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Toilet Revolutionin China
Source:Journal of Environmental ManagementTime:2018/2/28 19:25:59


In2015, one in three people (2.4 billion) in the world still used unimprovedsanitation facilities, including 946 million people who still practised opendefecation. Even in urban areas, where household and communal toilets are moreprevalent, over 2 billion people use toilets connected to septic tanks that arenot safely emptied or use other systems that discharge raw sewage into opendrains or surface waters. Today over 880 million people are estimated to beliving in slum-like conditions in the developing world’s cities. About 50 % ofpeople living in rural areas lack improved sanitation facilities, compared toonly 18 % of people in urban areas. Poor sanitation around the world results inincreased prevalence of diseases and pollution of the environment (MFA and UN,2015; UNICEF andWHO, 2015).The World Bank estimates that poor sanitation costs the world 260 billion USDannually (Hutton, 2012).Poor sanitation contributes to 1.5 million child deaths annually from diarrhoea(Prüss-Ustünet al., 2014),which is the second leading cause of morbidity and mortality among childrenunder the age of five, and the leading cause of death in sub-Saharan Africa (Lim et al.,2012; Murray etal., 2015; Walker etal., 2013).Excreta, grey water and solid wastes are the major contributors to thepollution load into the environment and pose a risk to public health (Katukiza etal., 2012).Public agencies often grapple with the question why the adoption of improvedsanitation technologies has been slow (Seleman andBhat, 2016).


When it comes toChina, the outlook is not optimistic either, although China had made greatprogress during the on-going toilet retrofitting action in rural areas. Accordingto up-to-date official data (NHFPC, 2016),the coverage of sanitary toilets in rural areas has increased from 7.5 % in1993 to 78.5 % in 2015, while the coverage of harmless sanitary toilets reached57.5 % by end of 2015. Fig. 1 presents the yearly number ofsix different harmless sanitary toilets, targeted by the government andinstalled in Chinese rural areas from 2000 to 2015 (NHFPC, 2015,2016). However,57 million households do not have their own sanitary toilet, but 40 million ofthose households among can use a public sanitary toilet. There are 17 million remaininghouseholds that still have serious hygiene issues resulting from poor toilets.

Fig. 1 Yearly number ofsix different harmless sanitary toilets installed in Chinese rural areas from 2000to 2015


In light of urban sanitation, in 2015, the collectedamount of urban faecal sludge was 14.28 million tons. Among this, 6.76 milliontons was treated, while the treatment ratio was 47.3 %. Of all the provincesand municipalities, Beijing led the nation in that the treatment ratio offaecal sludge reached 92.3 %. Fig. 2 shows the trend of collected faecal sludgeand quantity of public toilets in urban China (MOHURD, 2016). It is observed that the amount of faecal sludge hasdecreased in the past decade. The reason may come down to the greater distributionof municipal pipelines which can collect more human faeces into wastewatertreatment plants. Another reason would be that government contracts withprivate companies for collection and handling of faecal sludge are not undergovernmental responsibility and so are not taken into statistics. However, thisdoesn’t mean that the actual faecal sludge amount and its potential damage tothe environment is reducing.

Fig.2 Collectedfaecal sludge and quantity of public toilet in urban areas



When foreigners visit China tourist areas,they complain about the issue of public toilets the most. Many foreigners saidthey will never forget the scary toilet experience. Given this fact, how couldour tourism industry take big strides?(China Daily, 2015)Thus,the tourism sector has fired the first shots in the toilet revolution. The ChinaNational Tourism Administration (CNTA) set the target that from 2015 to2017, 25,000 public toilets will be upgraded and another 33,500 will be newlybuilt in tourist areas within 3 years. This is also known asthe Three-year Toilet Plan (CNTA, 2015). Clean andstandard toilets will be a key index for evaluating tourism areas. It wasreported that 89.33 % of the task had been finished byFeb of 2017(CPRI andCGPI, 2017).


ToiletRevolution” became a hot word in 2015 in China. On 1st of April2015, President Xi Jinping made important comments on toilet revolution andcivilized tourism. In addition, when he visited in Jilin Province on 16thof July 2016, he saw that some farmers still used traditional latrine pits. Hesaid China’s rural areas would also launch a “toilet revolution” to let farmersuse sanitary toilets. When talking about toilets in rural China, there would betwo barriers, one is bad odour, the other is hidden sanitary trouble. Actually, thetoilet revolution is tightly associated with the patriotic health campaign,which first started in the 1950s and aimed to improve sanitation and hygiene,as well as attack diseases (Yang, 2004).Since 2004, the central government has earmarked RMB 8.64 billion which has renovated21.03 million rural toilets. The scenarios of six differentharmless sanitary toilets are depicted in Table 1.The goal for rural toilet retrofitting in China is to reach the 85 % popularizingrate of sanitary toilets by 2020 (NPHCC, 2015)and100 % by 2030 (StateCouncil, 2016).Chronology of toilet plans and actions is presented in Table 2.


