The Swachh Bharat Revolution

Chief Financial Officer, Bill & Melinda Gates Foundation

THERE IS A large white board in Secretary Iyer’s office. On it, he tracks India’s daily progress towards the goal of becoming Open Defecation Free (ODF). Every now and then, whenever a village achieves that status, it goes up on the board. But the number of days left to reach zero keeps going down daily, one by one. It is impossible, then, to attend a meeting at the Ministry of Drinking Water and Sanitation (MDWS) without realizing three things: the Swachh Bharat Mission (SBM) is massively ambitious, it has changed the lives of hundreds of millions of Indians, and the clock is ticking.

The reason leaders like Secretary Iyer and his colleagues at MDWS can hold themselves accountable for results in this way is the remarkable support extended to the programme from the very top to get the job done. The Government has demonstrated through its actions that it is serious about a Clean India.

In the development sector, we talk a lot about the importance of ‘political will’. Indeed, it’s a requirement for success in every single thing we do. Still, the concept can be elusive. It’s hard to define ‘political will’. As the saying goes, though, you know it when you see it – and when you see it, it looks a lot like Swachh Bharat.

Partnering with Political Will

Prime Minister Narendra Modi made sanitation the centrepiece of his first Independence Day speech after assuming office in 2014. This was a breakthrough. As he said, ‘You must be shocked to hear the Prime Minister speak of the need to build toilets from the ramparts of the Red Fort.’

By linking SBM to Mahatma Gandhi’s vision for the nation, that speech made it clear that sanitation was not just a political promise; it was a national duty. The Mission’s logo, featuring Gandhi’s spectacles, conveys the idea that history is watching – to see Clean India succeed.

Just as important as what India’s leaders have said, the Government too has put its money where its mouth is. The $30 billion the Government has invested in SBM has made it possible for the Mission to achieve results where previous, smaller Government-funded sanitation programmes had failed.

But money isn’t the only resource the Government has devoted to sanitation. It has also spent significant political capital by working across party lines when necessary to make sure that state and local officials fully support the Mission.

Finally, the Government – notably the Prime Minister himself – has spent an extraordinary amount of time on the issue. He has held at least seven massive public events around the themes of a Swachh Bharat and sanitation, and he receives regular updates about the Mission’s progress. For Government leaders to pay this kind of attention to the details of sanitation is simply unheard of.

A Substantive Partnership

Political will isn’t the only abstract ingredient in the recipe of successful development. Another theme we can’t stress enough is ‘partnership’. In this regard, too, SBM has provided an object lesson.

It is very easy to think that you have fulfilled your partnership obligations when you are able to put a few organizations’ logos on a website. The Government, however, has taken a much more substantive view of what it means to engage partners.

At the Gates Foundation, we have found the Indian Government to be admirably open to new ideas. SBM’s leaders start from the point of view that to accomplish something of this magnitude, they need as much expertise and as much perspective as possible, even if it means sharing some of the credit. They have invited partners from every sector to participate, because they know that each brings particular strengths.

Soon after the Mission was announced, many development partners alerted the Government to the need for attention to faecal sludge management. Just building toilets and persuading people to use them isn’t enough. While the preferred toilet technology of the Government for rural areas, the twin-pit toilet, is self-sufficient with regard to treatment of faecal waste, other technologies like septic tanks fill up and, therefore, need concurrent waste management. If that waste isn’t collected and treated, the toilets become unusable and pathogens leak back into the environment, undoing all the progress.

As a result of this advocacy, India then became one of the first countries to announce a Faecal Sludge Management National Policy and backed that up with resources to build the treatment infrastructure. In response, many states issued their own policies and set aside state funding as well.

