Synergies and trade-offs between sanitation and the sustainable development goals

This article has been re-reviewed by Peter Hawkins . The previous review can be found at https://www.doi.org/10.14293/S2199-1006.1.SOR-EARTH.AP9PLO.v1.RETCOE

Report:

1. The paper is unconvincing as a tool to support policy development, which I think is the underlying purpose.
2. The focus on the SDGs is very inward-looking and donor-biased.
3. Policy-makers focus on the political realities of their countries.  They recognize the SDGs as important – but only insofar as they can help to obtain donor funds.  Both donor funds and domestic funds are strictly limited, so the important question is actually whether sanitation represents better value for money than other sectors.
4. It is possible that the approach outlined in the paper could contribute in some way to the development of economic models to demonstrate the potentially massive economic returns available from improving sanitation.  This is, however, difficult, and the most recent work seems to be that of Guy Hutton, now at UNICEF, back in 2012.  I believe academic brains would be better occupied in that kind of work, with real potential to influence policy-makers.
5. Whilst I agree with the general thrust of the recommendations and conclusions, it seems to me that the research does not itself directly support the most important statements.  It seems merely to demonstrate that the extensive work by the great and the good that went into developing the SDGs is synergistic and internally consistent.  I should hope so!!
6. In summary, while I find little that is incorrect in the paper, I do wonder what significant contribution it makes to this difficult sector.

Peter Hawkins
March 2021

It is a fascinating and systematic evaluation of the interactions between sanitation and the SDG. However it would benefit from careful, ruthless editing to ensure clarity through out.

A flaw with the method is that it is based on looking at the peer reviewed literature. It is therefore only capable of evaluating hypotheses that have been tested previously. This could lead to important aspects being overlooked: for example climate change. As I said this flaw is inherent to the method used and cannot therefore be rectified. However, it can be acknowledged as a limitation of the study.

The lessons for policy makers practitioners and researchers are well made. However, the discussion will be more powerful if it focusses on those conclusions we can reasonably draw from the research presented and refrains from sentiments which though laudable are not directly supported by the findings of the researchers.

This article has been reviewed by Peter Hawkins

Importance:

The paper adds a new perspective to the already wide consensus that sanitation contributes to many aspects of development and needs to be managed in a cross-sectoral manner.  By linking sanitation to all the SDGs, it might provide extra justification for the use of international development assistance – which tends to be aligned with the SDGs – to fund sanitation.

Level of validity:

While the study clearly demonstrates the interlinkage of sanitation with the whole range of SDGs, the recommendations and conclusions seem to draw largely on views established within the sanitation sector, without particular reference to the SDGs.  The implicit hypothesis, that demonstrating synergies between sanitation and the SDGs in general can guide policy and decision-making towards increased prioritisation of sanitation, is not supported, since this would demand comparison with all the other sectors competing for limited resources.

Level of completeness:

The authors would appear to have carried out a very systematic and wide-ranging piece of work.  However, in at least one case, a reference (Bartram et al. , 2012, quoted in the spreadsheet, and also in box 2) does not appear in the list of references appended to the text.  I am not sure whether this is a mistake, or if the list is only supposed to contain references quoted in the text.  If the former, then I would suggest the authors run a quick check.

Level of comprehensibility:

Apart from a few minor lapses, the text is clear and correct.  A quick proofing could resolve these.

Report:

Sanitation practitioners have recognised for some while that sanitation cuts across sectors, and that successful action on sanitation requires the coordination of many partners.  The SDGs represent the consolidated views of many development specialists, so it is not surprising that the SDGs corroborate this finding.  The high level of synergies identified (77%) provides further reinforcement.  However, to be useful for policy and decision-making, the analysis would need to address the relative priorities of different sectors, and this it does not do.  Nor does it examine the potential magnitude of the benefits that could be derived from sanitation.  It seems to be written from a sanitarian’s perspective, while aiming to exert influence at the level of overall policy and planning.  It is perhaps relevant to ask who the intended audience is, and what action they are being asked to take on the basis of the paper.

From within the sanitation silo, the paper does support the growing view that sanitation should be delivered as part of a package of basic services, which is a useful silo-breaking concept.  This has been recently examined by Scott, R. et al. , 2019, Sustainability, 11, 6706 , which found widespread agreement among expert opinion, but a dearth of evidence, possibly due to (a) rather few examples of such interventions in practice and (b) a paucity of published data where they have occurred.  This paper adds to that expert opinion, but also runs up against the same obstacles.  Indeed, in the recommendations to researchers it calls for just such documentation.

The paper takes many positions which would be widely accepted by sanitation practitioners, such as: “the need for increased understanding of behavioural aspects, such as needs, aspirations, values and acceptance of sanitation services” ; “wide-ranging benefits of investing in sanitation” ; “addressing the financing gap in sanitation requires either convergence of efforts across ministries or the creation of dedicated cross-sectoral agencies” ; or “the need to adopt holistic sanitation systems which consider the entire value chain” .  However, it is not clear how this study of synergies and trade-offs with other SDGs leads to these positions, although it is consistent with them.

Overall, I found the study as a whole somewhat frustrating in that it fails to provide a compelling argument which decision-makers could use for prioritising sanitation – the “evidence base to inform strategic investment in sanitation and particularly by integrating sanitation interventions into collaborative cross-sectoral development efforts” .  This is a useful and laudable objective, but simply demonstrating the interlinkages between the SDGs does not achieve this.  In any case, the challenges to achieving integrated and cross-sectoral action do not arise so much from lack of information, but rather from the practical constraints imposed by limited resources and weak governance systems.

Although the foregoing comments may seem critical, this is directed towards the line of argument, and not the conclusions, which I fully share, but primarily on the basis of experience, rather than the linkages with the SDGs identified by the authors.  The evidence base that will make a compelling case to policy-makers for an integrated and cross-sectoral approach to sanitation will in the end arise from implementing and documenting it, as recommended by the study.

Peter Hawkins

September 2020