Business Model Innovation: East Meets West Delivers Sanitation Solutions at Scale | Source: Rahim Kanani, Forbes – Sept 12, 2012
In a recent interview with John Anner, President of the East Meets West Foundation, we discussed their efforts to provide clean water and sanitation services in Southeast Asia, a recent $10.9M grant by the Bill and Melinda Gates Foundation to expand on their work, how they go about measuring impact on the ground, critical challenges when dealing with water and sanitation in the developing world more broadly, and much more.
John Anner
EMW President John Anner has been with the East Meets West Foundation since February 2003. John sees his job as building EMW into a global leader in effective, catalytic solutions to development issues such as the lack of clean water and high infant mortality. Prior to EMW, John was the founder and executive director of the Independent Press Association, a membership organization that provided technical assistance and business services to hundreds of independent and ethnic periodicals.
Rahim Kanani: How would you describe EMW’s history of effort in the area of water and sanitation, and what have been your results thus far?
John Anner: East Meets West has been working in Southeast Asia since 1988 to help improve health, education and infrastructure. We find sustainable solutions through innovative, yet practical, programs that improve the lives of disadvantaged communities.
We launched our clean water and sanitation program in 1998, starting small with village-based water systems. In 2007, we expanded the program significantly with a grant from the World Bank with a clean water program that helps connect poor, rural communities to safe water systems. But of course, safe water is impossible without proper sanitation and hygiene, so we launched those efforts shortly afterwards. We’ve worked with partners that include Watershed Asia, USAID, the World Bank and a host of local organizations that help us reach those poor, rural communities where the problem is most serious and where we know we can make a powerful difference.
The numbers are striking. Fully 50 percent of Vietnamese and approximately 80 percent of Cambodians do not have proper sanitation at home. What’s more, good hygiene practices – including regular hand washing with soap – are not widely adopted. Poor sanitation helps create a breeding ground for disease, and is responsible for 17,000 deaths each year – 90 percent of them among children under age 5. And illness alone results in an estimated US $1.2 billion in economic losses annually in these two countries, and contributes to the problems keeping poor Vietnamese and Cambodians trapped in a cycle of poverty.
To date, EMW has built over 213 water systems serving nearly 400,000 people and brought improved sanitation to almost 62,500 people. And what is more meaningful, in my opinion, is that these families and communities are still using their water and sanitation systems. We have focused a lot of our attention on long-term sustainability and durability, so that the projects last over time.
Rahim Kanani: In this context, you were recently granted a US $10.9 million grant from the Bill & Melinda Gates Foundation to improve sanitation and hygiene practices among the rural poor in Vietnam and Cambodia. How will this grant be spent, and what will be the approach?
John Anner: Our approach can best be described not as some new dramatic new innovation in technology, but as an innovation in the business model for delivering sanitation solutions at scale. We work with local partners to reach and educate communities; we help these communities get access to the financing, training and other forms of assistance they need to afford and install the systems; and we reward the results. It’s a model that accelerates behavior change, helps develop a sustainable approach to sanitation that is owned by the community and makes the most of every dollar – a true win-win for donors, suppliers, recipients and entire communities.
We were honored to receive the grant from the Bill & Melinda Gates Foundation. It not only furthers their continued commitment to improving sanitation and hygiene, but we certainly view it as a vote of confidence for our proven approach. What it means is that we’ll be able to dramatically scale up the program we had launched in a few Vietnamese provinces to reach significantly more households in both Vietnam and Cambodia. To date, there have been 2,500 latrines built through our program. Thanks to the important support of the Gates Foundation, we will now be able to bring safe latrines to 344,000 additional households over the next three years. That will benefit 1.7 million of Vietnam and Cambodia’s rural poor, many of whom earn less than US $2 per day.
The costs associated with delivering latrines and achieving behavioral change through this program are among the lowest in the industry, ensuring smart investments that reach more people for less money – something that makes us very proud.
