Kate Medlicott (WHO), Yvonne Magawa (ESAWAS), Peter Mutale (NAWASCO), Chola Mbilima (NWASCO), Sam Drabble (WSUP), Mohammad Said Al Hmaidi (WSRC), Massa Antoine Traore (MoESSD, Mali), Jelena Krstić (MoEP, Serbia), Alyse Schrecongost (BMGF)
Upon the launch of the State of the World's Sanitation report in 2020, WHO along with UNICEF, ESAWAS and BMGF shared a blog entitled "Regulating sanitation services as a public good". That post outlined the service failures inherent in a household-led retail-based approach to urban sanitation. It made the case that, if goals of inclusion and public health were to be achieved, governments needed to craft and apply regulatory and accountability tools to mandated sanitation authorities and associated service providers. In summary:
- First, regulations can help to better link sanitation services to public health protections.
- Second, as with public health regulation, economic and performance regulation must focus on safe, inclusive service outcomes, irrespective of the infrastructure used.
- Finally, when regulators and authorities operate within a well-structured policy and regulatory environment, it can increase business opportunities, attract private finance, and incentivize investment in innovation for public health and inclusivity goals, and related goals including (for example) climate resilience.
However, while the case for sanitation regulation is strong, in practice coherent regulation across the sanitation service chain is often absent or unenforced. In high-, middle- and low-income countries alike, regulators (where they exist) lack autonomy, a clear legal basis for their work, political will, budgets, and data systems required to perform their function effectively. This is particularly universal in non-sewered service contexts.
Changing this norm is complex, but it is necessary, possible, and several countries offer examples. Malaysia, Philippines, Japan, Zambia and Brazil are among the countries that offer a range of examples of nascent, mature and constantly evolving approaches to regulating sanitation services from plot through disposal, in formal and informal communities, encompassing economic, service quality, environmental and public health goals. This always involves coordination across multiple government agencies, public service authorities, and private service providers.
In the intervening years, WHO along with partners including ESAWAS, ADERASA and WSUP, have been learning from and supporting countries to identify risk-based priorities for regulation and appropriate regulatory mechanisms (Fig 1) following the sanitation safety planning approach.
Fig 1: Sanitation service chain regulatory mechanism options
(Source: Guidelines on sanitation and health)
Based on this experience, two connected themes have emerged across regions: 1) mandates for the design and implementation of sanitation regulation are unclear and incomplete, and 2) to regulate for public health and inclusivity, clear legal service mandates must be accompanied by revised accountability mechanisms and tools (these issues are explored by ESAWAS in a 2021 series on key functions of Citywide Inclusive Sanitation, available here).
A working paper prepared for the 2022 RegNet meeting affirmed that, while there are exceptions, the mandates of regulated sanitation authorities rarely includes on-site sanitation services or a funded mandate to expand sewered services, particularly in vast informal urban and peri-urban areas. As a result, households without large bore network connections remain effectively beyond the protection of public regulation or public finance, including in parts of the WHO European and North American Regions. In particular, responsibilities for regulating on-site containment standards, emptying services, and sludge disposal are frequently unclear or not executed. Together with the RegNet paper, these issues were explored in the recent World Water Week session Who's responsible? Sorting out mandates for regulation of sanitation services and ESAWAS Landscape assessment for Africa.
For countries to achieve urban health, social, and economic development goals, they must clarify these goals in service mandates, and define accountability mechanisms, as fundamental first steps towards functional sanitation service sectors. Best-fit regulatory frameworks will vary by context, and every country needs to chart its own path. However, partners like WHO and ESAWAS are collaborating with public sector innovators to capture and share lessons, guidelines and tools with countries choosing to improve sanitation services for all urban households.
