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A wide overview of past accomplishments by the United Nations on improving access to clean drinking water, and future goals.

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Access to Clean Water and Sanitation: A Guide To Global Issues | Global Citizen

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Access to Clean Water and Sanitation: A Guide To Global Issues | Global Citizen

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Improvements have been made in spreading clean water access, but many people in rural areas still lack access.

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Access to Clean Water and Sanitation: A Guide To Global Issues | Global Citizen

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(Prüss, Kay, Fewtrell, and Bartram 2002) Estimating the Burden of Disease from Water, Sanitation, and Hygiene at the Global Level)

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(Prüss, Kay, Fewtrell, and Bartram 2002) Estimating the Burden of Disease from Water, Sanitation, and Hygiene at the Global Level)

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An examination of various diseases resulting from unsanitary water.

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Water shortages in Cape Town, South Africa indicate similar problems in other places if changes do not occur.

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Your Country Will Also Face 'Day Zero' If You Don't Prepare: UN

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Poor planning, experts say, is compounding the problems from climate change and population growth to create growing public health crises around the world.

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Bill and Melinda Gates Foundation: Strategy Overview of Water Sanitation Goals

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Bill and Melinda Gates Foundation: Strategy Overview of Water Sanitation Goals

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Our Vision:

Enable widespread use of safely managed, sustainable sanitation services, contributing to positive health, economic, and gender equality outcomes for the world's poorest.

The Challenge

At A Glance

In the developing world, an estimated 4.5 billion people practice open defecation or use facilities that do not safely dispose of human waste.

Inadequate sanitation and hygiene are estimated to have caused more than half a million deaths from diarrhea alone in 2016.

Safe sanitation is essential to a healthy and sustainable future for developing economies.

The foundation focuses on accelerating innovations in non-sewered sanitation technology and service delivery, particularly in densely populated areas of South Asia and Sub-Saharan Africa.

Our Water, Sanitation & Hygiene strategy is led by Brian Arbogast and is part of the foundation's Global Growth & Opportunity Division.

Unsafe sanitation is a massive problem that is becoming more urgent as our global population increases and trends like water scarcity and urbanization intensify. About 4.5 billion people-more than half the world's population-either practice open defecation or use unsafe sanitation facilities and services. To be effective, sanitation must be carefully managed at all stages, from the point that waste is collected and contained to how it is transported and treated. If there are gaps or breaks at any stage, then harmful human waste flows into surface waters and fields where children play and people of all ages live, eat, drink and bathe.

Poor sanitation, which is widely accepted as a chief contributor to waterborne diseases, is the cause of more than 1,200 deaths of children under five-years-old per day, more than AIDS, measles, and tuberculosis combined. Inadequate sanitation and hygiene were the cause of more than half a million deaths from diarrhea alone, in 2016. Despite the indisputable connection between poor sanitation and human health risks, sanitation models and services aren't improving quickly enough. According to the World Health Organization and UNICEF, sanitation rated as "safe for people" increased by only three percent worldwide over the last five years.

Creating sanitation infrastructure and public services that work for everyone and keep human waste out of the environment is difficult-and it isn't a one-size-fits-all proposition. The toilets, sewers, and wastewater treatment systems that made sense in the past aren't necessarily the best solutions for the future, especially in poor countries. These types of systems require vast amounts of land, energy, and water and are extremely expensive to build, maintain, and operate, even by western standards. They are particularly difficult to introduce, as new infrastructure, into dense urban settings and informal settlements, where the impact of unsafe sanitation on people is the greatest.

The Opportunity

Solving the sanitation challenge in the developing world will require breakthrough innovations in technologies as well as systems that are practical, cost-effective, and replicable on a large scale. Building and proving these new models is difficult, but the potential benefits, in human health, economic growth, and dignity are enormous. These benefits include increased human productivity, improved infrastructure, new jobs, and expanded entrepreneurial opportunities.

According to estimates, the lack of proper sanitation costs the world an estimated $223 billion every year. Worldwide, it has been estimated that every dollar spent on sanitation on average provides at least five dollars in economic return. And market research shows that the annual market value for new, pro-poor sanitation technologies such as the reinvented toilet, could be more than $6 billion globally by 2030.

