Improving access to sustainable sanitation and hygiene

Project description

Title: Sanitation for Millions
Commissioned by: German Federal Ministry for Economic Cooperation and Development (BMZ)
Co-funded by: Water Unite; The Bill & Melinda Gates Foundation, Hungry Ministry of Foreign Affairs and Trade, Inter-American Development Bank
Country: Global; Currently active in Jordan, Pakistan and Uganda
Overall term: 2016 to 2022



The United Nations (UN) recognises sanitation as a human right. The German Federal Government has been particularly proactive on this issue and has committed itself to realising this right in its National Action Plan for Business and Human Rights. Access to quality essential health care services and sanitation, and improved wastewater treatment, are also enshrined in the Sustainable Development Goals (SDGs). 

Despite global efforts, in 2015, 4.4 billion people did not have access to safe sanitation (UN). The poor are particularly severely affected. The presence of faecal contamination in many sources of drinking water adds to the problem. According to a UNICEF report in 2018, schools often lack basic sanitation, resulting in around 900 million children being denied access to safe hygiene facilities at school. 

There are many reasons for this. There is often a lack of funds for sanitation facilities, both in the public and in the private sector. Roles and responsibilities relating to different components in the sanitation chain are either not clearly defined or not put into effect. Strategies for creating incentives for private investment are frequently not applied. In addition, the skills and capacities for undertaking proper installation, operation, rehabilitation and maintenance are often not available. 

The treatment of faeces and faecal sludge is particularly challenging. There is often little awareness of safe hygiene practices. For the situation to improve, also for particularly vulnerable groups, innovative funding mechanisms are required because these groups usually do not earn enough themselves. Ownership of the plants and facilities installed also needs to be clarified for the financing partners. 


Disadvantaged and vulnerable population groups have access to safe sanitation and hygiene facilities. Above all, access to adequate sanitation is improved in public places such as schools, health centres and mosques.

Construction of new toilets and handwashing facility  (Quetta, Pakistan),


The Sanitation for Millions initiative was launched in 2016 to enhance the impact and visibility of German development cooperation in this field. The global programme serves as a platform for cooperation between international donors and for acquiring partners for support and implementation. The regional focus has so far been on the main host countries for refugees and on countries significantly affected by internal displacement and conflict. Measures are currently being implemented in Jordan, Pakistan and Uganda. The programme is planning to expand its activities. 

The work with partners is tailored to the situation in the respective country in order to ensure lasting results incorporated into partner policies. In some countries, the programme cooperates with several political partners, particularly with national ministries and authorities working in the areas of water and sanitation, education, health, security, stability and religion; it also works with municipal authorities. To ensure effective implementation, Sanitation for Millions also cooperates with non-governmental organisations (NGOs), associations and the private sector. 

In Jordan, the programme supports the Pathfinder Association in implementing awareness-raising and educational activities. In Uganda, menstrual hygiene is improved in collaboration with the NGO Days for Girls. In Pakistan, the programme works closely with the Balochistan Rural Support Programme (BRSP) and the Bremen Overseas Research & Development Association (BORDA). The focus of the work is on planning and building local wastewater treatment plants. In Pakistan and Uganda, the programme cooperates with the German Toilet Organization (GTO) to conduct school competitions and campaigns. The aim is to encourage participants to take the-initiative to make the operation and maintenance of sanitation facilities eco-friendly and to improve hygiene practices among schoolchildren. The programme activities pay special attention to the needs of women and girls, as well as persons with disabilities. For example, care is taken to ensure barrier-free access in the provision of sanitation infrastructure. 

In addition to funding from the German Federal Ministry for Economic Cooperation and Development (BMZ), Sanitation for Millions also receives financial support from the Bill & Melinda Gates Foundation, the British solidarity fund Water Unite, and the Hungarian Ministry of Foreign Affairs and Foreign Trade.

Handwashing routines at a  group handwashing facility Gabba Uganda


In all three implementation countries, better sanitation services and hygiene behaviour in schools have become a political priority. There have been visible improvements:

  • Schools in Pakistan that had neither toilets nor water now have clean toilets and drinking water dispensers. 
  • In Uganda, there have been marked improvements in the state of the toilets and in the number of toilets per schoolchild. 
  • In Jordan, persons with disabilities now also have access to the facilities. 
  • The initiative has also been successful with regard to operation and maintenance. The improved strategies have benefited not only the facilities addressed by the initiative but also the facilities where other donors or the partners themselves are active. 
  • There has been a distinct improvement in cleanliness and maintenance. 
  • Examples of the programme’s achievements are the inclusion strategy for schools in Jordan; training personnel at basic health care centres and schools in Pakistan; the development of appropriate designs for sanitation systems in Uganda, plus the related construction and rehabilitation measures in schools, hospitals and mosques. 
  • By May 2019, over 200,000 people had been reached through the construction, expansion and rehabilitation of sanitation facilities in public buildings.
  • The programme has trained 810 people in operation and maintenance, which has benefited around 400,000 people indirectly.
  • Training courses and measures to raise hygiene awareness in schools, mosques, summer camps and communities benefit more than 300,000 people worldwide.
  • With the Bill & Melinda Gates Foundation, the Hungarian Ministry of Foreign Affairs and Foreign Trade and Water Unite new financing partners have been acquired.


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