Table 1. Scenarios ofsix different harmless sanitary toilets (Hu et al.,2016)

Type of toilet



Suitable area

Three-septic-tank type

It is composed of three septic tanks. The wastewater flows one by one. The first chamber is designed as settler, the second as post-settler and scum separator, and the third as storage tank, size of last tank depends seasonal reuse pattern or other available emptying services.


Most of rural areas, mainly South of China. If in North of China, freezing protection should be respected. In some areas, the tanks are emptied by vacuum trucks and the content is centralised treated.

Double-vault funnel type

The vault is prefabricated by ceramic, cements or composite. The installation is easy. Needs post-composting of liquid before used as fertilizer or only used as soil improve before planting seasons.

Huai River basin, middle and lower streams of Yangtze River, North China Plain, northwest and southwest arid areas where is short of rainfall.

Double pit alternate type

The two pits work alternately. When one is used, the other is stored for composting by correcting the C/N ratio.

Northwest and southwest arid areas where is short of rainfall.

Biogas-linked toilet

The toilet is built next to livestock shed. Human waste and animal waste are both used for biogas production, which is used mainly for cooking and lighting.

Nationwide, especially south and west of China where climate is warm.

Urine-faeces division toilet

Urine and faeces are collected separated, urine can be diluted with water and used for fertilizer directly. Faeces are dehydrated for harmless treatment.

Nationwide, especially arid and water-deficient area

Integrated flushing toilet

The toilet is connected with fresh water supply pipe and complete drainage connect for sewage treatment. It requires building sewage pipeline and treatment facility, so the overall cost is high.

Nationwide, rich rural areas or suburbs which are connected to sewer pipeline network combined with central or decentralized treatment station.


Table 2. Chronologyof toilet plans and actions in China



Leading department



Start of National Patriotic Health Campaign

State Council

Establish Patriotic Health Campaign Committee at all levels


Two Management and Five Retrofitting Action

National Patriotic Health Campaign Committee (NPHCC)

Management of human manure and water supply, retrofitting of water well, toilet, animal pen, stove and living environment in rural areas


Three-in-One Patriotic Health Campaign


Combine water supply, toilet retrofitting, and health education into one whole.


Outline of the Program for Chinese Children  Development in 1990s

State Council

List rural toilet retrofitting into the program


Decision on Sanitation Reform and Development

State Council, Central Committee of the Communist Party of China

List rural toilet retrofitting into the work plan


Ecological Household Enrichment Plan

Ministry of Agriculture (MOA)

Connect toilet with biogas digester, known as biogas-linked toilet


Outline of the Program for Chinese Women Development 2001-2010

State Council

List rural toilet retrofitting into the program


Decision on Further Accelerating the Rural Sanitation Work

State Council, Central Committee of the Communist Party of China

Focus on retrofitting toilet and water supply in rural areas to mobilize renovation of rural environment, in order to prevent disease.


Opinions on Deepening Medical and Health System Reform

State Council, Central Committee of the Communist Party of China

List rural toilet retrofitting into national major public health service program.


Key Implementation Plans on the Reforms of the Medical and Health Care System in Recent Period (2009-2011)

State Council

List rural toilet retrofitting into national major public health service program.


National Urban and Rural Environmental Sanitation Clean Action Plan (2010-2012)


Popularize rural sanitary toilet to make coverage increase 10% within 3 years.


Outline of the Program for Chinese Women Development 2011-2020

State Council

List rural toilet retrofitting into the program, set the target that coverage of rural sanitary toilet will reach 85% by 2020.


National Urban and Rural Environmental Sanitation Clean Action Plan (2015-2020) (NPHCC, 2015)


Set the target that coverage of rural sanitary toilet will reach 85% by 2020.


Health China 2030 Program Planning (State Council, 2016)

State Council, Central Committee of the Communist Party of China

Set the ambitious target that coverage of rural sanitary toilet will reach 100% by 2030.


Internationally,in 2011, the Bill & Melinda Gates Foundation (BMGF) initiated the Reinvent The Toilet Challenge (RTTC)to bring sustainable sanitation solutions to the 2.4 billion people worldwidewho do not have access to safe, affordable sanitation. Grants have been awardedto sixteen researchers around the world who are using innovativeapproaches—based on fundamental engineering processes—for the safe andsustainable management of human waste. In addition to these RTTC grants, BMGFhas made a range of other investments that are aligned with reinventing thetoilet, and we are continuously seeking to expand our partnerships on thischallenge.  In August 2013, thefoundation announced the Reinvent The Toilet Challenge –China (BMGF, 2013).The foundation would invest US$5 million to support Chinese investigators todrive research, development, and production of the “next generation toilet”(BMGF, 2013).This China toilet challenge is an effort targeted to a specific country afterIndia and is a testament to the research and development capabilities in China.After two-round selections, nine proposals have been funded finally(RTTC-China,2017).Domestically, CNTA, BMGF and USTBlaunched the toilet innovation programs in recent years (Table 3), inresponse to the “Toilet Revolution” and speedup the progress.


