The world must build toilets to save lives

THE practice of open defecation is increasingly dangerous to public health when people crowd close together. Worms and bacteria spread by human waste spread deadly disease and can be a big cause of malnutrition. India is, far and away, the country worst blighted by open defecation, made worse by the fact it has a large population crowded onto relatively little land. Why India suffers worse than much poorer countries, such as Congo or Afghanistan, and worse than fellow South Asian countries, such as Bangladesh, is a matter for contentious debate.

One reason could be political leadership: for too long India’s government failed to make sanitation, the building of latrines, a public health priority. India’s new government now plans to build 130m latrines by 2019. A second, more controversial reason, could be the influence of traditional Hindu culture on sanitation habits. Studies of India’s population show strikingly higher rates of open defecation in Hindu-dominated villages compared with Muslim ones, despite lower incomes, education and worse water supplies of Muslims. That suggests a good way to get India’s sanitation closer to global standards would be to begin with an education campaign, to persuade households to build—and use—their own latrines.