Our Strategy

We collaborate with government leaders, the private sector, and technologists to advance promising new toilet and waste treatment technologies, service delivery models, and policies with the greatest potential to revolutionize sanitation standards and practices, at the local and national level. Our core initiatives include:

Promoting policies and practical steps that governments can take now to establish safer sanitation through Fecal Sludge Management (FSM)-a sanitation strategy that does not require sewers;

Investing, alongside governments in our priority geographies, in city-wide inclusive sanitation to accelerate the adoption of safely managed sanitation at the city level, particularly focused on slums and informal settlements that are typically underserved;

Investing in technologies, such as the reinvented toilet and the omni-processor, that can radically change the way municipalities and households manage human waste affordably, at scale, and with little or no need for water and electricity; and

Conducting research to help the sanitation sector develop data and evidence about what works.

The burden of inadequate sanitation-and, therefore, the potential for progress-is greatest in Sub-Saharan Africa and South Asia, so that is where we have focused our efforts to date.

Sub-Saharan Africa - As African cities and towns continue to grow, especially within informal settlements, governments are acknowledging the need for innovative sanitation solutions that are less expensive and faster to deploy than building and operating sewer systems and wastewater treatment plants.

South Asia - Sanitation is a significant challenge for most South Asian countries, but many are now aggressively driving inclusive national sanitation strategies that prioritize safe sanitation. India, in particular, provides a global model for sanitation reform through the government's Swachh Bharat Mission and a growing network of sanitation operators and utilities practicing Fecal Sludge Management.

China - The Chinese government's Toilet Revolution, promising the rapid scaling of safe sanitation approaches for the country, presents a strong opportunity for the adoption of new technologies within the rural and public toilet markets in China, particularly in areas facing water scarcity issues.

Accelerating the development of safe non-sewered sanitation systems and technologies is our top priority within the water, sanitation, and hygiene continuum, because it is where we believe we catalyze the biggest change, by making investments that other partners are unlikely to. We acknowledge the critical role of clean water and hygiene initiatives, and efforts to end open defecation, in improving global health outcomes. We applaud the efforts of other organizations focused on these areas.

Areas of Focus

We focus our grantmaking in four complementary areas: developing and commercializing transformative sanitation technologies; transforming how cities can provide sanitation as a reliable, inclusive service; policy and advocacy; and measurement, evidence, and dissemination, for scale.

Transformative Technologies & Commercialization

The flush toilet and central sewer systems are considered by many consumers and governments around the world to be the gold standard for safe sanitation. However, decentralized sanitation systems incorporating technologies like the reinvented toilet present alternatives that can be safer, more resilient, more cost-effective, and environmentally-friendly.

Since 2011, the Gates Foundation's Reinvent the Toilet Challenge has worked with leading engineers and scientists to design low-cost toilets that do not require connections to the electrical grid, water supply, or sewers. Several designs debuted at the Reinvented Toilet Expo in 2018 and are now commercially available. These toilets work using internal combustion and chemical treatment systems, and they can be set up in areas that are hard to reach with traditional infrastructure. They can deliver the same benefits as toilets connected to sewers, plus wholly new benefits, including the removal of human pathogens and the generation of useable water and electricity. Some reinvented toilet models provide sanitation for single homes, and others are designed for public or shared toilet facilities serving communities. The foundation has also pioneered new fecal sludge treatment technologies and funded new types of pit latrine emptying solutions so that communities can make existing sanitation systems safer for people and more affordable for private companies, public utilities, and municipalities.

Urban Sanitation Markets

Providing city-wide, inclusive sanitation requires new service models and market structures, as well as different approaches and technologies to serve different community needs and settings. We are working with local governments, service providers, and community-based organizations in select cities to foster environments that support the use of community-responsive, non-sewered sanitation products, delivery methods, and business models. We see particular promise in models that rely on public sector agencies to provide regulation and oversight, and that allow private sector providers to deliver sanitation services and profit from byproducts that have market value, including energy and fertilizer. This is a sustainable partnership model that offers natural incentives for innovation and long-term delivery of safe sanitation to communities.

We also support initiatives that help stimulate market and community demand for improved sanitation in order to accelerate development of productive sanitation market conditions. Part of this effort involves working with sanitation providers and partners to help them adopt more evidence-based practices so they can deliver sanitation services that meet people's needs, especially the needs of women and girls. For example, in India, our work includes support for a national campaign to promote incremental shifts in social norms around toilet use that will lead to higher demand for better sanitation products and services as they become available.

