More than 700 million people live in urban areas without access to proper sanitation. Put into context, the line-up for people waiting for toilets in our cities and towns would stretch around the world 29 times.

WaterAid’s second annual report on the state of the world’s toilets, Overflowing Cities, examines the status of urban sanitation around the globe. With more than half of the world’s population living in towns, cities, and megacities, a number expected to rise to two-thirds by 2050, the state of urban sanitation is becoming an increasingly pressing issue.

Last month, Prime Minister Justin Trudeau and Marie-Claude Bibeau, minister of international development and La Francophonie, travelled to Antananarivo, Madagascar for the 2016 Francophonie Summit.

Poor sanitation is a familiar story in Madagascar where 88 per cent of the population does not have access to basic toilets. Diarrheal illnesses kill an estimated 3,000 Malagasy children each year. And 49 per cent of Madagascar’s children are stunted from malnutrition, their growth and development irreversibly damaged by poor nutrition and chronic intestinal infections.

Stunting is a lifelong consequence of malnutrition in the first two years of a child’s life and is largely irreversible after that age. Malnutrition is not just caused by a lack of food. A lack of access to a safe toilet, clean water, and good hygiene practices plays a major role too, as repeated bouts of diarrhea—often caused by dirty water and unhygienic environments—are directly linked to malnutrition.

Diarrheal diseases caused by dirty water and poor sanitation are the second biggest killer of children under five after pneumonia, taking 315,000 young lives every year. Even those children who survive severe bouts of diarrhea are at risk of having their lives, and life chances, forever changed.

As cities expand, the numbers of urbanites living without basic sanitation has swelled. Without systems for removing human waste, almost 100 million urban-dwellers have little option but to practice open defecation, using roadsides, railway tracks and even plastic bags known as “flying toilets,” The remaining 600 million people without access to proper sanitation rely on toilets that do not fulfil minimum requirements of hygiene, safety, or privacy including dirty and crowded communal toilets, and rudimentary pit or bucket latrines.

Global Goal 6 of the United Nations Sustainable Development Goals commits the global community to providing everyone, everywhere with access to water and sanitation by 2030, leaving no one behind. With nearly 2.4 billion people still without basic toilets and more than 650 million without access to clean water, there is still much work to be done.

Setting aside the statistics, the one thing we know for sure is that good sanitation is the bedrock of public health. Everyone deserves access to a toilet, not only for personal dignity, but to avoid the many preventable health risks, such as diarrhea and cholera, associated with improper sanitation. We need to prioritize the provision of safe toilets for everyone for a healthier, more sustainable future.

The sanitation crisis requires a combined global effort if we are going to reach everyone, everywhere with a decent toilet by 2030. Canada has an opportunity to lead by example and champion the human right to both water and sanitation by making it the cornerstone of Canada’s international development strategy. In doing so, we can transform the lives of the poorest and marginalized, help end malnutrition, and improve the lives of millions of the world’s most vulnerable populations, including women and girls.

Nicole Hurtubise is the CEO of WaterAid Canada.

The Hill Times