analysis is specifically in assessing therequirements to eliminate Toilet Loss in schools.
The initial focus on schools is driven by a combination of factors:
1. An understanding of accountability:
Establishing accountability is crucial for driving change, and these governance structures areclearest in the context of schools. While the roles and responsibilities of different stakeholders
are not yet fully defined when it comes to building, operating and maintaining school toilets,
there is an understanding of who the key players are within the system—education ministries,
local authorities and school bodies, and schools themselves. The same structures are not fullyin place at a household level, particularly when it comes to the governance of sanitation.
2. A measure of wider sanitation:“Schools are the place in which children
learn good habits and behaviours.”
Tom Slaymaker, senior statistics and monitoring specialist, UNICEF

Schools are a place where habits form. Good sanitation practices learned during childhood
are taken forward into adulthood, as well as into wider communities and future generations.
Understanding sanitation levels and requirements at the school level can provide a good
indicator for wider community sanitation.
3. Tackling the challenge one step at a time:
Driving system change requires a focused approach. By building a framework that is validated
and credible for assessing the losses from lack of sufficient investment in O&M in a school
environment, we hope that the same approach can be adopted to understanding sanitation
requirements in other contexts.

“A major challenge in the WASH sector is the lackof detailed monitoring and inadequate data. This
makes it hard to thoroughly evaluate the conditionof WASH infrastructure and, as a result, to identify
and address the sector's specific requirements.”
Christie Chatterley, Fort Lewis College; independent consultant
with WHO/UNICEF Joint Monitoring Programme©Economist Impact 2023

Tackling Toilet Loss

26

Overestimating infrastructure availability
Our analysis uses data and definitions from the WHO/UNICEF Joint Monitoring Programme( JMP) on access levels to basic, limited and no service sanitation facilities across schools as thebasis for our calculations. We assume that toilets defined as “limited service” exist, but havefallen out of use from lack of sufficient and regular O&M. Toilets defined as “basic service” both
exist and are usable.
However, these simplifying assumptions are likely to overestimate infrastructure availability in
two ways.
• The number of existing toilets is overestimated. We assume that WHO guidelines on
student-to-toilet ratios—one toilet per 25 girls, and one toilet and one urinal per 50 boys48—
are met in all schools that have access to “basic services”; however, the JMP assigns “basic
service” levels to any school that has at least one toilet facility each for boys and girls.
• The number of usable toilets is also overestimated. We assume that all “basic service”
facilities are usable in practice. The JMP’s definition of “basic service” accounts for school
toilets being accessible, functional and private. Other measures of usability—such as
cleanliness—are captured in “advanced services” for which data are not yet collected at thecountry level. Therefore, the analysis does not distinguish between “basic” and “advanced”
levels of service.
As a result, it is likely that we have underestimated the infrastructural and financial
requirements to close access gaps—as well as the benefits that could arise from doing so.

48

apps.who.int/iris/bitstream/handle/10665/44159/9789241547796_eng.pdf?sequence=1&isAllowed=y©Economist Impact 2023

Tackling Toilet Loss

27

The current state of Toilet Loss

To better explore how much investment is needed to close sanitation gaps, how that investment
needs to be allocated, and the benefit that countries would experience from universal accessto sanitation in schools, we conducted a deep-dive analysis into four countries—Ecuador,
India, Nigeria and the Philippines. These countries are geographically diverse and at different
stages of their school sanitation journey, allowing us to understand overarching trends
and implications across a range of contexts, geographies and levels of development.
These four countries are home to over one-quarter (26%) of the world’s childpopulation,49 and have sufficient availability of JMP data to conduct our analysis. We also
considered current gaps in sanitation access for country selection, which enables us todemonstrate the potential magnitude of impact and required levels of investment.
The countries assessed have each taken different approaches to meeting SDG targets 4.a and 6.2
in the context of schools. They have directed varying levels of investment towards constructing
new school toilets and maintaining existing ones. In the Philippines, investment has largely
focused on O&M to enable greater usability of already constructed school toilets. Conversely,
Ecuador’s investment efforts have focused on building additional toilets to close the gap in access.
India and Nigeria have invested in a combination of construction and O&M (see Figure 11).

“Governments often claim thatthey lack the funds to invest in
O&M. The problem is not thatthey lack the funds but thatthey do not know how muchthey need to set aside within
their budgets in the first place.”
Bella Monse, senior advisor, Fit for School, GIZ

49

Source: data.worldbank.org/indicator/SP.POP.0014.TO.ZS©Economist Impact 2023

Tackling Toilet Loss

28

FIGURE 11. Diving deeper: exploring past allocations of school toilet spend
Trends in access to sanitation services, 2015-21 (% of children)
Limited services
Basic services

No services

Limited services

Basic services

No services
India

Ecuador
100

100

75

75

50

50

25

25

0

2015services
Basic

2021
Limited services

16,000Ecuador
New toilets needing construction and subsequent O&M
100

45,000Existing toilets needing restoration and subsequent O&M

2015
No services

Nigeria
Investments
in school sanitation in Ecuador have
50
100
been largely targeted towards construction. As a25
result,access to limited-service facilities increased75
from
0 21% to 30% in 2015-21, while access to basic
50
servicefacilities
focus on2015 remained constant, at 59%. A2021
investment in construction over O&M has left 45,000
25
toilets across schools dysfunctional
16,000 and in need ofrehabilitation,
16,000andnew
toilets needneedingonly
construction
subsequent
O&M to0 New toilets while
be constructedgaps.
2015 to close
2021
45,000Existing toilets needing restoration and subsequent O&M

888,000

New toilets needing construction and subsequent O&M
Nigeria

878,000

India
New toilets needing construction and subsequent O&M

640,000

100

Existing toilets needing restoration and subsequent O&M

413,000

Existing toilets needing restoration and subsequent O&M

Philippines
India
has invested in both construction and O&M,
50
100
and significantly improved basic service access
25
in75schools from 63% to 86% in 2015-21. Still, an
estimated
878,000 toilets still require construction
0
50 subsequentand2015 O&M, and an additional 640,000
2021
existing toilets need to be rehabilitated with regular
25
O&M to follow.50
878,000
0 New toilets needing construction and subsequent O&M
2015
2021
640,000
Existing toilets needing restoration and subsequent O&M

65,000

New toilets needing construction and subsequent O&M
Philippines

100

75

75

50

50

25

25

0

2021

75

75

100

0

2015

2021

888,000

146,000

Existing toilets needing restoration and subsequent O&M

0

2015

2021

65,000

New toilets needing construction and subsequent O&M

New toilets needing construction and subsequent O&M

Existing toilets needing restoration and subsequent O&M

Existing toilets needing restoration and subsequent O&M

Nigeria has invested in both construction and O&M
when it comes to school sanitation. Although this has
allowed the country to increase access to basic services
by 13 percentage points, large gaps still remain, with
only 38% access to basic facilities across schools. At
least two in five children remain without any access tosanitation at school.