Policy and Advocacy

We work to improve the policy and regulatory environment for sanitation through partnerships across all levels of governments, multilateral organizations, community-based nongovernmental organizations, service providers, and others. With our network of partners, we advocate for policies and international standards that set guidelines for safe sanitation services at the local and national levels, as well as how to adequately fund these systems to ensure healthy outcomes for people.

As a part of this work, we support initiatives that can help accelerate gender equality for women and girls. We invest in initiatives that can generate gender-disaggregated data to inform the development of programs and products that increase women's participation in sanitation decision-making, at the household and policy level.

Measurement, Evidence, and Dissemination, for Scale

We invest in research and evaluation to understand the effectiveness of various sanitation approaches. We use this information to report on our progress, assess the impact of our grantmaking, and share lessons that we learn with our partners. This information is vital for helping national governments meet the Sustainable Development Goals, including goal 6.2, which calls for ending open defecation and providing adequate, equitable, and safely managed sanitation for all people by 2030.

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Enable widespread use of safely managed, sustainable sanitation services, contributing to positive health, economic, and gender equality outcomes for the world's poorest. The Challenge At A Glance In the developing world, an estimated 4.5 billion people practice open defecation or use facilities that do not safely dispose of human waste.

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Students Improving Water, Sanitation, and Hygiene in the Developing World | Lee Blaney | TEDxUMBC

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Students Improving Water, Sanitation, and Hygiene in the Developing World | Lee Blaney | TEDxUMBC

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TedTalk discussing how students can help impact water sanitation, as well as the difficulties brought on by not having access to clean water.

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Students Improving Water, Sanitation, and Hygiene in the Developing World | Lee Blaney | TEDxUMBC

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Photo gallery showing various parts of the world and how they access water.

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What you need to know about the global water crisis in photos and videos | World Vision

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The global water crisis affects millions worldwide; 785 million people lack access to clean water. Let's break this topic down - in photos and videos.

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UN News: Billions globally lack ‘water, sanitation and hygiene’, new UN report spells out

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UN News: Billions globally lack ‘water, sanitation and hygiene’, new UN report spells out

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News article discussing severity of lack of water sanitation, and how it affects the poor

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"Mere access is not enough" said UNICEF 's Kelly Ann Naylor, Associate Director of Water, Sanitation and Hygiene (WASH). "If the water isn't clean, isn't safe to drink or is far away, and if toilet access is unsafe or limited, then we're not delivering for the world's children".

The Joint Monitoring Programme report, "Progress on drinking water, sanitation and hygiene: 2000-2017: Special focus on inequalities", finds that while significant progress has been made toward achieving universal access to WASH, there are huge gaps in the quality of services provided.

"Children and their families in poor and rural communities are most at risk of being left behind", Ms. Naylor said, urging Governments to "invest in their communities if we are going to bridge these economic and geographic divides and deliver this essential human right".

The report reveals that since the turn of the century, 1.8 billion people have gained access to basic drinking water services, but vast inequalities in accessibility, availability and quality prevail.

Estimates show that 1-in-10 people still lack basic services, including 144 million individuals who drink untreated surface water. And the data illustrates that 8-in-10 people in rural areas lack access to these services.

"Countries must double their efforts on sanitation or we will not reach universal access by 2030," said Maria Neira, WHO Director, Department of Public Health, Environmental and Social Determinants of Health.

"If countries fail to step up efforts on sanitation, safe water and hygiene, we will continue to live with diseases that should have been long ago consigned to the history books", she spelled out. "Investing in water, sanitation and hygiene is cost-effective and good for society in so many ways".

While open defecation has been halved since 2000, from 21 per cent to 9 per cent, 673 million people continue this practice in 'high burden' countries. Moreover, in 39 countries, the majority of which are in sub-Saharan Africa, the number of people openly defecating has increased.

The report also highlights new data showing that in 2017, three billion people lacked basic soap and water handwashing facilities at home, including nearly three quarters of those in the Least Developed Countries category.

Every year, 297,000 under-age-five children die from diarrhea linked to inadequate WASH. Poor sanitation and contaminated water also help transmit diseases, such as cholera, dysentery, hepatitis A, and typhoid.

"Closing inequality gaps in the accessibility, quality and availability of water, sanitation and hygiene should be at the heart of government funding and planning strategies", Ms. Naylor stressed. "To relent on investment plans for universal coverage is to undermine decades worth of progress at the expense of coming generations".

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Billions globally lack 'water, sanitation and hygiene', new UN report spells out

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Some 2.2 billion people around the world do not have safely-managed drinking water, while 4.2 billion go without safe sanitation services and three billion lack basic handwashing facilities, according to a new report from the United Nations Children's Fund (UNICEF) and the World Health Organization (WHO).