Rahim Kanani: What makes this approach innovative in the water and sanitation space, and how will you measure your impact?
John Anner: A trend in clean water and sanitation in the past was for aid organizations to come into a community, dig a well or build a latrine, provide information on how it should be used, and then leave. Years later, these organizations would come back to discover that these systems had fallen into disrepair or had been repurposed for another use. We believe communities need to be a partner from the get-go – they need to understand why sanitation is so important for their heath and prosperity, and how it works. And they need to invest their own resources. People show they value something by paying for it. Our latrines are purchased by families and built by trained local masons and suppliers who can provide maintenance and care long after we’re gone. To make this happen, we bring everyone to the table – aid organizations, the private sector, government agencies, community organizers and others – to identify the challenges and, as a group, break them down. And another key part of our work is to line up the incentives, so that everyone has a stake in the long-term success of the program.
To have a meaningful public health impact, you need a catalyst – something that spurs large-scale behavior change. That’s where our results-based incentive comes in. By offering families a rebate to offset the cost of latrines and by offering communes a conditional cash transfer when they reach sanitation adoption goals, we make sure change happens quickly.
It’s worth noting that these rewards are only provided after independent verification that the systems are in place and in use – which helps us accurately track our success.
I think what makes us innovative is the way we combine all of these pieces.
Rahim Kanani: Does this particular approach lend itself to scalability beyond Vietnam and Cambodia?
John Anner: We believe this is a model that can be replicated throughout the developing world. Communities across sub-Saharan Africa are facing a similar crisis, with UNICEF estimating that 70 percent of its population lack access to proper sanitation coverage, particularly those living in rural areas.
The key ingredient to success is partnerships: partnerships with local organizations that have networks that reach rural communities and credibility within those communities, and partnerships with government and health organizations, local businesses and suppliers, financers and others who can help break down the barriers to adoption. Through the Millennium Development Goals, a priority has been placed on the delivery of global health solutions throughout the developing world, so these organizations, and networks, exist and are familiar with coordinating with foundations.
These partnerships can be built, materials translated, and programs launched wherever there is an urgent need and a willingness to make it work.
Rahim Kanani: As you survey the water and sanitation sector in the developing world, what are some of the critical challenges standing in the way of significant progress?
John Anner: Different parts of the world face different challenges. In some countries, excellent progress has been made on water supply, although of course much more needs to be done. However, sanitation solutions and hygiene practices are still far behind where we need to be.
One of the major challenges we face, which I think is true across the developing world, is that these systems haven’t been adopted for a reason. It’s not that the community is backward or ignorant, though there is something of a lack of understanding about just how important clean water and sanitation is to good health and economic progress. It’s that poor, rural communities confront enormous struggles on limited resources, and don’t really know what the best solutions are, at an affordable price. Generations of their families have carried water from nearby water supplies or have simply gone outside when they need to defecate. There is a cultural acceptance for these practices, and it is difficult to convince people that our solutions are a worthy and healthy investment of their very meager finances.
Rahim Kanani: Lastly, what are some of the leadership lessons you’ve learned with regard to international development more broadly?
John Anner: One lesson I’ve learned is that looking at international development through a business lens is a valuable tool – it leads you to smart ideas, effective partnerships and solutions that are woven into the fabric of the community.
Too often, organizations are put into one of two categories – those doing well (financially) or those doing good for the world around them. We should be able to do both. For a non-profit, our dedication to our causes shouldn’t mean we neglect building infrastructure, investing in our future or learning other valuable lessons from our business colleagues. The private sector plays an essential role in supporting development where it’s needed the most and ensuring success over the long-term.
As I once told Indra Nooyi, the CEO and Chairman of PepsiCo, “I really like PepsiCo’s motto of ‘”Performance with Purpose.’ Coming at some of the same problems from the non-profit side, we like to think EMW is all about ‘purpose with performance.’”
If we work as a team with partners in the community, the region and global business community, we can make a real difference.