Table 3. Toilet innovationactions in recent years






Reinvent the Toilet Challenge (RTTC)




Reinvent the Toilet Challenge-China (RTTC-China)

Chinese enterprise/academy



1st National Tourism Toilet Design Competition

Chinese enterprise, academy, private



1st Reinvent Toilet Contest for Chinese Students

Chinese college



1st National Toilet Technical Innovation Competition

Chinese enterprise/academy




Whetheryou call it the loo, john, privy, lavatory or toilet, this facility isessential wherever humans gather or live: toilet provision has even been calledthe barometer of civilisation (Stanwell-Smith,2010).However, toilets have always been treated as a matter of taboo, especially anyform of latrines, while flush toilets are considered prestigious and desirable.There is no explicit literature report on the origin of the toilet revolutionin China. Actually, the parlance “toilet revolution” was proposed first byUNICEF in 1997, when UNICEF and NPHCC cooperated to promote toilet retrofittingin China. It referred in particular to toilet retrofitting in developingcountries, following the sanitation targets under MDGs and SDGs.


Currently,the concept of a toilet revolution is enlarged andextended. It happens in many sectors, for instance, toilet retrofitting inrural areas, public toilets in tourist areas, public toilets in highway restingareas, reinvented toilets in R & D, etc. Moreover, it is not confined tothe toilet itself, but to the whole sanitary system. A sanitation system – comparedto a sanitation technology – considers all components required for the adequatemanagement of human wastes, such as storage, collection, transport, treatment,discharge or reuse at the following levels (Zurbrügg andTilley, 2009).Starting at the household level with waste generation, a system can includestorage and potentially also treatment and reuse of all products such as urine,excreta, greywater, rainwater/stormwater or even solid waste (Schmitt etal., 2017).However, problems can rarely be solved at the household level alone. Thehousehold exports” waste to the neighbourhood, town,or downstream population. In such cases, it is crucial that the sanitationsystem boundary is extended to include these larger spatial sections.


Lookingback, the concept of the toilet revolution issomehow equal to the concept of ecological sanitation (Eco-San) (Hu et al.,2016; Winblad andSimpson-Hébert, 2004).The term ‘Eco-San’ appeared in the 1990's (Esrey et al.,1998),and quickly got a shot at stardom with the new millennium concepts. The UNissued a declaration of ‘Eco-San - closing the loop in wastewater managementand sanitation’ in 2000 (Winblad, 2004).The Eco-San system is an alternative approach to realize sustainablesanitation, which is closely associated with toilets because toilet-basedsource separation always facilitates greater resource recovery as an alternativesolution. Source separation of wastewater flows, such as blackwater (i.e.wastewater from toilets) and urine, captures concentrated nutrient-rich wastewhich makes nutrient recovery and pollutant removal more efficient (Larsen etal., 2013; McConville etal., 2017; Simha et al.,2017).Eco-San is known as the resource-oriented sanitation and is based on ecosystemapproaches, the closure of material flow cycles, a novel trend of pollutiontreatment (from sewage disposal to resources reclamation), and a re-conceptualizationof sanitation (from a ‘drop-flush-forget’ mode to environmental protection atsources by means of ‘drop and reuse’ mode) (Haq andCambridge, 2012; Langergraberand Muellegger, 2005).It can be seen that the toilet revolution, from the viewpoint of Eco-San, isdedicated in optimizing cost efficiency, resource recovery and waste disposal (Werner etal., 2009).


To sum up, toilet revolution comes down to thedefinition that “toilet revolution is a step-wise campaign which tries toensure hygienic separation of human excreta from human contact, to providesanitary and comfort space for users, to prevent human excreta from pollutionof environment, and to realize the resource recycling.” 



China ownsthe biggest toilet market in the world. Some factors can promote a toiletrevolution, increasing the likelihood.