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(Montgomery, Wilson Jones, Kabole, Johnson, Gordon 2018) No end to cholera without basic water, sanitation and hygiene.

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(Montgomery, Wilson Jones, Kabole, Johnson, Gordon 2018) No end to cholera without basic water, sanitation and hygiene.

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How water sanitation can directly impact the spread of a disease.

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When is water safe to drink? - Mia Nacamulli

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When is water safe to drink? - Mia Nacamulli

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This video lesson discusses some water sanitation procedures, as well as some health effects from drinking unclean water.

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When is water safe to drink? - Mia Nacamulli

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WaterAid: India’s water and sanitation crisis

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WaterAid: India’s water and sanitation crisis

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Article discussing how open defecation and lack of safe toilets leads to poor water hygiene and sickness.

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Nearly half of the population in India currently practices open defecation.

WaterAid called on New York business leaders to ensure that millions of people in India have and use something that most of the world takes for granted within the next four years: a toilet. The unprecedented opportunity to achieve a clean India was presented in Manhattan at an exclusive gathering of prominent New York residents with a connection to India and an interest in the sustainable progress of humanity.

India faces herculean challenges in providing and maintaining the two basic services of safe drinking water and improved sanitation. With more people than any other country in the world living without access to improved sanitation, nearly half of the population in India currently practices open defecation.

Fourteen months after Indian Prime Minister Narendra Modi's Swachh Bharat (Clean India) Mission first announced an ambitious campaign to ensure that every household in India has a toilet by 2019, more than $360 million USD have been invested in toilet construction, and more than 2.5 million toilets have been built across the country.

But more than 100 million additional toilets must be built within the next four years in order to achieve the achievable vision of an open-defecation-free India. That's nearly 70,000 toilets that need to be built each day, and the resources required to achieve this are not yet fully in place.

The ambitious goal to deliver water and sanitation to all in India is achievable, but requires dedicated political will and financing. The political will is now in place, but financing such an ambitious goal also depends on support from people in the United States so that millions of Indians can move out of poverty and lead a life of dignity.

WaterAid America Chief Executive, Sarina Prabasi said: "With more than 600 million people forced to practice open defecation in India, we are talking about more than twice the number of people as in the next 18 countries combined who do not have a safe, private place to go to the bathroom.

Clean water, toilets and basic hygiene practices like handwashing with soap are critical to eradicating extreme poverty. We don't have a chance of meeting global goals for universal access to clean water and sanitation (Goal 6 of the UN Sustainable Development Goals), without accelerated, but long-lasting change in India. It's up to all of us to make that happen."

The lack of access to safe toilets has serious consequences. It spreads fecal matter, causing sickness. More than 140,000 children under the age of five die every year from diarrhea caused by unsafe water and poor sanitation in India.

Going for open defecation is also embarrassing, smelly and dirty, and it exposes women and girls to an increased risk of fear, harassment and attack.

In a WaterAid survey of 9,644 Dalit households from rural villages in four Indian states, a quarter (26%) of those questioned reported women from their household being insulted or humiliated when practicing open defecation. Six percent specifically reported women from their household being sexually harassed when practicing open defecation. Investment from US-based donors is critical to solving the sanitation crisis at the heart of these issues.

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India's water and sanitation crisis | WaterAid US

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WaterAid called on New York business leaders to ensure that millions of people in India have and use something that most of the world takes for granted within the next four years: a toilet.

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The surprising truth of open defecation in India | Sangita Vyas | TEDxWalledCity

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The surprising truth of open defecation in India | Sangita Vyas | TEDxWalledCity

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Open defecation and how it can affect health.

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The surprising truth of open defecation in India | Sangita Vyas | TEDxWalledCity

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(Kaysar, Rao, Jose, and Raj 2019) Water, sanitation and hygiene: measuring gender equality and empowerment 

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(Kaysar, Rao, Jose, and Raj 2019) Water, sanitation and hygiene: measuring gender equality and empowerment 

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Article examining how improved water sanitation can help lead to women's empowerment.

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WHO: How valuable are environmental health interventions? Evaluation of water and sanitation programmes in India

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WHO: How valuable are environmental health interventions? Evaluation of water and sanitation programmes in India

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An interdisciplinary examination of the economics of water sanitation programs and their success, focusing on India.