Pre-pandemic in November 2019, only 11 percent of the country’s over 42,000 barangays had achieved zero open-defecation or ZOD status. The problem was so bad that the Department of Health advised families to procure toilet bowls for their homes first before buying a mobile phone. The DOH said a simple toilet bowl at the time cost as low as P1,200 – cheaper than a low-end cell phone priced at P1,600.
Today the World Bank estimates that 3.5 million Filipinos across the country still lack toilets, and tend to practice open defecation, with the worst sanitation coverage observed in low-income and rural communities. In its latest Safe Water and Sanitation for All publication, the World Bank said that while about 50 percent of the Philippine population now has access to basic sanitation facilities, those belonging to the poorest 20 percent of rural households and 11 percent of urban households continue to practice open defecation.
Even before the pandemic, health experts had warned that open defecation promotes the spread of diseases including cholera, typhoid, diarrhea and hepatitis. In 2019, a Type 2 strain of vaccine-derived poliovirus was detected during environmental testing of sewage in Manila. The potential savings in health care, including the billions subsidized by the government, should offset the initial investment needed in providing universal access to toilet facilities.
Apart from the possibility of contracting diseases, experts have also warned that women and girls who defecate in public risk sexual assault and physical violence. The World Bank has noted that poor access to basic water and sanitation services is also linked to malnutrition and stunting. It estimates that nearly a third of Filipino children suffer from stunting – a problem that has been linked to poor academic performance.
The World Bank describes the lack of access to basic sanitation as a silent public health emergency. It estimates that only 48 percent of the Philippine population enjoy safe water access, while 63 percent have access to sanitation services. The figures are lower than the regional averages in East Asia-Pacific of 74 and 69 percent, respectively.
Pre-pandemic, the DOH had set a target of ZOD nationwide by 2025 under a sustainable sanitation program. In line with UN Sustainable Development Goals, the Philippines aims to achieve universal access to safe water and sanitation by 2030. Considering that this can entail an annual investment of over P100 billion a year by both the public and private sectors, the attainment of the goal is uncertain.
The responsibility falls on local government units, which now enjoy a greater share from national revenues. Still, the national government can support the LGUs in ensuring that the necessary investments will be made in the provision of safe water and sanitation.