1. Millennium DevelopmentGoals and Sustainable Development Goals

Atthe beginning of the new millennium, the United Nations (UN) MillenniumDevelopment Goals (MDGs) unveiled a special horizon - one that the entiredeveloping world has been tasked to arrive at by 2015. However, the world mustfirst cross the water barrier to fulfil the task (ADB et al.,2006).On 25th September 2015, world leaders gathered at the UN in New York to adoptthe 2030 Agenda for Sustainable Development, which comprises 17 new SustainableDevelopment Goals (SDGs). The new SDGs, and the broader sustainability agenda,go much further than the MDGs. Among them, Goal 6 ensures availability andsustainable management of water and sanitation for all (UNDP, 2015).By 2030, it aims to achieve access to adequate and equitable sanitation andhygiene for all. It also aims to end open defecation, paying special attentionto the needs of women and girls and those in vulnerable situations. In addition,it requires to improve water quality by reducing pollution, eliminating dumpingand minimizing release of hazardous chemicals and materials, halving theproportion of untreated wastewater and substantially increasing recycling andsafe reuse globally (UNESCAP etal., 2015).


Globally,at least 1.8 billion people use a source of drinking waterthat is fecally contaminated  (UNDP, 2015).Providing reliable and affordable sanitation facilities in rural areas is achallenge in many parts of the world, particularly in developing countries. Asroughly estimated, there is approximately 9 billion tons of domestic wastewaterdischarged every year in rural areas of China (Zhou et al.,2008).The world is striving to meet MDGs and SDGs and China is no exception.Popularization of improved sanitation facilities can undoubtedly increase thepossibility of achieving some of the MDGs and SDGs. i.e. Target 3 (by 2030, endthe epidemics of AIDS, tuberculosis, malaria, and neglected tropical diseasesand combat hepatitis, water-borne diseases, and other communicable diseases), andTarget 6 (by 2030, achieve access to adequate and equitable sanitation andhygiene for all and end open defecation) (UN, 2016).


Insuch cases, a toilet revolution can help to ensure environmental sustainabilityand reverse the loss of environmental resources. It does not implyoverexploitation of the existing resources, but improving their management byreducing, recycling and reusing human wastes (Libralato etal., 2012).


2. Government support at all levels

Since the18th National Congress of the Communist Party of China, the central governmentindicated the future development direction for the whole nation thatinfrastructure construction and social undertaking will give priority to ruralareas. Sanitation is important to implement the Socialism New CountrysideConstruction. The popularization of sanitary toilets is helpful to improverural living conditions and promote rural civilization, and thereby achieve thegoal of building a moderately prosperous society.


Toiletrevolution has aroused leaders’ attention.President Xi Jinping has given special instructions on the toilet revolutionand civilized tourism in 2015. Premier Li Keqiang has also called forinnovation in the country’s patriotic health campaign (The State Council, 2015). Thecampaign “plays an irreplaceable role” in preventing and controlling the spreadof disease, improving hygiene in urban and rural areas and strengthening publicawareness. Toilet revolution has been listed as the Number 1 prioritized workof CNTA since 2015. 


Undercentral government, local governments built up “Leading Group for ToiletRevolution”, which is in charge of formulating and promoting a toilet andsanitation improvement plan. For instance, eight provinces have held deploymentmeetings for tourist toilets, eleven provinces have been building up province-levelleading and coordinating groups for a tourist toilet revolution up to now. Onthe 2015 World Toilet Day, CNTA, Ministry of Housing and Urban-RuralDevelopment (MOHURD) and the Beijing government, held the activity of “ChinaToilet Revolution Mobilization Day”. On 1st April 2016, CNTA andNPHCC together held the activity of “China Toilet Revolution Advancing Day”.These activities all indicate the strong support from government at all levels.


3. Environmental protection andresources recovery

Urban-industrialgrowth is beginning to skew China’s water allocation balance. Already,competing demand for water is turning this resource into a basis for conflict (Narain, 2012). Chinasuffers a lot from environmental pollutants in the form of wastewater. In 2015,the total amount of COD discharge reached 22.2 million tons, the total nitrogenreached 4.5 million tons while the total phosphorus reached 5.3 million tons.Even though pollutant discharges had declined year by year since 2012, thetotal amount of pollutants is still huge (MEP, 2016).


In terms of theagriculture sector, the agricultural pollution sources exceeded industrialpollution sources in 2015 for the first time. MOA set the target that the useof chemical fertilizers and pesticides should become zero-growth by 2020. Thatmeans, in the coming few years, the use of chemical fertilizers will stillincrease until 2020. The up-to-date statistics show that the total amount ofchemical fertilizer applications in agriculture reach 60.0 million tons, amongwhich, nitrogenous fertilizer reaches 23.9 million tons (in N), phosphaticfertilizer reaches 8.45 million tons (in P2O5), potassicfertilizer reaches 6.42 million tons (in K2O), the remainder iscompound fertilizer (MOA, 2015).


