Flush and flourish: upgraded toilets can transform lives in rural Asia

Abstract

Poor sanitation remains a major challenge to rural development and human capital accumulation across many Asian countries. One of the biggest risks is the mismanagement of human waste, which leads to the contamination of drinking water and food—a key driver of infectious diseases that trap rural populations in poverty. In fact, over 80% of human infectious diseases, such as hepatitis A, diarrhea, and COVID-19, are spread through exposure to human feces.

Flush toilets offer a promising solution. Flush toilets safely contain human waste, reducing contamination and improving overall sanitation. Recognizing this, many Asian countries are working to accelerate flush toilet adoption, and progress has been made. As a result, 73% of households in the People’s Republic of China (PRC), 50% in India, and 46% in Cambodia have access to flush toilets (NBSC 2024; Tiwari et al. 2022; Yamada and Vu 2024). However, rural areas still lag behind, highlighting the urgent need for further improvements.