There are many such examples of strong partnerships that made the Mission work. For example, the Government has worked closely with Tata Trusts, which recruited trained experts to work alongside hundreds of district collectors through the Zila Swachh Bharat Prerak programme. SBM has also been on the cutting-edge with the behaviour change messages it uses because it is willing to listen to partners. In the beginning, the programme focused a lot on the fact that open defecation poses a safety threat to women, which is true. However, working together – the Gates Foundation, UNICEF and the Ministry – we learned that these messages subtly discouraged men from listening to them, so the appeal was broadened to include and, indeed, specifically target men for behaviour change around toilet usage. At the same time, the Ministry started highlighting the role of women and children as sanitation champions in communities around India, to make it clear that they have the power to be change agents and leaders in this important national movement.

These strategies are working. Recent national and international surveys have shown that a majority of rural Indians who have access to a toilet use it.

The Urgency of Zero

The all-out assault on open defecation in India reminds me in many ways of the country’s success in eradicating polio. Like SBM, the polio campaign’s goal was also zero. Not ‘less polio’, but ‘no polio at all’. When you have to get to zero, and when you have to do it in a place as large and complex as India, you have to adopt a systematic stance towards the work – and you have to keep track.

When dealing with polio, India took a clear-eyed view of what an effective campaign would require: vaccinating every single child at least three times, which is challenging when 75,000 children are born every single day. The Government hired 2 million health workers to run the campaign, including some who had to carry coolers with a few vaccines across rivers and over mountains to reach children who’d never encountered the health system before. Celebrities like Amitabh Bachchan participated in public awareness campaigns, and Indians in communities across the country mobilized their friends and neighbours to get their children vaccinated. Eradication was everyone’s business. That’s why my boss, Bill Gates, said that India’s success in wiping out polio was ‘the most impressive global health success [he’d] ever seen’.

SBM is similarly impressive. The Government has trained hundreds of thousands of swachhagrahis in rural communities to trigger change and motivate hundreds of millions of Indians towards safe sanitation. It has signed up famous actors and cricketers to raise people’s awareness. It even put the Mission on Indian currency (refer to the Swachh Bharat logo on all currency notes). All this is necessary, because the same child who received a polio vaccine for the first time also needs to be reached by SBM. And the meaning of the word ‘reached’ is broader when it comes to sanitation. The polio vaccine is a single drop and you’re done, whereas SBM requires behaviour change coupled with a huge infrastructure build, which is harder and takes more time. And yet, after little over four years, India is on the threshold of achieving its goal.

Finishing the Job in India and Around the World

As Gandhi’s 150th birth anniversary and the deadline for India to become Open Defecation Free approaches, it is important to celebrate what SBM has accomplished. But, in keeping with the result-oriented culture of the Mission, I also want to conclude with some thoughts on what must come next in India’s sanitation revolution.

The immediate priority is not just to finish the job but to make sure it stays finished. Open defecation has been customary since the beginning of time. Meanwhile, for the 600 million Indians reached by SBM, the idea of using a toilet is less than five years old. The Government will need to continue spreading the message of why sanitation is so important – and it will have to continue to be creative and flexible about which messages are most effective – to ensure that India remains Open Defecation Free.

In addition, the Government and its partners, including our Foundation, must focus on innovations in faecal sludge management. A number of related technologies are being tested to serve the specific needs of remote villages, as well as thousands of large dense villages and urban cities and towns. India needs to get these technologies to all the people who are using toilets for the first time.

The second priority is gathering the lessons learned from SBM and sharing them so that other countries can replicate India’s success. Over a billion people around the world still don’t have access to basic sanitation facilities. As the largest sanitation programme in the world, SBM can serve as a laboratory of effective solutions.

India took an important step in this direction by hosting the Mahatma Gandhi International Sanitation Convention in 2018. Organized by the Government, the convention brought together representatives from 70 countries, including 55 Ministers of sanitation, to discuss the key issues facing the sector.

Perhaps the most important lesson they learned, however, was when the four-day event was opened by India’s President and closed by its Prime Minister. Sanitation programmes can work. SBM proves it. But they’ll never get off the ground until leaders make it plain that their country can no longer accept the status quo.