Current status and trends
Readers of the British Medical Journal recently identified sanitation as “the most important medical advance since 1840”. Despite this recognition, in 2006, only 62 percent of the world’s population had access to improved sanitation – that is, uses a sanitation facility that ensures hygienic separation of human excreta from human contact.
Proportion of the world’s population using an improved, shared or unimproved sanitation facility or practising open defecation
A further 8 percent of the global population shared an improved facility with one or more households; and another 12 percent used an unimproved sanitation facility – one that does not ensure hygienic separation of excreta from human contact. The remaining 18 percent practised indiscriminate or open defecation.
2.5 million people remain without improved sanitation
Open defecation is declining in all regions: dropping from 24 percent worldwide in 1990 to 18 percent in 2006. Open defecation is most widely practised in Southern Asia and sub-Saharan Africa – by 48 percent and 28 percent of the respective populations. In stark contrast, only 3 percent of those in East Asia practise open defecation.
Trends in sanitation practices, 1990-2006
Source: WHO-UNICEF Joint Monitoring Program for Water Supply and Sanitation, July 2008.
The world is not on track to meet the MDG sanitation target
Between 1990 and 2006, the proportion of people without improved sanitation decreased by only 8 percent. Without an immediate acceleration in progress, the world will not achieve even half of the MDG sanitation target by 2015. Based on current trends, the total population without improved sanitation in 2015 will have decreased only slightly since 1990, down to 2.4 billion.
Regional and global progress towards the MDG sanitation target 
If the current sanitation coverage trend continues, the MDG sanitation target will be missed by over 700 million people. To meet the target, an additional 170 million people per year will need to begin using improved sanitation facilities.
Urban-rural disparities in sanitation coverage
The world’s urban sanitation coverage has risen to 79 percent, while rural coverage has reached only 45 percent. The largest disparities between urban and rural sanitation coverage are found in Oceania, Latin America and the Caribbean, and Southern Asia.
Sanitation coverage is significantly higher in urban areas
In 2006, the world’s population was almost equally divided between urban and rural dwellers. Despite this parity, more than 7 out of 10 people without improved sanitation are rural inhabitants. Yet rapid population growth in urban areas poses a significant and growing challenge: the number of urban inhabitants using improved sanitation has risen by 779 million since 1990, but has not kept pace with the urban population growth that totalled 956 million in the same period.
A Snapshot of Sanitation in Africa
A Snapshot of Sanitation in Africa is a special tabulation based on sanitation coverage estimates for 2006 that was prepared by the JMP for the Second African Conference on Sanitation and Hygiene (AfricaSan +5) that took place in Durban, South Africa, on 18-20 February 2008.
References
MDG Assessment Report 2008 - Progress on drinking water and sanitation: Special focus on sanitation [PDF]