Global WASH Fast Facts

bucket being filled with water at borehole

Access to Clean Water, Sanitation, and Hygiene

  • The latest published information on access to clean water published in 2019 by WHO and UNICEF show that in 2017:
    • Globally, more than 785 million people did not have access to at least basic water services* and more than 884 million people did not have safe water to drink.2
    • The proportion of the global population using safely managed drinking water services pdf icon[PDF 2 Pages]external icon increased to 71% from 61% in 2000.
      • Over 5 billion people used safely managed drinking water services. An additional 1.4 billion used at least basic services. Over 206 million people used limited services, 435 million used unimproved sources, and 144 million still used surface water.1
    • The proportion of the global population using safely managed sanitation services pdf icon[PDF 2 Pages]external icon increased to 45% from 28% in 2000.1
      • Over 3 billion people used safely managed sanitation services. An additional 2.2 billion used at least basic sanitation services, 701 million used unimproved facilities, and 673 million continue to practice open defecation. 1
    • More than 2 billion people worldwide did not have access to basic sanitation (more than 25% of the world’s population).1
    • About 3 billion people worldwide lack adequate facilities to safely wash their hands at home. The regional disparities are stark: in sub-Saharan Africa, 75% of the population (767 million people) lacked basic handwashing facilities, followed by Central and Southern Asia at 42% (807 million people), and Northern Africa and Western Asia at 23% (116 million people).1
  • Lack of sanitation facilities for girls reaching puberty makes them more likely to miss school than boys.3
    • In 2018 and 2019, between 1 in 4 and 1 in 7 girls in West Africa missed school due to menstruation.3
    • Women and girls are also more likely to be responsible for collecting water for their family. For example, in 2017 they were responsible for collection in 8 of 10 households without onsite water supply. These responsibilities make it difficult for them to attend school during school hours.4
Man rinsing a plastic water bottle to fill at a borehole

*A basic water service is defined as water that is supplied through an improved water source and can be collected within a 30-minute timeframe. Examples of improved water sources include a household connection, public standpipe, borehole well, protected dug well, protected spring, and rainwater collection.

Disease and Death

  • Annually:
    • There are 1.7 billion cases of diarrhea among children younger than 5 years old.6
    • An estimated 446,000 children younger than 5 years old die from diarrhea, mostly in developing countries. This amounts to 9% of the 5.8 million deaths of children younger than 5. 6
    • There are 3 million cases of cholera and an estimated 95,000 cholera deaths.7
    • There are 11 million cases of typhoid fever and an estimated 129,000 typhoid fever deaths.8
  • Worldwide, parasitic worms found in contaminated soil infect hundreds of millions of people, such as Ascaris lumbricoides (819 million people as of 2010), Trichuris trichiura (465 million), and hookworm (439 million). Many of these infections are associated with inadequate or non-existent sanitation facilities.9, 10
  • Worldwide, millions of people suffer from neglected tropical diseases (NTDs), many of which are water and/or hygiene-related, such as Guinea worm disease, Buruli ulcer, trachoma, and schistosomiasis. These diseases are most often found in places with unsafe drinking water, poor sanitation, and insufficient hygiene practices. 11, 12
    • Guinea worm disease (GWD) is an extremely painful parasitic infection spread through contaminated drinking water. Due to the GWD Global Eradication Program, in 2018, there were only 28 cases of GWD reported worldwide.
    • Trachoma is the world’s leading cause of preventable blindness and results from poor hygiene and sanitation. An estimated 41 million people suffer from active trachoma and nearly 10 million people are visually impaired or irreversibly blind as a result of trachoma. 13

Prevention

  • Water, sanitation, and hygiene has the potential to prevent at least 9% of the global disease burden and 6% of global deaths14. The impact of clean water technologies on public health in the U.S. is estimated to have had a rate of return of 23 to 1 for investments in water filtration and chlorination during the first half of the 20th century.15
  • Water and sanitation interventions are cost effective across all world regions.
  • Unsafe drinking water contributed to 72% of diarrheal deaths, while unsafe sanitation contributed to about 56% of deaths from diarrheal diseases.14
    • Improved sanitation contributed to a 15% decrease in diarrheal deaths in Southeast Asia, East Asia, and Oceania, and more than a 10% decrease in diarrheal deaths globally.6
  • In order to meet the United Nations’ Sustainable Development Goalsexternal icon to achieve universal access to basic and safely-managed water and sanitation by 2030:
    • An estimated 2.2 billion people need access to safely managed drinking water, including 884 million currently without basic drinking water services.
    • An estimated 4.2 billion people need access to safely managed sanitation.
    • An estimated 3 billion people need access to basic handwashing facilities.