In the Philippines, sanitation investment since 2015
has predominantly focused on the O&M of existing
infrastructure in schools over the construction of new
toilets. Consequently, while the same proportion ofchildren remain in need of a toilet in school since 2015(8%), access to basic sanitation services has nearly
doubled from 40% to 74%.51

413,000

146,000

Source: WHO/UNICEF Joint Monitoring Programme, Economist Impact analysis

50

51

JMP data on limited and no service shares for India have been adjusted from published data based on consultations with experts to account for datacollection challenges
Includes only toilets that require construction to meet full sanitation coverage in 2021. Additional toilet construction will be required by 2030 toaccount for population growth.
©Economist Impact 2023

Tackling Toilet Loss

29

The cost of neglecting toilets
Ecuador, India, Nigeria and the Philippines have all invested in constructing school toilets to help
close the gap in access for children; however, not all of these constructed toilets have remained
usable at a basic service level. Across the four countries, 1.2m school toilets constructed since2015 have been “lost” through lack of O&M. In both Ecuador and Nigeria, nearly one in threeof the school toilets that exist have not been sufficiently maintained to be usable today.
This Toilet Loss also translates into a financial loss of the value of the initial investment spent inconstructing each lost toilet. These financial losses range from 3% of total estimated school sanitation
investment between 2015 and 2021 in India to almost 20% in Ecuador and Nigeria (see Figure 12). In
FIGURE 13. Toilet
Loss,for2021
other words,
every US$5 spent on school sanitation, up to US$1 is currently lost because of failure to
maintain school toilets. Total accumulated Toilet Loss across the four countries amounts to US$1.9 bn.52

FIGURE 12. Toilet Loss (2015-2021)
EcuadorNumber of
toilets lost
Loss oftotal expenditure

India

Nigeria

45,000638,000

413,000

17%

3%

18%

Philippines

Total toilets lost
(four countries)

146,000 = 1.2 million
10%“Some people who work in sanitationrefer to schools as "toilet graveyards".
While the infrastructure is present,
the essential operations andmaintenance are often neglected.”
Christie Chatterley, Fort Lewis College; independent consultant
with WHO/UNICEF Joint Monitoring Programme

Every time a toilet is constructed and not maintained, there is a loss of toilets and ofinvestment. The most effective method of minimising, and ultimately eliminating, Toilet
Loss is through first directing investment towards the maintenance of every toilet that isconstructed. Then, surplus funding can be allocated to the building of new toilets with an O&M
plan in place. Had countries taken this approach from the start, the world would be closer
to achieving our global sanitation targets (see “Investing smarter, not harder” below).

52

data.worldbank.org/indicator/NY.GDP.MKTP.CD?locations=CV©Economist Impact 2023

Tackling Toilet Loss

30

Investing smarter, not harder
Although constructing new toilets is necessary to reach full basic sanitation coverage,
construction without O&M results in a loss of resources. Building toilets without developing
and implementing a maintenance plan jeopardises one in every five US dollars invested in
toilets. The countries in this study could have had up to 10% higher levels of basic sanitation
access if the investments made in constructing new toilets that have not been maintainedsince 2015 had instead been allocated to the O&M of existing toilets (see Figure 13). Across thefour countries, this investment is equivalent to an additional 500,000 usable toilets of the 3.1m
required toilets for full basic coverage.
In Nigeria, Toilet Loss is estimated at US$580m in 2015-21. If this US$580m spent on building
unmaintained toilets had instead been put towards the maintenance of existing toilets, almost
half of the 70m children in the country could have had access to basic sanitation in schools in
2021 (compared to 38%). Even in the Philippines, where significant progress has been made inclosing the gap in basic sanitation access, access in schools could be 7 percentage points higher
than it is today (81% instead of 74%) if investment had been directed towards O&M of existing
toilets instead of construction.

FIGURE 13. What could have been
Share of basic service toilets, actual (2021) versus hypothetical: how much higher could accessto basic service toilets be with the same level of investment re-directed from construction
without maintenancetowards
O&M?
FIGURE
14. What could
have
been
Share of basic services (2021)

Gap in access to basic services (2021)

Gap in access closed with investment in O&M

2%

Ecuador

59%

India

86%

Philippines

74%

10%

Nigeria

38%

7%

9%

©Economist Impact 2023

Tackling Toilet Loss

31

The cost of a toilet and how we measured it
A policy decision to increase access to sanitation requires investment not only in constructing a
toilet, but also in maintaining that toilet over its lifetime.
Our analysis quantifies the costs of constructing and maintaining toilets in schools using abottom-up approach at the country level. Some of the costs included within this analysis go
beyond those required to achieve basic sanitation levels in schools based on the JMP definitions.
For example, pit emptying is not a basic service requirement. However, these costs are marginal(less than 1%) of the total estimated costs.
The diagram below summarises the construction and O&M costs incorporated within our
calculations. Further detail is provided in a technical annex.
It should be noted that rehabilitation costs—the costs incurred if an existing toilet has been left
unmaintained for an extended period of time and, therefore, requires rehabilitation to bringit back to a basic service level—are not included in our analysis. These additional costs vary
substantially across countries and depend on the type of toilet constructed and the extent
of disrepair. The existing data do not allow for an assessment of how many toilets require
rehabilitation. As a result, our estimated overall cost requirements for closing sanitation gaps
will be lower than they are likely to be in reality.

Construction costs

O&M costs

To calculate construction costs, the analysis
estimated weighted average country-specificcosts based on the types of sanitation
technologies most commonly deployed including:

Cost estimations are based on assumptions on
the units of requirement for each cost category
and country-level costs per unit:• Pour-flush• Simple-pit• VIP-latrine• Cistern flush• Urinal
Country-specific unit costs of construction are used
to estimate the average cost per school toilet.

• Operation costs: Day-to-day regular costs to ensurethat toilets have the resources required for use (e.g.
hand washing soap) and for operations (e.g. cleaning
tools and resources, including cleaning staff)• Maintenance costs: Semi-regular costs to ensure theupkeep of toilets over time, for example pit emptying
and hardware repair including required tools.

“Some schools build toilets but quickly close them because
they realise that the cost of maintenance is expensive.
What they don’t realise is that building toilets and not
maintaining them can be even more expensive. Better
planning is needed to prevent these costs.”
Bella Monse, senior advisor, Fit for School, GIZ©Economist Impact 2023

Tackling Toilet Loss

32

The societal impacts of Toilet Loss
Toilet Loss extends beyond the financial losses from neglecting toilets—it creates real impacts forchildren, economies and societies (see discussion in “The why: the need to address Toilet Loss” above).
Although the longer-term implications of Toilet Loss can be substantial, the evidence on impacts isinconclusive.53 As such, longer-term impacts cannot be robustly quantified.Instead, our analysis
focuses on the immediate impact that arises through three key channels: additional healthcare costs,
loss of income and loss of economic output.

FIGURE 14. Socioeconomic costs of toilet neglect

Short-term
Healthcare costs

Lack of sanitation leads to greater
incidence of diseases, resulting in higher
expenditure on healthcare

Long-term

Lost future income
for children

Poorer educational outcomes frommissed schooling can impact onlifelong opportunities for children

Lost income

Caring for sick children can negatively
impact on earned income for families

Loss of future
economic productivity
Lost economic output

Investment in toilet O&M creates jobs
and demand within the local, which is lostwhen toilets are neglected

Deaths caused by sanitation-relateddiseases and worse education outcomes
result in a smaller and less productive
workforce, reducing economic output

Included in analysis

Across the four countries assessed, total immediate socioeconomic losses from toilet neglect are
estimated at over US$10bn in 2015-21. India and Nigeria suffered the greatest respective losses, of
US$5.1bn and US$4.4bn.
The greatest contributor to these costs is healthcare expenditure to treat infections in children. In
India, healthcare expenditure constitutes two-thirds of the total cost—these costs result from anaverage of 9m additional annual cases of diarrhoeal infections among school children that could
have been avoided with better access to clean and usable toilets.

