World Toilet Day is observed each year on Nov. 19 to bring attention to the lack of toilets for billions of people globally. It encourages everyone to learn and spread the word about how proper toilets and sanitation can save lives.

This year, the United Nation’s (UN) theme is Toilets: A Place for Peace, with a focus on this essential space being safe and secure for everyone. The World Health Organization (WHO) reports that 3.5 billion people still live without safely managed sanitation, including 419 million who practice open defecation.

Additionally, “safe toilets for all by 2030” is one of the targets of Sustainable Development Goal 6 . Conflict, extreme weather events, and disasters can destroy, damage, and disrupt sanitation services. When toilet systems don’t work or don’t exist, untreated human waste spreads in the environment, unleashing diseases such as cholera.

Each day, nearly 1,000 children die globally from diarrhea related to poor sanitation and contaminated water sources. Safe sanitation, the practice of good hygiene, and a safe water supply can save the lives of more than 300,000 children a year.

The number of sexually transmitted infections (STIs) remains high in the United States, with more than 2.4 million reported last year, according to the U.S. Centers for Disease Control and Prevention (CDC). However, the latest CDC data shows signs the epidemic could be slowing. In 2023:

• Gonorrhea cases dropped for a second year—declining 7% from 2022 and falling below pre-COVID-19 pandemic levels (2019).
• Overall, syphilis cases increased by 1% after years of double-digit increases.
  • Primary and secondary syphilis cases, the most infectious stages of syphilis, fell 10%—the first substantial decline in more than two decades. These cases also dropped 13% among gay and bisexual men for the first time since CDC began reporting national trends among this population in the mid-2000s.
  • Increases in newborn syphilis (known as congenital syphilis) cases appear to be slowing in some areas—with a 3% increase over 2022 nationally, compared to 30% annual increases in prior years.

“I see a glimmer of hope amidst millions of STIs,” said Jonathan Mermin, M.D., M.P.H., and CDC’s National Center for HIV, Viral Hepatitis, STD, and TB Prevention director. “After nearly two decades of STI increases, the tide is turning. We must make the most of this moment—let’s further this momentum with creative innovation and further investment in STI prevention.”

While the STI epidemic touches nearly every community, some geographic areas and populations are affected more severely, including American Indian/Alaska Native, Black/African American, and Hispanic/Latino people, as well as gay and bisexual men. These health equity differences are due in part to deeply entrenched factors that create obstacles to quality health services, such as poverty, lack of health insurance, less access to healthcare, and stigma. 

The new data follow important developments and innovations in STI prevention, such as CDC’s guidelines for doxy PEP to prevent bacterial STIs; newly Food and Drug Administration- (FDA) authorized self-tests (or at-home tests) for syphilis, gonorrhea, and chlamydia; and a nationally coordinated response to the U.S. syphilis epidemic spearheaded by the National Syphilis and Congenital Syphilis Syndemic Task Force.