Annually, an individual can produce as much as 5.7 kg of N, 0.6 kg of Pand 1.2 kg K which are key ingredients found in chemical fertilizers (Esrey et al., 1998; Karak and Bhattacharyya, 2011). More than 90 % of nitrogen and phosphorus come fromhuman excrement in the form of urine and faeces (Fittschen andHahn, 1998; Larsen andGujer, 1996). Comparedwith the amount of chemical fertilizer applications, if the valuable nutrientelements are collected and recovered in agriculture, this can replace 20 % ofchemical fertilizer by rough calculation. The community associated greatbenefits from using human excreta in agriculture, especially if composted, anddid not associate risks with the use of composted excreta if it was dry andlacked odour (Mackie Jensenet al., 2008). Empiricalresearch has shown that the use of manure significantly improves crop yield,soil fertility and water and moisture conservation (Andersson etal., 2016; Liu et al.,2014).


4. Diseases prevention and povertyalleviation

Modernmedicine indicates that human faeces contain many kinds of pathogens which cancause serious intestinal infectious diseases and parasitic diseases. The amountof untreated faeces sludge discharged into the open environment poses a seriouspublic health risk. For instance, the WHO reported that poor sanitationcontributes to 1.5 million child deaths from diarrhoea each year. Chronicdiarrhoea can also hinder child development by impeding the absorption ofessential nutrients that are critical to the development of the mind, body, andimmune system. It can also impede the absorption of life-saving vaccines (Bassan etal., 2014).


Thepotential for pathogen contamination are high, since faeces is the greatestsource within the components that make up conventional wastewater (Skambraks etal., 2017; Vinnerås etal., 2006).A 5 m3 truck load of faeces sludge dumped into the environment isthe equivalent of 5,000 people practicing open defecation. The consequences ofthis waste from open defecation entering the environment are staggering. In addition, pathogenshave been known to be a major constraint when using wastewater products inagriculture, and since faecal sludge can be highly contaminated, this is a keyfactor for implementing sanitation systems, which aim to reuse thesewastewaters (Afolabi andSohail, 2017; Magri et al.,2015).


TheToilet Revolution aims to achieve popularization of sanitary toilets, whichwould play an important role in disease prevention. For instance, biogassanitary toilets can kill a considerable percentage of pathogens inside humanexcreta (Wu and Xu,2003).A study was carried out by Sichuan Province Institute of Parasitic DiseasePrevention and Control to test the treatment effect of biogas-linked sanitarytoilets in six projects. Generally, Faecal coliforms of treated sewage was >10-4. The number of parasitic ovum ranged from 0.565/L–1.074/L. BOD< 50 mg/L. SS< 60 mg/L. Chromaticity was < 100. These indicators couldmeet the requirement of the Integrated Wastewater Discharge Standard(GB8978-2002) and Sanitary Standard for the Non-hazardous Treatment of NightSoil (GB7959-1987) (Zheng et al.,2006).


Asestimated, the input-output ratio is approximately 1:5.3 forretrofitting a sanitary toilet (NPHCC, 2014).The benefit mainly attributes to the diseases prevented and health improvementsmade (Mills andCumming, 2016).The World Health Organization estimates that poor sanitation costs the world260 billion USD annually(Hutton, 2012).Due to diseases prevention, cost on health-care and medicine will be reduced,thus, implementing a toilet revolution will contribute to alleviate poverty andimprove wellbeing.



Many challengesstill exist and must be overcome for sound development.


1. Insufficient fund and policy support

The independentsupport policy on a toilet revolution is still missing, although some subsidy policieshave been introduced at local economic development level. The absence ofincentive policies makes social financing difficult. Enterprises and researchinstitutes should be encouraged to be involved in a toiletrevolution by incentive policies, such as tax preferences. Interms of local government initiatives, it is suggested that the toiletrevolution is integrated into the assessment index system of a government’sachievement. This can vastly mobilize the initiative of local governments and urgethem to formulate related regulations and plans to implement a toiletrevolution. What’s more, toilet revolution can be integrated into social andeconomic development plans.


Allkinds of toilets require initial funds, let alone the following treatmentsystem. By rough estimation, the toilet revolution requires billions of CNY fornew construction. In some cases, when a toilet is damaged by natural disasters,the repair of the toilet is also short of funds. The fund shortage has become abottleneck for promoting rural sanitation systems, especially in less-developedareas. The main fund support is from national subsidies,the market is still at the rudimentary stage (Gao et al.,2014).For instance, thesanitary toilet retrofitting can only be subsidised by the government. What isworse is that there is no specific subsidy for the toilet itself, it has tonormally be attached to a household biogas program, which is under a nationaldebt program. The toilet revolution is often associated with Three Rural Issues(issues about agriculture, farmers and ruralareas) or Socialism NewCountryside Construction, public health, povertyalleviation, environment protection, etc. In such cases, the fund from otherfields can be partly transferred towards toilet revolution.


