Experts from more than 40 countries took part in the World Toilet Summit in October 2007 in New Delhi, India. The world is still grappling with the problem that many people still don't have access to adequate sanitation.
An event like World Toilet Day — observed on Nov. 19 — is naturally going to spark some bathroom humor.
But the day also serves as a reminder that for the 2.4 billion people who don't have access to basic sanitation, that lack of toilet facilities is no laughing matter. In fact, it's a deadly serious health crisis.
"Think of living in a giant cesspool and then you get some idea of the problem," said William Moomaw, professor of international environmental policy at Tufts University.
"It's a life and death issue for those who don't have access to good sanitation," he said. "The spread of disease like cholera and typhus from lack of proper sanitation is just horrific."
Where the problem's worst
If trends continue, by 2015 the regions where people are least likely to have basic sanitation will be sub-Saharan Africa (only 31 percent will have adequate sanitation), southern Asia (36 percent) and Oceania or islands of the tropical Pacific Ocean (53 percent). According to the World Health Organization, 1.1 billion people in the world relieve themselves in open areas.
The World Health Organization estimates that at any given moment, half of the developing world's people are sick from diseases associated with dirty water and bad sanitation.
Getting past the "first-grade jokes" is not easy, said Christiana Peppard, professor of theology, science and ethics at Fordham University, but "this problem has existed for such a long time and so many people suffer from it."
Besides the heavy human toll, there's an economic cost: The World Bank says that lack of proper sanitation results in $260 billion losses a year due to health costs and loss of output.
People who are unable to find adequate sanitation often use clean water supplies for defecation, which becomes contaminated and spreads disease.
The hardest hit are children. Diarrhoeal diseases, stemming from improper sanitation, are the second-leading cause of deaths — respiratory diseases are first — among the young in developing countries. Some 2,000 children die each day from poor sanitation and contaminated water supplies, according to Unicef.
Women are also at special risk from improper sanitation, said Peppard, who pointed out that many women wait until nighttime to relieve themselves in the fields because they risk sexual attack if they're spotted in seclusion during the day.
"And a lot of young girls don't go to school because there are no facilities to take care of their menstrual cycles," she added. "They can't get an education because there's no real sanitation."
'Trap systems' for less than $2
Issues keeping the problem from being solved include a country's weak infrastructure and scarce resources. But there are attempts to get help to the people who need it.
The American Standard plumbing company received grant money from the Bill and Melinda Gates' Foundation to help fund a project in Bangladesh to develop a trap system to keep latrines free of disease-carrying insects, CEO Jay Gould said.
"It's working very well and we've had success with it," he said.
Gould said that the trap system costs less than $2, and American Standard is working with a local company to continue to make the systems.
Next up for Gould's engineering team is sub-Saharan Africa.
"They have a different culture there for sanitation than Bangladesh, so we have to come up with a new solution to help them," he said. "But it only took us six months to come up with the solution in Bangladesh so we're optimistic we'll find a way," Gould said.
The company plans to donate a latrine system to Bangladesh for every top brand toilet it sells in North America, Gould said.
More have mobile phones than toilets
Peppard said such efforts are helpful, but much more is needed.
"Privatization can be good, but one of the challenges is making sure the poorer people see the benefits," she said. "That's not always the case. Governments need to take more action as well."
Moomaw agreed but said right now "most governments don't even face the issue."
World Toilet Day, started in 2001, has been sanctioned this year by the United Nations in an effort to make sanitation a global development priority.
The task is daunting. Of the world's 7 billion people, 6 billion have mobile phones but only 4.5 billion have access to toilets.
That said, there is hope.
"I'm optimistic about finding solutions to this. The technologies exist," said Moomaw.
"But something needs to be done now. The Philippines after Typhoon Haiyan hit are suffering from bad sanitation. It's not serving anyone's interest to have people living in these miserable conditions and watch their children die," he said.
—By CNBC's Mark Koba. Follow him on Twitter @MarkKobaCNBC.
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First published November 15 2013, 1:49 PM