New York – Open defecation is an issue that has received little public attention. Often overshadowed by the larger and more palatable issue of water, open defecation has been a silent problem and too much of a taboo to be addressed.

The Global Citizen Festival presents an opportunity to break down this barrier and it’s critical that Prime Minister Modi is attending this year. Modi came to power with the issue of toilets at the front and centre of his agenda. With the campaign slogan of “Toilets before Temples,” this priority may have been polarizing, but it left no doubt as to Modi’s vision of the country in the years and decades ahead. And since then, the Prime Minister has been delivering on his pledge.

Most notably, at his now-famous Red Fort address on India’s Day of Independence, he talked about the impact of open defecation. It marked something of a change from previous Independence Day addresses because it touched on an aspect of societal behavior hitherto thought an acceptable part of everyday life for millions of people in India.

Put simply, the Prime Minister used this address to challenge this acceptance. Indeed, past state-led projects in India have sought to increase access to toilets. But because they haven’t addressed the underlying reasons for why people defecate in the open, many toilets are left underutilized, or at best used by those seen “unfit” to defecate in the open.

As a result, these projects have had limited success because they fail to challenge the socio-cultural reasons as to why people prefer to defecate in the open.

While the consequences of lack of access to water are well-versed, less so are those of inadequate access to sanitation. Recent medical research from the Research Institute for Compassionate Economics (RICE) indicates a strong correlation between open defecation and growth stunting.

Add to this scientific research anecdotal evidence of women being raped and killed after defecating in the open, and you have a growing body of evidence which suggests that open defecation has broader consequences than one might expect. And yet, 53% of households in India practiced open defecation in 2011, 89% of whom were in rural parts of the country.

Evidently, while the negative consequences of open defecation continue to stack up, this has provided little motivation for people to prefer to use toilets instead. So it appears engrained social norms are more difficult to displace than state-led infrastructure projects.

This presents something of a challenge for Prime Minister Modi, whose country is on the cusp of lifting millions of people out of poverty and into middle class India. Clearly, reducing open defecation would help to provide the economic engine room for generations to come, and propel India well into the twenty-first century. Until then lack of adequate sanitation will continue to act as a handbrake on economic development. And although India feels the impact of open defecation most acutely (60% of people who defecate in the open in the world are live in India), it’s not the only country to face this challenge.

It’s not only significant, therefore, that Prime Minister Modi is coming to the Global Citizen Festival, but it’s even more telling that he will use this platform to speak about open defecation and toilets. This global platform enables world leaders and heads of corporations to come to the stage and show what they are doing to end extreme poverty.

Crucially, he will not only be there representing India, but a seventh of the world’s population. A man whose words carry such a significant slice of humanity is to be respected, and so with such a stage the fact he will be speaking about something as simple as a toilet shows the earnestness with which he regards improving access to sanitation.

Leading the world’s most populous democracy, the Prime Minister of India is in a unique position, and he will soon have centre stage on an equally unique platform.

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