This powerpoint was presented by WSP Consultant, Sophie Hickling,during AfricaSan 3 (Kigali, Rwanda - 2011) under the "Economics of Sanitation for Advocacy and Decision Making" session. This session introduced the Economics of Sanitation Initiative (ESI) aims, rationale, and methods. A panel of experts from government, donors and other sector specialists in Africa commented on the use of ESI results for sanitation financing; the use of media to influence stakeholders; the mechanisms for adopting ESI results into government decision making; and critical assessment and proposed improvement to ESI methods.

1. Results of ESI Phase 1 in Africa Sophie Hickling Consultant Water and Sanitation Program

2. Countries included in the study Benin Burkina Faso Congo, Dem Rep of Ghana Kenya Madagascar Mozambique Niger Nigeria Rwanda

3. Costs of poor sanitation included in the study Mortality Healthcare Access Productivity

4. How these costs were derived Desk study Estimation

5. Mortality costs are the largest national cost of poor sanitation Example: Burkina Faso loses US$ 136 million each year due to mortality

6. Healthcarecosts resulting from poor sanitation are a heavy burden Example: Ghana spends US$ 54 million on health care each year

7. Finding a private location to defecate leads to economic loses which affect women most Example: Niger loses US$ 23 million each year in access time

8. Incapacity due to sickness and time accessing healthcare result in lost productivity Example: Kenya loses US$ 2.7 million each year in productivity

9. Costs associated with open defecation are greater than fixed point sanitation Example: In Rwanda OD costs US$ 2 more per open defecator than either unimproved or shared latrines

10. The economic burden of poor sanitation falls most heavily on the poorest Example: In Nigeria average cost of poor sanitation is almost 10% of average salary for the poorest.

11. Other potentially significant costs Epidemics: Annual additional cost of responding to cholera in Mozambique is est. US$ 5.1 million. Funerals: Sanitation-related funerals costs in Burkina Faso is est. US$ 1.5 million per year Water pollution: Poor sanitation affects drinking water sources increasing costs of treatment and supply

12. Other potentially significant costs Tourism: Based on existing travel and tourism contribution to GDP, by addressing poor sanitation in Ghana could gain est. US$ 8.5 milion each year. Cognitive development: Long term economic losses: early childhood diarrhoeaunder nutrition reduced cognitive development. STH infection  impaired cognitive development. Excreta re-use: Could bring potential economic benefit.

13. Conclusions Public financing of sanitation is a good investment and should be increased Public sector investment in sanitation is an important tool in poverty alleviation Public sector financing of sanitation strengthens other areas of the economy