GENEVA - Unsafe water, sanitation and hygiene continue to pose a major global public health threat, contributing to at least 1.4 million preventable deaths every year, according to the World Health Organization (WHO).
The findings are included in the WHO’s Water, Sanitation, Hygiene and Waste Strategy 2026–2035, published on February 20, which sets out the organization’s priorities for improving WASH services over the next decade.
The strategy comes amid persistent inequalities in access to basic services, compounded by climate change, disease outbreaks, conflict, migration and limited development financing.
Billions Still Lack Basic Services
Globally, around 2.1 billion people still lack safely managed drinking-water services. This includes 106 million people who rely directly on untreated surface water for drinking.
Sanitation remains another major gap, with around 3.4 billion people lacking safely managed sanitation services. Of these, approximately 354 million people continue to practise open defecation.
Healthcare facilities also face significant WASH deficiencies. In 2023, around 1.1 billion people were served by facilities without basic water services, while 3 billion lacked basic sanitation, 1.7 billion lacked basic hygiene services and 2.8 billion were served by facilities without basic waste services.
WASH as Health Infrastructure
The WHO strategy positions water, sanitation, hygiene and waste management as essential public-health infrastructure, linking them directly to primary healthcare, infection prevention, antimicrobial resistance, emergency preparedness and disease control.
The organization will focus on three main areas: stronger standards and regulation; improved monitoring and data for decision-making; and integrating WASH into health programmes and health systems.
Climate resilience will also be incorporated across WHO’s WASH work, including water and sanitation safety planning, health-facility improvements and national climate adaptation plans.
The strategy also calls for WASH monitoring to go beyond simply measuring access. Future monitoring will increasingly consider service resilience, climate risks, inequalities, gender and menstrual health.
Investing in WASH Could Save Millions of Lives
The WHO estimates that scaling up WASH services globally could save more than 9 million lives by 2075 and generate a net economic benefit of around $32.7 trillion.
The strategy estimates that every $1 invested in WASH could generate more than $19 in economic returns, although the benefits vary by intervention. Improved drinking water has an estimated benefit-cost ratio of around 11:1, sanitation around 17.6:1, and hand hygiene as high as 86:1 under some scenarios.
The WHO also highlights wastewater and environmental surveillance as increasingly important tools for detecting outbreaks, preparing for pandemics and monitoring pathogens, including those linked to antimicrobial resistance.
Rather than relying on fragmented projects, the strategy calls for countries to strengthen national systems, regulation, institutions, financing and data, while coordinating action across the health, water, environment, climate and finance sectors.