53

www.mdpi.com/1660-4601/9/8/2772©Economist Impact 2023

Tackling Toilet Loss

33

FIGURE 15. Counting the losses
Socioeconomic losses from Toilet Loss by country, 2015-21 (US$m)

5,130
3,450

4,440
2,350

1,810

1,250

810
430

120
60

20

280

410
120

40

Ecuador

Healthcare costs

280

India

Nigeria

Lost income

Lost economic output

Philippines

Total socio-economic loss

Total socioeconomic loss across four countries

US$10bn©Economist Impact 2023

Tackling Toilet Loss

34

A CASE STUDY BY UNILEVER
How Unilever and GIZ joined forces to tackle Toilet Lossin the Philippines
Unilever brand Domestos and the German Development Cooperation (GIZ) joined forces to findrealistic answers, starting small to scale effectively. In 2016, JMP data showed that only 40% of
Philippines schools had useable, gender-segregated toilets, impacting millions of school children.
Closer inspection showed a significant number of toilets physically in place, but ‘lost’ for dailyuse; simply requiring improved maintenance to bring them back into use. To address the issue,
Domestos and GIZ jointly implemented a project within the develoPPP programme—the German
Federal Ministry for Economic Cooperation and Development’s (BMZ) funding scheme forsustainable company initiatives. The team agreed to start with a pilot study to assess school toilet
conditions and maintenance solutions in the Batangas region of the Philippines. The interventions
there were proven to work across the country, creating a blueprint for scaling nationwide.
A practical, sustainable, scalable solution
The on-ground project team worked closely with local schools and education sector leaders to test
and verify a practical, scalable and sustainable school toilet operation and maintenance (O&M)
programme. It includes daily cleaning reports; checklists and standards; simple management tools
and quantifiable supplies; Massive Open Online Course to train teachers and school heads; and,an app for schools to calculate the costs for maintenance and cleaning supplies. After on-going
iteration, testing and approvals, Domestos and GIZ supported the Department of Education for anationwide school roll-out.
The Unstoppable Award
To drive uptake and sustained commitment to the programme, the Unstoppable Award wascreated. The award is an annual interschool competition rewarding schools for regular toilet cleaning
and the recording of O&M measures. The award builds on the Filipino tradition of Brigada Eskwela(school maintenance week)—a national preparatory celebration whereby parents, guardians and theentire local community get schools clean and ready for the beginning of the new school year.
It works
Increase in useable,
gender-segregatedtoilets acrossPhilippines schools
from 40% to 74%

Over 19 million
children reached,according todata verified by
the Philippines’
government (2017-22)

Increase in thenumber of schools
reporting dailycleaning from
26,811 to 38,563(2017-22)

What we learnt
Understanding what data shows, testing the efficacy of materials, and rewarding data collection arewhat underpin the effectiveness of this programme.
For school children in the Philippines, the quality of data and the impact of this intervention helped
the Department of Education recognise and prioritise the issue of access to school toilets andensured preparedness ahead of schools reopening after the Covid-19 pandemic.
For school children around the world, the programme fundamentals have formed the basis of theDomestos ‘Cleaner Toilets, Brighter Futures’ school toilet cleaning and maintenance programme.
This has been now rolled-out in Vietnam, South Africa and Turkey.
In summary
Public Private Partnerships work best when the sum is even greater than the parts. Unilever
Domestos provides materials and guidance for schools and manages the annual Unstoppable
Award; GIZ contributes its system strengthening expertise by developing support structures for thegovernment to implement and scale up the national WASH in Schools programme. All parties play
to their strengths in pursuit of a bigger goal—in this instance, a way to keep toilets clean and safe forall school children in the Philippines.

©Economist Impact 2023

Tackling Toilet Loss

35

A pathway to full sanitation
coverage in schools
Closing sanitation gaps
The global needCountries, communities and individuals have incurred large losses from not providing children withaccess to clean and usable toilets at school—these include infrastructure losses, financial losses andsocioeconomic losses. What is needed to close the gap and prevent these losses from growing?
Globally, the number of basic service school toilets will need to grow by at least 20m by 2030, from38m today, to fully close the gap—double the number of basic toilets that exist in India, and nearly
ten times that in the US. In practice, this means that for every two basic school toilets that exist
today, another basic school toilet will need to be added—including construction and maintenance.

“For many countries, especially in Sub-SaharanAfrica, another significant challenge is the
rapidly growing school-age population. It
becomes challenging to keep up with the demandfor building and maintaining schools when
maintaining existing ones is hard enough.”
Tom Slaymaker, senior statistics and monitoring specialist, UNICEF

FIGURE 16. Getting to full global sanitation coverage across schools
At least 20 million additional basic school toilets will be needed across the world by 2030, of which:38.2 million

8.3 million

Exist and meet basic service requirements
for usability today. Need continued O&M

Do not exist and are needed today
Need construction and regular O&M

Total: 20 million
additional basic school toilets

8.1 million
Exist today but are dysfunctional (limited service).
Need rehabilitation and regular O&M

3.4 million
Do not exist and will be needed by 2030
Need construction and regular O&M©Economist Impact 2023

Tackling Toilet Loss

36

Achieving this goal will require a six-fold acceleration in progress on access to basic school
toilets compared to what countries have achieved since 2015. In 2015-21 the numberof basic usable school toilets grew by an average of 340,000 each year. Meeting the
SDG targets will require an average annual growth of 2.2m basic school toilets—more
than the number of existing school toilets in the US today. Nearly 90% of this growth
will be required in Asia and Sub-Saharan Africa where, respectively, 1.1m and 850,000
additional basic school toilets will be needed each year between now and 2030.

FIGURE 17. Accelerating global progress in providing sanitation in schools
Global access to basic sanitation services in schools (number of toilets, millions)

Required growth: acceleration
to meet targets

58 million
Sanitation service
gap across schools

41 million

38 million

Projected growth:
continuation of historic paceof growth

Historic growth

36 million
2015

2021

2030

Country-level implications
Looking specifically at the countries of focus for this study, across India and Nigeria alone
at least 2.5m school toilets still need to be constructed and maintained to close the gap by2030, and an additional 1.1m need to be rehabilitated and receive O&M (see Figure 18).
Although the gaps that need to be closed are large and may seem unachievable, some countries
are on track to meet the SDG target for school sanitation if rates of progress are maintained. If
the Philippines continues to maintain its current progress rate, it could reach full basic service
coverage across schools within the next six years. Nigeria, however, needs to accelerate its
annual progress four-fold to meet target 6.2. At its current pace, it will not meet full basic
service coverage in schools until 2054. And, without a shift in focus towards O&M, Ecuador
will need at least 100 years to reach full coverage at current progress rates (see Figure 19).

