Review of 'Synergies and Trade-offs between Sanitation and the Sustainable Development Goals'

On behalf of the authors I would like to thank Peter for taking time out to review our work. Please find our response as below:

1. The paper is unconvincing as a tool to support policy development, which I think is the underlying purpose.

The purpose of this paper is to provide the evidence base to support policy development. Through a review of over 500 publications we demonstrate synergies between sanitation and 130 out of the 169 SDG Targets. An important aspect the paper emphasises is the need for applying the methodology to context-specific settings to support relevant and appropriate policy development. Thus, on the back of this work we have been commissioned by Water Aid to develop a concise policy brief. This would have not been possible without the evidence we set out in the academic publication.

2. The focus on the SDGs is very inward-looking and donor-biased.  

The scope of our publication was to explore how action in sanitation would benefit and could be integrated into efforts in other sectors in lieu of critically evaluating the scope and impact of SDGs. I have been looking at the Africa 2063 Agenda for another project. I note from our evaluation that the African Agenda is more focussed towards economic empowerment and development as compared to the SDGs. More on this to be published later this year but this is outside the scope of this article.

3. Policy-makers focus on the political realities of their countries.  They recognize the SDGs as important – but only insofar as they can help to obtain donor funds.  Both donor funds and domestic funds are strictly limited, so the important question is actually whether sanitation represents better value for money than other sectors.

Our paper is helpful in starting the conversation on how sanitation interventions would align with non-sanitation programmes and interventions and help deliver outcomes for different sectors say health and education ministries in an integrated way. We argue that the benefits of sanitation go beyond the sector and hence including sanitation as part of the narrative can actually reduce competing for scarce resources. Some of the team members are now working with eThekwini Municipality to make a case for prioritisation of sanitation through the benefits across governmental departments and an important aspect in this work is to explore the alignment of the SDG agenda with existing policies and programmes.

4. It is possible that the approach outlined in the paper could contribute in some way to the development of economic models to demonstrate the potentially massive economic returns available from improving sanitation.  This is, however, difficult, and the most recent work seems to be that of Guy Hutton, now at UNICEF, back in 2012.  I believe academic brains would be better occupied in that kind of work, with real potential to influence policy-makers.

Economic benefits of improving sanitation are important but capture only one of the multiple benefits that can be gained, which are equally important and raised in the paper. As part of any context-specific application of the methodology that might follow, there is scope to zoom into the aspect of economic models but this goes beyond the scope of the paper. During my doctorate I explored the health and economic benefits of investing in sanitation in slums in India. I agree that this a under researched topic and needs stronger focus. Our paper in a way sets out the linkages between sanitation and other sectors including economic opportunities to kick start conversations around models.

5. Whilst I agree with the general thrust of the recommendations and conclusions, it seems to me that the research does not itself directly support the most important statements.  It seems merely to demonstrate that the extensive work by the great and the good that went into developing the SDGs is synergistic and internally consistent.  I should hope so!!

We revised the results and discussion section so as to better align our recommendations to the evidence captured in the study. We go well beyond saying that there are synergies by providing the evidence on where they are and by highlighting more surprising links while also pointing out potential trade-offs to be mindful about.

6. In summary, while I find little that is incorrect in the paper, I do wonder what significant contribution it makes to this difficult sector.

The sector is fraught with underinvestment and we hope that our publication would influence policy makers and funders to invest more in the sector to achieve wide ranging benefits. The paper provides the basis for context-specific applications that can really make a difference in the sector, something that a global mapping exercise will always be limited to do.