2. Region imbalance and lagging approval process

Thereis an imbalance of development of sanitary facilities with considerableurban-rural and regional gaps. The penetration rate ofsanitarytoilets in central and western parts of China are obviously lower than those ofeastern regions. Poor sanitation normally exists in poor areas, where theburden of inadequate sanitation is greatest. By 2020, the coverage of ruralsanitary toilets should reach 85 %, which can be treated as the nationalaverage target. When it comes to provinces, five developedmunicipalities/provinces including Beijing, Tianjin, Shanghai, Jiangsu, andZhejiang will reach 100 %, with another twelve provinces on track to reach 82 %.There is no specific goal for Tibet currently (NPHCC, 2014).This can indicate the imbalanced development of sanitary facilities. In somevillages, people want a sanitation technology that requires more water just tobe able to bring pressure on the government for an improved water supply. Insome villages, people reject water-intense sanitationtechnologies for lack of water(Liu et al.,2016).


Toiletrevolution involves multiple departments. At the level of the State Council,the ministries include the National Health and Family Planning Commission (NHFPC,i.e. former Ministry of Healthy), CNTA, MOHURD, Ministryof Environmental Protection (MEP), MOA, Ministry of Transport (MOT), andMinistry of Land and Resources (MLR), etc. Generally, CNTA is in charge oftoilets in tourist areas, which is reported most by news media. MOT is incharge of toilets at the rest areas of highways or railways. NHFPC and MOA arein charge of sanitary toilet retrofitting in rural areas, MOHURD is in chargeof public toilets in cities. MEP is in charge of environmental impactassessments for most toilets. MLR is in charge of land use for toilet construction.However, when one department (e.g. CNTA) implements its own aspect, it alsoneeds to coordinate with other departments. It must face a series of approvalprocesses from each department. In such cases, overall coordination isimportant. The high-level coordination group from central government which cancoordinate all these ministries seems to be missing. At this moment, centralgovernment establishes more than 20 leading groups in key issues. For instance:the comprehensively deepening reform leading group; the network security andinformatization leading group; the addressing climate change and energyconservation and emissions reduction leading group; etc. It is also suggestedto establish a toilet revolution leading group, which can coordinate the differentdepartments. In addition, the “green channel” for the toilet project should beopen, in order to shorten the construction time, especially, the approvalprocess for land use.


3. Weak sanitaryawareness and low acceptance of new toilets

Thepublicthink that environmental pollution has become a serious problem for China (Jingling etal., 2010).Public awareness towards the problem of wastewater pollution has growntremendously in recent years (Wolters etal., 2016).However, the education gap between urban area and rural areas is still huge.Due to the limitation of education levels, toilet and human waste are alwaystreated astaboos: people do notlike talking about toilets in public. In addition, there are still manyuncivilized phenomena regarding the use of toilets in public areas, e.g.tourist toilets. Some people do not take care of public facilities so much,they only focus on their own sanitation maintenance but neglect the publicenvironment. The early education had a significant associationwith whether the study households had an improved toilet or not. It was evidentthat education, water supply and sanitation all had some connection with eachother. Therefore, a strong collaboration between agencies that are in charge ofelementary education, water supply, sanitation, and public health is necessaryfor implementing sanitation technology.


Anotherissue for improving sanitation involves acquiring a sound knowledge of thefeasible sanitation systems and technologies which, in the site specificcontext, can achieve the intended objectives of health, hygiene and wellbeingimprovements (Zurbrügg andTilley, 2009).In spite of many benefits, the lack of knowledge and awareness of new toiletsremains a barrier to their acceptance and implementation. Engineers and the water/constructionindustry are resistant to accepting a new toilet they are unfamiliar with (Cordova andKnuth, 2005).With the new sustainability paradigm of the 21st century, interestin new toilets has been growing. With this growing interest there are stillgaps in knowledge about the engineering of sanitary toilets, it is now timelyto revisit the status of sanitary toilets and bring awareness to thistechnology so they can be better evaluated for possible adoption as analternative sustainable sanitation system. Conventional water flushing toiletsare still the mainstream technology. In the past, sludge management from onsitefacilities has not been a priority of engineers or municipalities, and hastraditionally received little to no attention. Several generations of engineershave considered waterborne, sewer-based systems as the most viable, long-termsolution to fulfil sanitation needs (Dodane etal., 2012).This lack of awareness andnegative image of new toilets is likely to arise from insufficient experienceand literature. There are only a few success stories regarding new toilets inlow-income countries. The public may notaccept the technology because of perceived odour and maintenance issues, whichare the key factor for neglecting new toilets(Ramani etal., 2012).