©Economist Impact 2023

Tackling Toilet Loss

37

FIGURE 18. Country-level requirements for school toilets (2030)
Non-existent toilets needing construction and O&M

Existing basic service toilets needing continued O&M

Limited service dysfunctional toilets needing rehabilitation and O&M

Number of school children (2030)

Ecuador

5.7m

37,10044,500169,100

87,500India

376.8m10,934,700

9,315,300
981,200 638,200

Nigeria88m
1,489,700

413,200

Philippines
163,200

146,300

2,687,900

785,000

30.2m
601,300

910,800©Economist Impact 2023

Tackling Toilet Loss

38

FIGURE 19. The required pace of progressComparing historic progress in providing basic sanitation access (2015-21) torequired progress (2021-30), number of basic service toilets in schools
Historic growthRequired growth to meet targets

India

Ecuador
169,000

10,935,000
9,315,000

82,0002015

7,035,000

88,0002021

2030

Nigeria

2015

2021

2030

Philippines
911,000

2,688,000

601,000

431,000
2015

282,000

785,000
2021

2030

2015

2021

2030

©Economist Impact 2023

Tackling Toilet Loss

39

Developing the policy environment to enable toilet use
Investing in construction and O&M to provide children with a clean and usable basic toilet inschool gets us part of the way towards encouraging use and the benefits that come with it.
However, having a clean toilet is not enough if the school environment itself deters use.
One critical aspect in promoting toilet use is safety.54 Creating a safe environment aroundschool toilets is vital for encouraging regular use, and improving the overall wellbeing andconfidence of students.55 Gender-segregated toilets are critical to instilling a sense of safety,
particularly for girls.56 In Tanzania and Bangladesh, the construction of gender-segregatedtoilets has increased school enrollment of girls by 10% annually.57
Hygiene education policies are also vital. Having a usable toilet is one thing, but being able
to use it in a safe and hygienic way is another. Schools need to implement programmesthat teach students proper techniques for toilet use and general hygiene practices such as
handwashing, to help reduce the spread of infections and illnesses, and promote a healthierschool environment.58 Hygiene education also teaches lifelong habits that can positively impact
communities outside of school walls.59“All parts of the school are properly
regulated except for toilets. Security
issues, vandalism, and crime occur inmany countries, making them unsafe.
Some schools have toilets located further
away due to septic tanks. All of thesefactors impact the use of toilets beyond
their cleanliness.”
Bella Monse, senior advisor, Fit for School, GIZ

washmatters.wateraid.org/sites/g/files/jkxoof256/files/female-friendly-public-and-community-toilets-a-guide.pdf
washmatters.wateraid.org/sites/g/files/jkxoof256/files/female-friendly-public-and-community-toilets-a-guide.pdf
www.unicef-irc.org/evidence-for-action/how-wash-in-schools-empowers-girls-education/
57
ideas4development.org/en/access-toilets-gender-equality/
58
www.cdc.gov/handwashing/handwashing-school.html
59
www.ncbi.nlm.nih.gov/pmc/articles/PMC7723000/
54
55

56

©Economist Impact 2023

Tackling Toilet Loss

40

The pathways ahead
Although some countries are on track to meeting the school-sanitation targets, the challengeahead is by no means trivial. All countries still need to, at minimum, maintain the current pace ofschool sanitation progress; most need to accelerate their pace in an environment of tight budgetary
constraints. What can stakeholders do to close school sanitation gaps in the most cost-effective way?
Our analysis explores different investment scenarios that focus on a combination of construction and O&M(see Figure 20).

FIGURE 20.
Futureinvestment
scenarios
schoolsanitation
sanitation
FIGURE
20. Future
investment
scenariosfor
for school
We assess three alternative investment scenarios which lead to different levels of access to school
sanitation by 2030, illustrated below.

100%
Construction
alone scenario

Limited services

BY 2030:
0% no services
Some children without access tobasic service toilets at school

Basic services

All investment is assumed towards constructing new toilets

100%
O&M alone
scenario

No services

0% limited services
Some children without access to any
sanitation facilities at school

Basic services

All investment is assumed towards maintaining existing toilets

100%
Construction andO&M scenario

Basic services

100% basic services
All school children with accessto clean and usable toilets

All investment towards both constructing new toilets and maintaining new and existing ones

Decoding the options
For each future investment scenario, our analysis compares the socioeconomic gains that could
arise in the short term with the financial costs of delivering these gains over and above current
spending on school toilets.60 Although all additional investment into construction and/or O&M
delivers some benefit, the magnitude of these benefits varies substantially across the scenarios.
A “one size fits all” country-level approach will not, therefore, work and different countries will needa unique context-specific strategy to meet the SDG targets. This section discusses the impacts ofeach option individually and concludes with a summary of the best way forward depending on
the current state of progress within a country and the financial requirements to close the gap.
Construction only: full, but unusable, toilet access for all
The first option investigates a scenario in which all additional sanitation investment is directed
entirely towards constructing new school toilets, leaving no child without access to a school toilet(regardless of whether that toilet is usable). Investing in school toilet construction is essential for
closing access gaps, and the SDG targets cannot be met without this investment. However, without
additional O&M investment, constructed toilets quickly become dysfunctional, resulting in Toilet Loss.
60

See technical annex for further detail on the methodology©Economist Impact 2023

Tackling Toilet Loss

41

The benefits of investing only in the construction of new toilets are minimal, and arise
through a short-term increase in activity within the local economy associated with theconstruction activity. In short, the benefit of construction alone is that construction workers
are employed, generating income and demand within the economy. However, unless there
is an accompanying investment plan for O&M, these toilets quickly become unusable andthe economic benefits are not sustained. There are also no health benefits relative to current
investment levels, as no additional children have access to a usable basic service toilet. The
burden of disease remains the same and, therefore, healthcare costs also remain the same.
Investing only in construction also requires high levels of investment. In Nigeria, building enoughschool toilets so that every child would have access could cost nearly US$1.5bn. However, since this
scenario does not set aside additional funding for O&M, under current levels of O&M investment in
the country, nearly US$1bn of the invested US$1.5bn would end up being allocated to toilets that
immediately become unusable. And since two-thirds of the investment would be lost, up to seven-inten children (60m children) would still not have access to a school toilet in 2030.

Socio-economic impacts of construction alone:
Socioeconomic impacts of construction alone:

Socio-economic impacts of construction alone:

Healthcare savings:

Family income gains:

Economic output:

No benefit

No benefit

Marginal one-off benefit“Sustaining progress on sanitation
requires considering not only the initialinfrastructure, but also accounting for
education, maintenance and budgetaryprovisions to ensure long-term viability.
Programmes that solely focus onbuilding infrastructure without these
considerations often end in failure.”
Heather Murphy, associate professor and Canada researchchair in One Health, University of Guelph©Economist Impact 2023

Tackling Toilet Loss

42

FIGURE 21. Cost versus benefits: Construction alone

FIGURE 21. Cost vs. benefits: Construction alone

Comparing the costs and benefits of investing in construction to advance school sanitation (total, 2021-3061), US$m

Investment required

Gains to society

US$m

1,446.8

1,136

883.1

588.6

41.2

106.7
16.6

Ecuador

India

Nigeria

Philippines

46%

19%

67%

30%

of children without
access to basic
usable services

61

41.8

of children without
access to basic
usable servicesof children without
access to basic
usable servicesof children without
access to basic
usable services

The total estimated costs and benefits are discounted to present value terms.

©Economist Impact 2023

Tackling Toilet Loss

43

O&M only: full basic toilet access for someAn alternative strategy to close access gaps is investing in existing school toilets to convert
all existing limited service toilets into basic service toilets. Investing in the O&M of existing
toilets delivers significantly higher socioeconomic benefits. More children have access to a
usable school toilet, so the transmission of diseases such as diarrhoea is reduced. Households
save on healthcare expenditure and are less likely to lose out on income generation
owing to illness, which ultimately increases overall household disposable income.
At an economy level, the employment created for regular O&M creates additional benefits. In Nigeria,
while construction alone would deliver socioeconomic benefits of only US$590m between now and2030, O&M alone would generate nearly four times the benefit (US$2.1bn).

