LONDON, Nov 19 (Thomson Reuters Foundation) - Nearly two billion people use water contaminated by faeces, posing a global health risk despite billions of dollars spent on sanitation, said a report published on Wednesday.
One in seven people, mostly poor and living in rural areas, still defecates in the open, contaminating water and creating a breeding ground for diarrhea, cholera, dysentery and typhoid.
"If people don't invest in sanitation the costs are going to be incredible and health is going to be a big issue," said Bruce Gordon of the World Health Organization (WHO).
"Extraordinary efforts need to be made now to take it to those remaining pockets of people who don't access water and sanitation," he told the Thomson Reuters Foundation.
According to WHO, inadequate water supply and sanitation results in annual economic losses of $260 billion.
Even though aid money for the sector is at an all time high, 1.8 billion people are exposed to contaminated water, said a report published on World Toilet Day by WHO and UN Water.
Most of the funds go towards investments in water and only a quarter to sanitation, while rural areas are often neglected.
But money is not the only reason that one billion people, most of them in South Asia and sub-Saharan Africa, still take their private business outdoors.
Jack Sim, the founder of the World Toilet Organization, said in some societies open defecation is a cultural norm and even a social thing to do.
"People enjoy that social event," said Sim. "But they have to understand that the contaminated water ... eventually comes back as diseases to kill the children and to make people sick."
More than two billion people have gained access to clean water in the last two decades and almost two billion gained access to improved sanitation over the same period.
Thanks to those gains, the number of children dying from diarrheal diseases fell from 1.5 million in 1990 to just above 600,000 in 2012, the report said.
However, insufficient financing and planning mean that the Millennium Development Goal of halving the proportion of the population without access to toilets by 2015 will not be met.
Gordon, WHO's water and sanitation coordinator, said preventing children's deaths and illness, privacy and safety for women, and economic and environmental benefits as some of the reasons to invest in sanitation.
"Water and sanitation and hygiene are fundamental pre-requisites to have in place not only for development, but to stop outbreaks of diseases like Ebola or cholera," said Gordon.
(Reporting By Magdalena Mis; Editing by Ros Russell)