4. Lack of R&D and service system

Diffusionof toilets as a pro-poor innovation is a challenge because their successfuladoption calls for a change in individual behaviour, daily routines and perhapseven social norms (Ramani etal., 2012).Toilet technology is always the primary topic in the R&Ds of the toiletrevolution. By far, the most well-known R&D activity is RTTC-China,launched by BMGF. Although it has been well received, the popularity is limitedbecause the innovations BMGF supports can be most immediately valuable indensely populated areas, its main focus is on urban sanitation. This is farfrom enough for the Chinese toilet revolution. R&D on the toilet revolutioncontains process design, device development, ergonomic human engineering,psychology, behavioural science, etc. Many aspects are still at the startingstage. The support from the Ministry of Science and Technology is missing, and insuch a case, China has not formed a sound R&D environment nationwide.


Onceone sanitation system is built, a service chain makes access to sanitation areality. For instance, without collection and transport companies to removefaecal sludge, onsite systems will not function properly. The matched servicesupporting system includes a technical consulting service, operational trainingservice, resident publicity service, public and household facility maintenanceservice. One barrier to low persuasion of sanitary systems is the lack ofsuccessful projects, which can be overcome by better maintenance based on awell-established service system. Construction attributes less to sustainableoperation of a sanitary system than maintenance. However, qualifiedconstruction is the prerequisite to subsequent convenient maintenance.Jerry-built toilet must be avoided in the beginning, so a strict acceptanceinspection is strongly recommended. In addition, toilet maintenance could beoutsourced by specialized team, which can be paid in accordance with itsservice. The users’ feedback should capture attention as well.  



The toiletrevolution is a nationwide action. Institutionally, the toilet revolutionshould be integrated into social reform and new countryside construction, whichis highlighted by central government. Toilet revolution requires concertedeffort from many departments. It is recommended that one department ororganization should be built solely aiming at implementing toilet revolution.It should be responsible for coordinating each department, managing localtoilet and sanitation systems, including the decision-making, R & D,design, manufacture, and maintenance of sanitation systems: in a word,considering sanitation systems from cradle to grave. A new system should bebuilt, which integrates urban and rural sanitation facilities. Meanwhile, a completemanagement and service network should be structured to maintain thehigh-efficiency and sustainability of the sanitation system. In terms ofR&D, integration of orientalism and developed technology, modern technologyand traditional custom, high-tech technology and common appropriate technologyshould be taken into consideration carefully.


Providingsustainable solutions for toilet revolution needs to address not onlytechnology implementation but also cost, ownership and maintenance issues.Technologically, solving the sanitation challenge in China will requireradically new innovations that are deployable on a large scale. Innovation isespecially needed in densely populated areas, where billions of people are onlycapturing and storing their waste, with no sustainable way to handle it oncetheir on-site storage—such as a septic tank or latrine pit—fills up. Ground-breakingimprovements in toilet design, pit emptying, transportation method (Fan et al.,2017),and sludge treatment, as well as new ways to reuse waste, can help governmentsand their partners meet the enormous challenge of providing quality publicsanitation services. There is much technical guidance available free of chargevia the internet for designing and improving complete access to environmentalsanitation. Considering the scenarios in China, especially aiming at toiletrevolution, readable resources in Chinese are in shortage. Conceptof toilet revolution should be propagandized step by step.


Toiletrevolution should be well aligned with the Eco-San principles. TheEco-San aims to meet socio-economic requirements (Uddin et al.,2014),prevent pollution of surface and ground water, sanitize urine and faeces,recover nutrients for food production, and save water, energy and resources ina given local context. By being decentralized, requiringlittle to no water, and producing a value product (fertilizer), ecologicaltoilets offer good promise as a sustainable solution to water and wastewaterinfrastructure issues (Lens et al.,2001; Mankad andTapsuwan, 2011; Sasse, 1998). When appliedto the water and sanitation infrastructure, ecological design principles pointto human dimension (e.g. incorporating stakeholders in design), learning fromnature (e.g. decentralization; elimination of the concept of waste; meetingmultiple functions such as treating human waste while producing a value product,limited energy input to the system, and system design specific to location andscale), and integrating nature (e.g. relying on nature’s processes fortreatment) (Apul, 2010). Itis considered more ready and suitable to be applied in rural areas, where theresidence is more decentralized and nearer to farmlands than urban. Sustainabilitywith respect to sanitation implies that the system needs to comprise ofcollection, storage, transport, and treatment of human excreta, grey water,solid waste and rainwater/stormwater, as well as the safe disposal or reuse ofend products (Katukiza etal., 2012). A sustainablesanitation system should be technically feasible, acceptable to the users,affordable and contribute to health improvements and environmental protection.Population density, settlement patterns, landscape, water availability, householdincomes, ownership and socio-cultural issues are also key factors that cannotbe ignored. Sustainability of sanitation also requires institutional structuresand arrangements to be in place for operation, maintenance and upscaling ofinterventions (Chinyama etal., 2012).