Socio-economic
impacts of O&M alone:
Socioeconomic impacts of
O&M alone:

Healthcare savings:

Family income gains:

Economic output:

Benefits for some children
who gain access to a
usable toilet

Benefits forsome families

Benefits from sustained
O&M employment

An O&M-only strategy—in which all existing toilets in schools receive the required
levels of maintenance each year to 2030—is more costly than investing in the one-time
construction of toilets in most countries. In Ecuador, investing in the O&M of all existing
school toilets would cost a cumulative US$110m, whereas construction alone would
cost US$40m. However, the gains from O&M investment are substantially higher andoutweigh the costs (see Figure 22), unlike with investment in construction alone.
Despite the substantial benefits from investing in O&M, this solution is inequitable and serves
to widen the gap between children with and without access to sanitation services in school.
Children with access today to unusable limited service toilets gain access to a usable basic
service toilet, while children without any access remain without any access. In Nigeria, as manyas 40m—two in five—children could still lack access to sanitation facilities at school by 2030.

“WASH intervention efforts by
local governments drive demand
creation across the sanitation
supply chain, which significantly
impacts local economies.”
Josh Garn, assistant professor, Universityof Nevada School of Public Health©Economist Impact 2023

Tackling Toilet Loss

44

FIGURE 22. Cost vs. benefits: O&M alone
Comparing the costs and benefits of investing in O&M to advance school sanitation (total, 2021-3062), US$m

Investment required

Gains to society

2,315.7

US$m

2,101.6

1.398

810.9
467.2
266.1
107.6

137.1

Ecuador

India

Nigeria

11%

8%

43%

of children without
any access tosanitation services

62of children without
any access tosanitation servicesof children without
any access tosanitation services

Philippines

8%of children without
any access tosanitation services

The total estimated costs and benefits are discounted to present value terms.

©Economist Impact 2023

Tackling Toilet Loss

45

How O&M creates a local sanitation economy

Case study

What starts off as something as seemingly small as maintaining toilets in schools can havefar-reaching impacts across societies and economies as a whole. Investments in O&M andsanitation in schools and wider communities offers myriad benefits for local economies. The
construction and O&M of sanitation facilities—and the provision of water supply systems
and related services—create employment opportunities for the local population.63 Localising
O&M also boosts innovation, as it fosters the development of sanitation-related products andservices.64
The Toilet Board Coalition (TBC, a business-led body that seeks solutions to sanitation
issues) identifies three core channels through which a “sanitation economy” is created frominvestments in expanding access to sanitation:65
1. T
 oilet economy: supply-chain impacts and employment creation from investingin sanitation and toilets
2. C
 ircular sanitation economy: collection and use of waste as renewable resources—
water, energy, nutrients—for business operations
3. Smart sanitation economy: data and innovation technologies to improve sanitation systems
In 2021 the sanitation economy was valued at US$62bn in India alone (almost 2% of GDP).66
An illustrative case highlighting the sanitation economy impacts of O&M investment is a 2017accelerator project initiated by the TBC in Malindi, Kenya.67 The primary objective was toenhance sanitation infrastructure and services by treating faecal sludge and combining it withother waste materials to produce briquettes as a substitute for biomass energy. By addressing
both waste removal from latrines—a crucial component of O&M—, and the implementation ofeffective waste treatment strategies, the initiative generated significant local economy impacts
across the entire sanitation value chain, including transportation, waste treatment, briquette
production, and sales and marketing. Overall, the project created employment for 140,000
local residents in wet sludge processing and briquette production. Annually, it creates capacity
to process 31,200 tonnes of wet sludge, yielding 5,850 tonnes of briquettes, with further
implications on the value added to the local economy.68

www.ilo.org/global/about-the-ilo/newsroom/news/WCMS_462279/lang--en/index.htms
journals.openedition.org/factsreports/6451
www.toiletboard.org/media/52-Scaling_the_Sanitation_Economy.pdf
66
www.toiletboard.org/media/52-Scaling_the_Sanitation_Economy.pdf
67
www.toiletboard.org/wp-content/uploads/2023/07/Case-Study-Sanivation.pdf
68
www.toiletboard.org/wp-content/uploads/2023/07/Case-Study-Sanivation.pdf
63

64
65

©Economist Impact 2023

Tackling Toilet Loss

46

Construction and O&M: full basic toilet access for all
A combination of construction and O&M to meet 100% basic service coverage is the mosteffective and equitable way to provide all children access to a functional school toilet.
This approach also provides the greatest societal benefit. It minimises healthcare costs
and loss of income through illness and maximises economic returns in the local economy.
In Nigeria, fully closing the school toilet access gap could deliver estimated gains of
US$6.7bn in the short term, with the potential for even larger gains over time throughimproved educational outcomes and subsequent upticks in workforce productivity.
Unsurprisingly, investing in both construction and O&M will cost the most. Giving every child access toa usable school toilet by 2030 will cost an additional US$180m in Ecuador, and up to nearly US$4bn inboth India and Nigeria.69 These costs will require additional funding (see Figure 23) but deliver thelargest benefits and allow countries to meet SDG targets on sanitation for children at school on time.

Socioeconomic impacts of construction and O&M:

Socio-economic impacts of construction and O&M:

Healthcare savings:

Family income gains:

Economic output:

Benefits for all children

Benefits for all families

Benefits from sustained construction
and O&M employment“There's strong plausibility that with clean
and usable school toilets, students will beless likely to contract diseases, more likely
to attend and remain in school, and more
likely to achieve higher educational levels.
In short, having usable toilets at school canmake a long-term difference to a child’s life.”
Josh Garn, assistant professor, University of Nevada School of Public Health

69

These estimated costs do not include the cost of rehabilitating currently dysfunctional toilets and are therefore conservative estimates.

©Economist Impact 2023

Tackling Toilet Loss

47

FIGURE 23. Cost versus benefits: construction and O&M
Comparing the costs and benefits of investing in construction and O&M to advance school sanitation (total, 2021-3070), US$m

Investment required

Gains to society

6,742.7

US$m

5,005.7

3,624.9

183.2

467.4

197.4

Ecuador0%of children without
basic sanitation
services (full access)70

3,826.5

India

Nigeria0%0%of children without
basic sanitation
services (full access)of children without
basic sanitation
services (full access)675.1

Philippines

0%of children without
basic sanitation
services (full access)

The total estimated costs and benefits are discounted to present value terms.

©Economist Impact 2023

Tackling Toilet Loss

48

Mapping the road to full coverage
Each school toilet investment pathway offers different levels of benefit at different levels of financial
investment. So what is the best way forward?
To compare between the various options, the overall benefits after accounting for theinvestment costs need to be evaluated (see Figure 24). Across all countries, the ideal strategy
from a societal perspective is to invest in constructing and maintaining school toilets. In
India, this approach would provide a net benefit of US$1,380m up to 2030, comparedwith US$920m from O&M alone and a loss of US$250m from construction alone.

