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  • Writer's pictureWorld Health Organization

Revolutionising sanitation: leading the way to regulation of services


During the All Systems Connect International Symposium 2023, experts from around the world will discuss how to strengthen sanitation systems for everyone, especially those living in urban areas. Ahead of this, Batsirai Majuru, Technical Officer and lead for RegNet, World Health Organization (WHO), discusses the importance of regulation, and recommends five steps to achieving the improvements needed to achieve this goal.

In 2021, the State of the World's Sanitation report showed that the current approach to providing sanitation services especially in cities is too slow, not equitable and failing to realise the full health, social and economic benefits of safely managed sanitation for all. It recommended that governments should create and enforce rules to make sure that sanitation providers do their job properly. The main points were that:

  1. Regulations can help make sure that sanitation services protect people's health.

  2. Regulations should focus on providing safe, inclusive services, no matter what kind of infrastructure is used.

  3. A well-structured system can create business opportunities, attract private investment, and encourage innovation for public health and other goals, like climate resilience.

However, many countries still lack proper regulation of their sanitation systems, especially non-sewered services. Even when there are regulators, they often don't have the power, legal support, political backing, or resources to do their job effectively. But there are some countries, like Malaysia, the Philippines, Japan, Zambia, and Brazil, that are starting to find better ways to regulate all types of sanitation services. WHO and its partners – Eastern and Southern Africa Water and Sanitation (ESAWAS) regulators association, Asociación de Entes Reguladores de Agua Potable y Saneamiento de las Américas (ADERASA), Water & Sanitation for the Urban Poor (WSUP), and the International Network of Drinking-water and Sanitation Regulators (RegNet) members – with the support of Bill & Melinda Gates Foundation (BMGF) have been working together to help countries figure out how to prioritize and create better regulations for their sanitation systems. They've found that:

  1. Clear mandates and responsibilities for sanitation services are often missing.

  2. To improve public health and inclusivity, legal mandates need to be supported by better accountability mechanisms and tools.

Many countries do not have proper rules or funding for sanitation services, especially in informal urban and peri-urban areas. To achieve urban health and development goals, countries need to clarify their goals and define better ways to hold people responsible for providing sanitation services. Based on the experiences of successful countries, like Zambia, here are five steps that can help improve sanitation regulation:

  1. Understand the current legal situation. Conduct a detailed legal review to identify which agencies are responsible for regulating sanitation services and find any gaps or overlaps.

  2. Review and strengthen the institutional and regulatory framework. Make necessary changes to the regulatory model, mission, and mandate.

  3. Develop effective, funded accountability mechanisms. Regulators need the authority and tools to hold service providers responsible for delivering proper sanitation services.

  4. Establish and fund strong public data management systems. These systems help regulators, service providers, and citizens plan, perform, and improve services.

  5. Improve the capacity and motivation of regulators, service authorities, and providers. Provide training, incentives, and resources for staff to learn, grow, and actively work towards better sanitation services.


The process of creating a functional sanitation regulatory system is a long-term effort. It requires constant adaptation and improvement to address changing circumstances and challenges. By following the steps above and learning from successful examples, countries can work towards better sanitation services for all. This topic will be explored at All Systems Connect – see the Wash Learning strand of our programme, session w1.8 on day 3 How regulators can enhance the delivery of onsite sanitation services. Find out more:

Photo: 1) WHO Polio Eradication Officers Dr Samreen Khalil and Farukh S. conduct environmental sampling for polio along with their team in Shaheen Town, Peshawar, Khyber Pakhtunkhwa, Pakistan. © WHO/Blink Media - Saiyna Bashir. 2) Kakuma, Kenya - NOOR / Sebastian Liste.

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