A toiletrevolution needs to provide everybody with access to improved sanitation andsanitary toilets, irrespective of whether the area is rural or urban, thepeople rich or poor or the toilet private or public. In rural areas, the sixkinds of harmless sanitary toilets should be promoted as before. It is encouraged to construct a four-chambereco-toilet and biogas digester, and thereby strengthen the harmless use andresource-oriented use of human faeces. New-built housing andgovernment-subsidized housing in rural areas should be attached to harmlesssanitary toilets. Public sanitary toilets should be popularized at townshipgovernment buildings, primary and middle schools, health clinics in towns andtownships, rural community integrated service stations, pedlars' markets,tourist attractions, highway roadsides, etc. Health education should behighlighted. Farmers should be guided to use sanitary toilets, and the long-termeffect management mechanism should be formed on the build-maintenance-use ofsanitary toilets.


The toiletrevolution has evolved from a purely technical discipline to one that includessocial, environmental, economic and, increasingly, gender considerations (Tilley etal., 2013). The genderdistribution for public toilets should be re-considered. It is inspiring thattoilet design specification has been modified for future planning and design. Currently, the cost of new toilets (e.g. vacuum orair-flushing toilet) is estimated from the purchase of a new toilet, which ishigher than a flush based toilet. From a user’s perspective and in presence oflow water and sewer utility rates, new toilets are not currently economical.Therefore, the cost is a barrier from a building designer or a home ownerperspective. However, the true cost of large scale use of new toilets is notknown since system level analyses comparing new toilets to centralizedinfrastructures have not been researched. So research on scaling up ofdemonstration projects should be conducted.


Public toiletservices have traditionally been under public procurement provision. Unfortunately,there are many experiences in which public provision failed to achieveacceptable results. There are many experiences public-private partnerships(PPP) in this sector worldwide and PPP has become the buzzword in wastewaterand solid waste management circles. PPPs are long-term contracts between thepublic and private sector in which the private sector has responsibility forsignificant aspects of the building and operation of an infrastructure for thedelivery of public services that the public sector should provide while bothsectors share risks, costs and benefits (Arbulú etal., 2016; Johannessenet al., 2014). Toiletrevolution can also introduce PPPs and absorb private capital to make up thelack of funds, as well as arouse the enthusiasm of the public. Prevailingopinion is that inadequate toilet and sanitation infrastructure is not aproblem. The problems are a lack of investment in creating infrastructure and alack of managerial capacities to operate the systems, once created. Theargument leads logically to defining the meaning of toilet revolution. On onehand, there are infrastructure projects created via private investment, throughconcession agreements and, on the other, there is handing over of public watersystems to private parties to operate and “maximise efficiency” (Narain, 2012).


Finally, thesanitation control of human pathogens in effluent should gain more attention.This is because health should not be jeopardized by residual pathogensremaining in the water after treatment (WHO, 2016;Winward et al., 2008). Even thoughvarious wastewater treatment technologies including centralized anddecentralized systems have been developed, the overall treatment capacity isstill relatively low in developing countries due to the economic concerns (Wu et al.,2016). Appropriatetechnology should be highlighted and employed to fulfil the end requirements ofthe toilet revolution. For instance, composting toilets require little to nowater and can therefore disconnect the toilet from both the water supply andwastewater infrastructure (Anand andApul, 2014), a biogastoilet can make use of human waste and other household organic waste to producebiogas for cooking and return the digestate to farmland as fertilizer. Meanwhile,pathogens are killed in the digester which results in sanitary disposal ofhuman waste (Mang and Li,2010).



Improvedsanitation—including waste treatment and resource recovery—is essential to ahealthy and sustainable future for the developing world, with China as noexception. Toilet revolution in China is not just a buzzword,instead, it integrates environmental protection, disaster prevention, resourcerecovery, and sustainable development into a consolidated whole. Toiletrevolution requires understanding issues across the entire sanitation servicechain, including waste containment (toilets), emptying (of pits and septic tanks),transportation (to sewage treatment facilities), waste treatment,and disposal/reuse. MDGs and SDGs, government support, environmental protectionand resource recovery provides opportunities for implementing the toiletrevolution in China. Meantime, the challenges faced are: insufficient fundingand policy support, regional imbalance and lagging approval processes, weaksanitary awareness and low acceptance of new toilets, lack of R&D andservice system. The toilet revolution in China requires a concerted effort frommany governmental departments. It needs to address not only technologyimplementation, but also social acceptance, economic affordability, maintenanceissues and, increasingly, gender considerations.



The authorswould like to take this opportunity to express our sincere appreciation for thesupport of National Environment and Energy International Science and TechnologyCooperation Base, National Key Research and Development Plan (2017YFC0403401) andReinvent the Toilet Challenge - China Regional Program (Global DevelopmentGrant Number OPP1051913).



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