FIGURE 24. The net effect

FIGURE
24.ofThe
netineffect
The net benefits
investingschool sanitation (total benefits less costs, 2021-30 ), US$m71

Construction only

O&M only

Ecuador

India

Construction and O&M

Nigeria

Philippines

2,920

1,380

1,290

920

200 210

30 20
-20

-60
-250

-860
71

Total additional
spendingto present value terms.
The net impactsannual
are discounted
per child (US$)©Economist Impact 2023

Tackling Toilet Loss

49

Overall, weighing up the options:
Construction alone: generates very few societal benefits
O&M alone: delivers large benefits for children already with some sanitation access
Construction and O&M: drives equitable access to school toilets while providing large
societal benefits, particularly for children with no access to sanitation services
However, this road comes with a substantial financial cost for governments and schools,
challenging policymakers who already face tough budgetary decisions on where toallocate funding in a global environment of fiscal tightening and rising public debt.72
An additional
cent in every
dollar of
education
spending willallow mostcountries toachieve fullcoverage ofbasic sanitation
services inschools by 2030.

Meeting the SDG targets and providing basic service school toilets for all children will require an
estimated additional investment ranging from US$180m in Ecuador to US$3.8bn in Nigeria. In per
child terms, these figures translate to additional spending on sanitation per year of between US$2
and US$11 across the countries assessed (see Figure 25). Across these countries, the vast majorityof this spending needs to be allocated towards O&M for existing and new toilets.
While the additional investment requirements are not immaterial, they are equivalent to an increase ineducation expenditure of less than 1% per child each year in most countries.73 The only country assessed
where a more significant increase in spending is needed is Nigeria, where current education spending per
child will need to increase by 23% to provide sufficient funds to close school toilet access gaps.

FIGURE
25. Getting
to full coverage:
investment
Acrossall countries,
additional investment
will be neededAdditional
beyond those estimatedto achieveneeds
moreadvanced service levels in schools, particularly in terms of sanitation software such as training, and theimplementation of monitoring and evaluation systems.74
FIGURE 25. Getting to full coverage: Additional investment needs per child
Additional annual spending needed per child to achieve full basic sanitation coverage (US$ per child)7

Ecuador

India

2
10.5

Nigeria

Philippines

72
73

74

4

www.imf.org/en/Publications/FM/Issues/2023/04/03/fiscal-monitor-april-2023
Investments in school sanitation do not come entirely or partially from education budgets in all contexts. These numbers are intended to put thescale of requirements to meet full coverage into perspective.
https://www.ircwash.org/sites/default/files/Peal-2010-Hygiene.pdf©Economist Impact 2023

Tackling Toilet Loss

50

FIGURE26.
26.Required
Required annual
annual increase
increase in
FIGUREin educational
educationalexpenditure
expenditureperperchild
child (% of current annual spend)(% of current annual spend)

Ecuador

India

Nigeria

Philippines

+0.9%

+0.5%

+23%

+0.7%

Increase in educational
expenditure

Increase in educational
expenditure

Increase in educational
expenditure

Increase in educational
expenditure

In countries like Nigeria, where sanitation gaps are larger and more investment is needed to meettargets, investing simultaneously in construction and O&M may not be financially feasible. In abudget-constrained environment, an initial focus on the upkeep of current toilet facilities throughO&M provides a path forward that maximises the value of past investments. The data consistently
underscore the value of investing in O&M in these countries: in Nigeria, while investing in bothconstruction and O&M together offers an economic return of US$1.8 for every US$1 invested,
investing exclusively in O&M offers returns of US$2.6.

FIGURE 27. Returns on investment
Returns for every US$1 invested in school sanitation by investment strategy
Construction alone

O&M alone

Construction and O&M

Every US$1 invested returns:

Ecuador

0.4
1.27
1.08
0.78

India

1.66
1.38

Nigeria

0.41

2.59
1.76

Philippines

0.39
1.76
1.44

©Economist Impact 2023

Tackling Toilet Loss51

Ethiopia’s approach to financing sanitation

Case study

Ethiopia has one of the strongest enabling environments for sanitation in schools in Easternand Southern Africa.75 Since 2013 the One WASH National Program (OWNP) has been
established as a sector-wide approach to enhance the health and wellbeing of both rural andurban populations across Ethiopia.76
Ethiopia stands out as one of the few countries that have public-sector budget lines at thenational, regional and district levels specifically earmarked for WinS. The OWNP follows amatched funding approach, where government contributions are aligned with development
assistance, amounting to US$46.3m sourced from the national treasury.77 The Ministry of
Finance and Economic Development takes charge of the comprehensive fiscal management of
the Country WASH Account.
As of 2020, according to the African Development Bank, the number of schools equippedwith sanitation facilities in Ethiopia is 3,440. Importantly, half of these facilities are designatedfor female students.78 The programme continues to operate and aims to extend access tosanitation services to more than 400,000 individuals across rural, urban and refugee regions inEthiopia by 2025. This effort aligns with the overarching goals of the OWNP and SDG 6.79
Ethiopia's improvement in sanitation in schools can be partly attributed to the establishment ofan enabling environment, which includes policy support and dedicated budget lines for WASH
in Schools (WinS). This underscores the importance of establishing a supportive framework at
the national, regional and district levels. Similarly, both the gender-sensitive and rural-urban
approaches are contributing factors to the improvement of the WinS environment in Ethiopia.

www.unicef.org/esa/media/4356/file/UNICEF-Wash-in-Schools-Scoping-Report.pdf
www.moh.gov.et/site/One_WaSH_National_Program#:~:text=The%20One%20WASH%20National%20Program,policies%2C%20strategies%20
and%20development%20plans.
77This aligns with 2018 figures: www.unicef.org/esa/media/4356/file/UNICEF-Wash-in-Schools-Scoping-Report.pdf
78
www.afdb.org/sites/default/files/documents/projects-and-operations/ethiopia_-_one_wash_national_program_-_project_completion_report.pdf
79
sdgs.un.org/partnerships/danish-support-unicef-ethiopia-wash-programme-2022-2025
75

76©Economist Impact 2023

Tackling Toilet Loss

52

Conclusion

Investing in both building (and then maintaining)
new school toilets and maintaining existing onesis the most equitable way to close gaps in toilet
access in schools. It is also the pathway thatprovides the greatest benefits to society.
However, in countries that are either financiallyconstrained and/or require significant levels ofadditional spending, the findings from thisresearch emphasise the economic sense ofchannelling resources into the maintenance ofexisting school toilets. This strategy offers acost-effective means of achieving partial
coverage of school toilets with a path to fullcoverage as more funding is unlocked.

No matter what journey a country takes toreach full basic sanitation coverage acrossschools, reaching the goal will provide
substantial benefits at an individual andsocietal level. And these benefits will not
end in 2030. They will continue in the longterm, driving individual prosperity andwellbeing and local economic growth.
The only poor decision that countries
can make along the way is to compound
existing Toilet Loss. As long as all toilets
are built with a plan for maintenance,
both children and society will benefit.

