HUNDREDS OF MILLIONS OF INDIANS DEFECATE IN THE OPEN KEEP IT THAT WAY

A federal minister announced on 2 September that the Bill & Melinda Gates Foundation would recognise Mr Modi for his government's efforts to end open defecation. The Swachh Bharat Abhiyan, as it is known, or Clean India Mission, seeks to improve sanitation across the country by building tens of millions of toilets for the poor.

But the seemingly innocuous award has sparked scathing opinion pieces, the disapproval of at least three Nobel laureates, a petition by more than 100,000 people, and even rejection by celebrities - British Asian actors Jameela Jamil and Riz Ahmed were due to attend but dropped out of the event, although neither has explained why.

The award for Mr Modi has raised eyebrows because to date recipients of the Gates Foundation's "Goalkeeper" award have largely been grassroots political and community activists.

Hundreds of millions of Indians defecate in the open because they have no access to toilets or even running water. It has been a persistent problem, polluting soil and water, causing diseases and putting women and girls at risk as they go out alone in the night to relieve themselves.

So Mr Modi's ambitious promise in 2014 that he would end this practice caught the attention of India and the world. And that goal lies at the heart of the Clean India Mission, arguably Mr Modi's most beloved campaign.

How successful has the scheme been?

Well, it depends on how you evaluate it.

While it's true that the number of toilets has increased significantly, a BBC investigation found that many of them are not working or aren't being used for various reasons, from lack of running water to poor maintenance to deeply ingrained cultural habits. Recent research found that people in some parts of northern India preferred to defecate in the open because they found it more "comfortable" or thought it to be "part of a wholesome, healthy virtuous life".

Another common problem is that the government offers subsidies for the poor to build a toilet in their home. But since the subsidy is paid out in instalments over more than a year, many poor households wait for months for the construction to be complete.

"Many beneficiaries have started construction but not competed it," says Siraz Hirani from the Mahila Housing Sewa Trust, a non-profit group that also works to improve sanitation. As a senior programme manager, Mr Hirani has worked closely with rural and urban governments to implement the Clean India scheme.

His other big worry is that the subsidy does not account for the cost of laying a sewer, which has often meant that people in rural areas end up building soak pits for drainage. This, he fears, will eventually lead to ground water and soil pollution in coastal areas where the water table is higher.

Mr Hirani says open defecation has "significantly reduced", but the "biggest challenge is how do we sustain this?"

He adds that the government data relies heavily on the existence of infrastructure - such as the toilet itself - rather than actual use or behavioural change to measure success.

He says the Clean India mission is a "great idea" that put the spotlight on open defecation - and for that Mr Modi deserves the award. But he fears that such recognition might be seen as a victory.

"It's alright to prove yourself, but you must improve while proving yourself."

What does the foundation say?

The Bill & Melinda Gates Foundation never made an official announcement that Mr Modi would receive the 2019 Goalkeeper award - and the awards website says the names of this year's winners will be released at the event.

But as the criticism gathered steam, it acknowledged that Mr Modi was indeed one of the recipients.

Mr Modi is not the first politician to receive the award - Ellen Johnson Sirleaf, the former president of Liberia, was honoured in 2017.

Defending its decision to honour him, the foundation said in its statement to the BBC that "sanitation has not received significant attention" and "a lot of governments are not willing to talk about it, in part because there are not easy solutions".

"Before the Swachh Bharat mission, over 500 million people in India did not have access to safe sanitation, and now, the majority do. There is still a long way to go, but the impacts of access to sanitation in India are already being realized. The Swachh Bharat Mission can serve as a model for other countries around the world that urgently need to improve access to sanitation for the world's poorest."