The experience of NWASCO, the water and sanitation regulator in Zambia, is an exemplar in a country that is newly taking on this challenge. NWASCO is an autonomous regulator with clear responsibilities for regulating authorities' economic and service quality performance across the sewered and on-site sanitation chain, who only started formalizing the non-sewered aspects of that responsibility in the past few years. Drawing on experience shared by Peter Mutale and Chola Mbilima (NWASCO) and wider discussions at IWA World Water Congress, Stockholm World Water Week, and the RegNet meeting, the following five steps emerge as potentially instructive for other countries looking to structure and regulate their sanitation sectors based on priority service outcomes :
- Establish the current legal basis for service regulation. A critical first step for countries looking to strengthen sanitation regulation is to conduct a detailed legal review, to clarify what agencies are responsible for regulating which aspects of sanitation services, and any gaps or overlaps in mandates. Only when the current legal status is known can there be a basis to move forward.
- Review and strengthen the institutional and regulatory framework. Following from the legal review, revisions to the overarching institutional framework may be required, including the design of a regulatory model and potential changes to the regulator's mission and mandate. One example of a country now engaging with this process is Mali , where a sanitation policy is under development, potentially involving the creation of an autonomous regulatory entity. Such a review may also lead to changes in the framework for sanitation service provision – as in Zambia, where NWASCO changed commercial utilities' licensing terms to include on-site services, as part of recent steps to implement its own technology-agnostic mandate to advance sanitation service outcomes.
- Develop effective (funded) accountability mechanisms, including for on-site sanitation. Regulators need both the mandated authority and politically and financially viable tools to hold service authorities and providers accountable for delivering service mandates. Tools can include licensing and performance contracts, public performance benchmarking, and time-bound resources and incentives that can foster a period of learning and improvement among service authorities and service providers. In Zambia, this step was underpinned by the development of an urban sanitation and faecal sludge management service provision and regulatory framework, and resourced with time-bound funds for learning, research, collaboration and iterative adjustments among regulators, utilities, municipalities, communities, and private formal and informal operators.
- Establish and fund robust public data management systems to inform regulation and service improvements. Regulators, service providers, and citizens need data-backed information to plan, perform, and improve services. In many contexts, public data systems are missing, not digitized or updated, and do not include any aspect of non-sewered hardware or services. The Palestinian regulator, WSRC, is working to change this by proactively incorporating small-scale sanitation service provision into public data systems. The regulator has collected data from over 300 providers across 450 communities, to provide a better understanding of the service sector as a foundation for improving regulation and enforcement in this area.
- Strengthen regulator, service authority, and service provider capacity and incentives. Staffing levels and skill sets enable or constrain regulators, service authorities and service providers' performance. Any expansion in responsibilities must be accompanied by expanded staff hours, training, and incentives to learn, grow and actively create and iterate toward improved service outcomes. NWASCO, for example, has funding for its own staff learning and development in this area, and is coordinating training and technical assistance support for utilities and private sector providers newly expanding into formalized non-sewered services.
The above steps, as applied by NWASCO and others, offer a rough roadmap for countries reforming their sanitation sectors. Establishing a functional sanitation regulatory system from one that does not exist, or does not function for large segments of the population, requires a long-term plan for sector transition. Improving the effectiveness of sanitation regulatory systems for public health and inclusivity outcomes requires its own mechanisms and incentives for internal and external regulatory performance assessment and improvement. And the job is never complete. Regulators at the RegNet forum underlined that, as individuals and agencies, regulators are constantly adapting and evolving in the context of ever-changing resource levels, threats, challenges, and directives.
Two critical points remain unaddressed by the steps above. First is the role of the regulator as a leader and as a facilitator of stakeholder learning and coordination for sector reform. This is a role NWASCO has performed notably in Zambia, and which we also see in other countries in Africa and Latin America with autonomous regulatory authorities. The second is the importance of institutionalizing downward accountability mechanisms, through rules around data transparency and citizen review and engagement processes. Such mechanisms are key in keeping regulators informed and accountable to the service consumers and those excluded from public finance and services who they are ultimately working for. Quoting the recent ESAWAS paper: "In the context of clarifying responsibilities, the process of convening stakeholders to develop dialogue, enhance coordination and strengthen information flows is fundamental. Emerging experience suggests that no-one is better positioned to perform this function than a regulator".