Figure 28. The road ahead: a context-specific strategy

Sanitation gaps
Large

High

Budgetavailability

Low

Small

Prioritise budget spendingon sanitation:
invest in both construction andO&M to close large existing gaps

Go the last mile:
invest simultaneously in bothconstruction and O&M to rapidly
close remaining gaps

Maximise the cost effectiveness ofinvestments:
direct available funds towards
maintaining existing infrastructure,
while creating fiscal space forconstruction investment over time

Close all remaining gaps:
use limited funds to first maintainexisting infrastructure before investingin new infrastructure©Economist Impact 2023

Tackling Toilet Loss

53

So what needs to be done? What steps can different groups of stakeholders take to get countries
closer to full basic sanitation coverage? Based on the insights of experts interviewed, publishedresearch and learning from countries leading the way towards sanitation for all children, we haveidentified a three-point action plan as a baseline for developing local strategies:
Accelerate future planning
No school toilet built
without a plan and budget for
operations and maintenance

Political
commitment
Better monitoring
Collecting systematic
data against clear
guidelines to measureand monitor theavailability of and accessto basic sanitation
services in all schools

Prioritise school
sanitation acrossinternational, national
and local policy levels

Clear governanceClarifying roles andresponsibilities for all
stakeholders providing
sanitation services in schools

Accelerating progress towards achieving the goal of eliminating Toilet Loss will require system-levelchange in how sanitation services in schools is planned, delivered and managed. Central to thischange will be political commitment across international, national and sub-national levels. Politicalcommitment will ensure that sanitation is prioritised on political agendas and sufficient funding andresources are allocated towards it.
1. Accelerate future planning: Going forward, no school toilet should be built without a plan andbudget for O&M. Toilets built without a plan quickly become unusable, which leads to Toilet Loss.
Ensuring that sufficient funds are allocated from the planning stage for not only the construction but
also the regular O&M of school toilets can stretch initial infrastructure investment, maximising thereturns on investment. Understanding the specific requirements for each country in terms of current
Toilet Loss, investment needs and the types of investments that will deliver the greatest returns is
crucial to developing an effective plan.

“The primary challenge is in the planning andimplementation of WASH interventions.
Many interventions, even those that initiallyshowed promise, were poorly executed withinsufficient resources, resulting in them
becoming unsustainable after a few years.”
Josh Garn, assistant professor, University of Nevada School of Public Health©Economist Impact 2023

Tackling Toilet Loss

54

The role of different stakeholders in: Accelerate future planning• Establish investment planning protocols requiring all financial plans forbuilding school toilets to incorporate both construction and maintenance

Donors andinternational
development partners• Prior to investing in toilet infrastructure, ensure that the education sector
has budget allocation for O&M at the school level• Prioritise budget allocation towards achieving basic toilet access for all
children across schools

National governments,
policymakers and
WASH planners

Local education sector
and schools• Establish national guidelines for planning sanitation investment tosupport schools in estimating financial needs for the daily use andmaintenance of school toilets (see guidance provided by the
Department for Education in the Philippines80)• Identify resource requirements at planning stages to construct,
operate and maintain toilets to ensure that toilets are both cleanand safe to use

2. Better monitoring: In addition to planning for sanitation investment in schools, the implementationof these programmes also needs to be monitored to ensure that stakeholders are held to account against
indicators of the quality of sanitation services. Countries collect and aggregate national-level data acrossschools on levels of access to functional and private toilets. However, these data are not collected
systematically across all countries. Countries also collect little data on the usability of school toilets inpractice, including whether the number of toilets is sufficient for the number of children enrolled in aschool and whether they meet cleanliness standards for use. Systems need to be put in place to monitor
progress against clearly established guidelines for the quality of sanitation services. This includes
embedding indicators of school sanitation within Education Management Information Systems.80"Regular inspection and surveillance,
together with data collection, are vital forunderstanding the status of school toilets. It's
important that governments have clear criteria
for measuring what “good” looks like."
Oliver Schmoll, programme manager, water and climate,
WHO European Centre for Environment and Health80

http://www.fitforschool.international/wp-content/ezdocs/WASH_in_Schools_Operation_and_Maintenance_Manual_2017.pdf©Economist Impact 2023

Tackling Toilet Loss

55

The role of different stakeholders in: Better monitoring

Donors andinternational
development partners• Hold decisionmakers and policymakers at national, subnational andschool levels to account for the returns on investment put towards
sanitation with requirements for monitoring and evaluating the resultsof sanitation programmes and discourage investment in construction
without O&M• Establish clear measurable guidelines on definitions for sanitation
facilities to be adequate and safe to use (see self-assessment guidelines
provided by the Ministry of Human Resource Development in India81)

National governments,
policymakers and
WASH planners• Integrate indicators on school sanitation into Education Management
Information Systems to gather school-level information on sanitation
conditions, including access and quality, which can be collated at anational level for bodies such as the JMP• Conduct regular checks on the quality and functioning of sanitation
services at the school level to maintain standards

Local education sector
and schools• Allocate resources towards regular data collection and collation toprovide to policymakers and other external stakeholders which can be
aggregated across schools

81“Many countries still lack reliable data on the statusof WASH in schools, especially for pre-primary,non-government schools and advanced levels ofservice. Strengthening routine monitoring systems
will be critical to target investments where they areneeded most.”
Tom Slaymaker, senior statistics and monitoring specialist, UNICEF

81

https://www.education.gov.in/sites/upload_files/mhrd/files/upload_document/Swachh_Vidyalay_Puraskar_Guidelines.pdf©Economist Impact 2023

Tackling Toilet Loss56

3. Clear governance: Unlocking the benefits that come from full access to basic sanitation
services in schools requires an acceleration in progress, which cannot be achieved withany single stakeholder group working in isolation. The roles and responsibilities of all
stakeholders involved in providing sanitation services in schools needs to be clarified:• Who is responsible for building school toilets?
• Who cleans the toilets on a regular basis?
• Who maintains the toilets and fixes them when there is a fault?
Governance structures and arrangements may look different in different local
contexts, but they need to exist and these roles need to be clearly defined tocreate accountability for both building and maintaining toilets in schools.
The role of different stakeholders in: Clear governance82

Donors andinternational
development partners

National governments,
policymakers and
WASH planners• Establish requirements for financial plans for sanitation investment toinclude clear governance structures and lines of accountability, in
addition to budget lines for O&M• Clarify the roles and responsibilities for the construction and O&M ofschool toilets across national, subnational and local government bodies(including departments responsible for health, education and water),
private sector, and schools (see guidelines established by the Ministry of
Education in Liberia82)• Promote effective inter-agency collaboration involving various
stakeholders—such as government departments, NGOs, donors, andpartners—to combine resources and expertise in addressing sanitation
challenges• Allocate human resource capacity to ensure that toilets on school
premises are clean and safe to use

Local education sector
and schools• Coordinate with local stakeholders to ensure that toilets are usable forchildren, including with suppliers for essential resources (e.g. soap,
water) and service providers for regular maintenance (e.g. ad hoc
repairs and regular pit emptying)“One of the most significant issues is that there isn’t asystematic approach to assigning responsibility andaccountability for WASH in schools. Once a toilet isconstructed, schools are often expected to be responsible
for the O&M, but they are not provided with the required
resources or know-how.”
Claire Chase, senior economist, World Bank
82

https://www.humanitarianresponse.info/sites/www.humanitarianresponse.info/files/documents/files/annex_8_liberia_wins_guidelines_and_tor_0.docx©Economist Impact 2023

Tackling Toilet Loss

57

“Responsibility for constructing school toilets isdifferent from responsibility for operating andmaintaining them. The construction of toilets
is typically managed and financed by the local
government or the water and rural development
sector - they are responsible for ensuring that
toilets are available. Meanwhile, the education
sector is responsible for ensuring that toilets areusable and often faces challenges in securing thenecessary funds for maintenance.”
Bella Monse, senior advisor, Fit for School, GIZ©Economist Impact 2023