Water and sanitation interventions have demonstrated economic benefits ranging from $5 to $46 per $1 invested.16

References:

  1. World Health Organization and UNICEF Progress on household drinking water, sanitation and hygiene 2000-2017. Special focus on inequalitiesexternal icon. United States: United Nations Children’s Fund (UNICEF) and World Health Organization (WHO) Joint Monitoring Programme for Water Supply and Sanitation, 2019.
  2. Prüss-Üstün A., Bos, R., Gore, F. & Bartram, J. 2008. Safer water, better health: costs, benefits and sustainability of interventions to protect and promote health. World Health Organization, Geneva.
  3. World Health Organization and UNICEF. Progress on drinking water, sanitation and hygiene in schools pdf icon[PDF – 88 Pages]external icon.United States: United Nations Children’s Fund (UNICEF) and World Health Organization (WHO) Joint Monitoring Programme for Water Supply and Sanitation, 2020.
  4. World Health Organization and UNICEF. Progress on drinking water, sanitation and hygiene: 2017 update and SDG baselines pdf icon[PDF – 66 Pages]external icon. United States: UNICEF and WHO, Joint Monitoring Programme for Water Supply and Sanitation, 2017.
  5. Liu, L., Johnson, H. L., Cousens, S., Perin, J., Scott, S., Lawn, J. E., Rudan, I., Campbell, H., Cibulskis, R., Li, M., Mathers, C., Black, R. E., & Child Health Epidemiology Reference Group of WHO and UNICEF (2012). Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. Lancet (London, England), 379(9832), 2151–2161. https://doi.org/10.1016/S0140-6736(12)60560-1external icon
  6. GBD 2016 Diarrhoeal Disease Collaborators (2018). Estimates of the global, regional, and national morbidity, mortality, and aetiologies of diarrhoea in 195 countries: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet. Infectious diseases, 18(11), 1211–1228. https://doi.org/10.1016/S1473-3099(18)30362-1external icon
  7. Charles, R. C., Kelly, M., Tam, J. M., Akter, A., Hossain, M., Islam, K., Biswas, R., Kamruzzaman, M., Chowdhury, F., Khan, A. I., Leung, D. T., Weil, A., LaRocque, R. C., Bhuiyan, T. R., Rahman, A., Mayo-Smith, L. M., Becker, R. L., Vyas, J. M., Faherty, C. S., Nickerson, K. P., … Ryan, E. T. (2020). Humans Surviving Cholera Develop Antibodies against Vibrio cholerae O-Specific Polysaccharide That Inhibit Pathogen Motility. mBio, 11(6), e02847-20. https://doi.org/10.1128/mBio.02847-20
  8. Obaro, S. K., Iroh Tam, P. Y., & Mintz, E. D. (2017). The unrecognized burden of typhoid fever. Expert review of vaccines, 16(3), 249–260. https://doi.org/10.1080/14760584.2017.1255553external icon
  9. Ziegelbauer, K., Speich, B., Mäusezahl, D., Bos, R., Keiser, J., & Utzinger, J. (2012). Effect of sanitation on soil-transmitted helminth infection: systematic review and meta-analysis. PLoS medicine, 9(1), e1001162. https://doi.org/10.1371/journal.pmed.1001162
  10. Pullan, R.L., Smith, J.L., Jasrasaria, R. et al. Global numbers of infection and disease burden of soil transmitted helminth infections in 2010. Parasites Vectors 7, 37 (2014). https://doi.org/10.1186/1756-3305-7-37external icon
  11. World Health Organization. Neglected Tropical Diseases, Hidden Successes, Emerging Opportunities.
  12. Hotez PJ, Molyneux DH, Fenwick A, Ottesen E, Sachs SE, et al. (2007) Correction: Incorporating a Rapid-Impact Package for Neglected Tropical Diseases with Programs for HIV/AIDS, Tuberculosis, and Malaria. PLOS Medicine 4(9): e277. https://doi.org/10.1371/journal.pmed.0040277external icon
  13. Stocks, M. E., Ogden, S., Haddad, D., Addiss, D. G., McGuire, C., & Freeman, M. C. (2014). Effect of water, sanitation, and hygiene on the prevention of trachoma: a systematic review and meta-analysis. PLoS medicine, 11(2), e1001605. https://doi.org/10.1371/journal.pmed.1001605external icon
  14. Prüss-Üstün, Annette & World Health Organization. (‎2008)‎. Safer water, better health : costs, benefits and sustainability of interventions to protect and promote health. / Annette Prüss-Üstün … [‎et al]‎. World Health Organization. https://apps.who.int/iris/handle/10665/43840external icon
  15. Cutler, D., & Miller, G. (2005). The Role of Public Health Improvements in Health Advances: The Twentieth-Century United States. Demography, 42(1), 1-22. Retrieved March 7, 2021, from http://www.jstor.org/stable/1515174external icon
  16. Hutton, G., Haller, L., & Bartram, J. (2007). Global cost-benefit analysis of water supply and sanitation interventions. Journal of water and health, 5(4), 481–502. https://doi.org/10.2166/wh.2007.009external icon