Tackling Toilet Loss

58

Appendix: Country data summary

Ecuador
Looking back: 2015-21
Tracking progress
Percent of children with access to sanitation services acrossschools:

Access in 2021
Total number of children: 4.9m, of which:100• Limited service access: 1.5m

• No sanitation access: 0.5m
• Basic service access: 2.9m

75
59

59

Toilet Loss

50
25

Lost expenditure: US$114.9m (17% of investment)
Lost toilets: 44,500

30

20

Lost socioeconomic benefits: US$121.8m, of which:• Healthcare costs: US$61.1m

11• Lost family income: US$22.2m

02015
Basic services• Lost economic activity: US$38.5m

2021
Limited services

No services

The road ahead: 2021-2030
Toilets needed by 2030
Total number of toilets needed:
169,100, of which:• Existing toilets needing
continued O&M: 87,500• Dysfunctional toilets needing
rehabilitation and O&M: 44,500• Non-existent toilets needing
construction and O&M: 37,100

Costs and benefits
School toilet access (2030)

Gains tosociety(US$m)

Investment
required(US$m)

Returnper US$1
investment

Constructionalone

2.6m children (46%)
without basic toilet access

16.6

41.2

0.40

O&M alone

625,000 children (11%)
without any toilet access

137.1

107.6

1.27

Construction
and O&M

No children without access

197.4

183.2

1.08

©Economist Impact 2023

Tackling Toilet Loss

59

India
Looking back: 2015-21
Tracking progress
Percent of children with access to sanitation services acrossschools:

100
75

Access in 2021
Total number of children: 369.7m, of which:• No sanitation access: 30m• Limited service access: 21.8m

86• Basic service access: 317.9m

63
Toilet Loss

50
25

Lost expenditure: US$994.4 million (3% of investment)
Lost toilets: 638,200

25

Lost socio-economic benefits: US$5,132.2m, of which:

12• Healthcare costs: US$3,449.8m

8• Lost family income: US$428.3m

0• Lost economic activity: US$1,254.1m

2015
Basic services

2021
Limited services

No services

The road ahead: 2021-2030
Toilets needed by 2030
Total number of toilets needed:
10,934,700, of which:Costs and benefits• Existing toilets needing
continued O&M: 9,315,300

School toilet access (2030)

Gains tosociety(US$m)

Investment
required(US$m)

Returnper US$1
investment• Dysfunctional toilets
needing rehabilitation
and O&M: 638,200

Construction
alone

69.7m children (19%)
without basic toilet access

883.1

1,136.0

0.78• Non-existent toilets needing
construction and O&M: 981,200

O&M alone

30.6m children (8%)
without any toilet access

2,315.7

1,398.0

1.66

Construction
and O&M

No children without access

5,005.7

3,624.9

1.38©Economist Impact 2023

Tackling Toilet Loss

60

Nigeria
Looking back: 2015-21
Tracking progress
Percent of children with access to sanitation services acrossschools:

Access in 2021
Total number of children: 70m, of which:100• Limited service access: 13.9m• No sanitation access: 29.8m• Basic service access: 26.3m

75

50
25

Toilet Loss

49

42

Lost expenditure: US$577.6m (16% of investment)
Lost toilets: 413,200

38
20

26

Lost socioeconomic benefits: US$4,446.6m, of which:• Healthcare costs: US$2,347.6m• Lost family income: US$275.6m

02015
Basic services• Lost economic activity: US$1,823.4m

2021
Limited services

No services

The road ahead: 2021-2030
Toilets needed by 2030
Total number of toilets needed:
2,687,900, of which:• Existing toilets needing
continued O&M: 785,000• Dysfunctional toilets needing
rehabilitation and O&M: 413,200• Non-existent toilets
needing construction
and O&M: 1,489,700

Costs and benefits
School toilet access (2030)

Gains tosociety(US$m)

Investment
required(US$m)

Returnper US$1
investment

Constructionalone

58.5m children (67%)
without basic toilet access

588.6

1,446.8

0.41

O&M alone

37.9m children (43%)
without any toilet access

2,101.6

810.9

2.59

Construction
and O&M

No children without access

6,742.7

3,826.5

1.76©Economist Impact 2023

Tackling Toilet Loss

61

Philippines
Looking back: 2015-21
Tracking progress
Percent of children with access to sanitation services acrossschools:

100

Access in 2021
Total number of children: 27m, of which:• No sanitation access: 2.3m
• Limited service access: 4.9m
• Basic service access: 20m

74

75
52
50

Toilet Loss
Lost expenditure: US$248.9m (10% of investment)

40

Lost toilets: 146,300

25

Lost socioeconomic benefits: US$804.1m, of which:18
8• Healthcare costs: US$405.6m

8• Lost family income: US$117.2m

0• Lost economic activity: US$281.3m

2015
Basic services

2021
Limited services

No services

The road ahead: 2021-2030
Toilets needed by 2030
Total number of toilets needed:
910,800, of which:Costs and benefits• Existing toilets needing
continued O&M: 601,300

School toilet access (2030)

Gains tosociety(US$m)

Investment
required(US$m)

Returnper US$1
investment• Dysfunctional toilets
needing rehabilitation
and O&M: 146,300

Constructionalone

9.2m children (30%)
without basic toilet access

41.8

106.7

0.39

• Non-existent toilets needing
construction and O&M: 163,200

O&M alone

2.4m children (8%) without
any toilet access

467.2

266.1

1.76

Construction
and O&M

No children without access

675.1

467.4

1.44

©Economist Impact 2023

While every effort has been taken to verify the accuracy of thisinformation, Economist Impact cannot accept any responsibility
or liability for reliance by any person on this report or any of
the information, opinions or conclusions set out in this report.
The findings and views expressed in the report do
not necessarily reflect the views of the sponsor.

©Economist Impact 2023

LONDON

The Adelphi
1-11 John Adam Street
London WC2N 6HT
United Kingdom
Tel: (44) 20 7830 7000
Email: london@economist.com

NEW YORK

900 Third Avenue
16th Floor
New York, NY 10022
United States
Tel: (1.212) 554 0600
Fax: (1.212) 586 1181/2
Email: americas@economist.com

HONG KONG

1301
12 Taikoo Wan Road
Taikoo Shing
Hong Kong
Tel: (852) 2585 3888
Fax: (852) 2802 7638
Email: asia@economist.com

GENEVARue de l’Athénée 32
1206 Geneva
Switzerland
Tel: (41) 22 566 2470
Fax: (41) 22 346 93 47
Email: geneva@economist.com

DUBAI

Office 1301a
Aurora Tower
Dubai Media City
Dubai
Tel: (971) 4 433 4202
Fax: (971) 4 438 0224
Email: dubai@economist.com

SINGAPORE

8 Cross Street#23-01 Manulife Tower
Singapore048424
Tel: (65) 6534 5177
Fax: (65) 6534 5077
Email: asia@economist.com

SÃO PAULO

Rua Joaquim Floriano,
1052, Conjunto 81
Itaim Bibi, São Paulo,
SP, 04534-004
BrasilTel: +5511 3073-1186
Email: americas@economist.com

WASHINGTON DC

1920 L street NW Suite 500
Washington DC
20002
Email: americas@economist.com