Polski
Business and economics, Issue 7/2026
Is Water a Health Hazard? New WHO Strategy Aims to Support the Development of WASH Services
Aug
Unsafe water, a lack of adequate sanitation, and poor hygiene practices contribute to at least 1.4 million deaths annually. The World Health Organization has developed a strategy for the development of WASH services for 2026–2035 to minimize the enormous social costs resulting from a lack of access to clean water and sanitation. What direction are things heading?
Things are improving, but the situation is still far from ideal
The WHO Strategy on Water, Sanitation, Hygiene, and Waste Management for 2026–2035 summarizes the current global water situation, highlighting the dire living conditions in many parts of the world. Despite the progress made since 2015, 1 in 4 people worldwide still lack access to safely managed drinking water resources. This group includes 106 million people who drink water from untreated surface sources.
Furthermore , 3.4 billion people still lack access to safely managed sanitation services, and 354 million continue to practice open defecation. Climate shocks, disease outbreaks, migration, and aging infrastructure place an additional burden on global public health, increasing the risk of the spread of waterborne diseases.
The World Is Sick Because of Water
The need to invest in WASH services (water, sanitation, and hygiene) is starkly underscored by the global resurgence of cholera, which has affected more than 30 countries over the past 5 years and prompted the WHO to declare a Level 3 public health emergency.
The number of malaria and dengue fever cases is also on the rise, a trend closely linked to the level of development of WASH services. Improper water storage, uncontrolled waste disposal, and inadequate sanitary conditions promote mosquito breeding and increase the risk of disease transmission.
Another problem is hospital-acquired infections—in 2023, approximately 1.1 billion people used healthcare facilities lacking basic access to water, and more than 130 million of them fell ill due to infections caused by antibiotic-resistant bacteria. In low- and middle-income countries, as many as 15 percent of hospital patients contract an infection at least once during their stay in a healthcare facility.
WHO Strategic Plan for 2026–2035
Summarizing these grim facts won’t change anything, so the World Health Organization is proposing an ambitious plan for the coming decade. The new strategy is based on three key areas:
- standards, risk management, and regulations that ensure safe practices from source to tap and throughout the entire water supply chain;
- monitoring and evidence to support decision-making, that is, creating a data backbone that will guide policies and investments;
- integration with health programs in the areas of primary health care, emergency response, and the control of priority diseases.
The specific operational objectives related to drinking water include, among other things, the development of risk assessments for priority issues, including per- and polyfluoroalkyl substances (PFAS), fluorine, and disinfection byproducts, as well as updating the performance targets for pathogen control.
In the context of sanitation services, however, attention is drawn to the need to develop joint epidemiological surveillance and pandemic preparedness, build climate-resilient infrastructure, and implement a flagship regulatory initiative: the update of the Guidelines on the Safe Use of Wastewater.
The Financial Aspect of WASH Development
Unfortunately, as the authors of the strategy acknowledge, the implementation of the planned actions may be hampered by financial instability. WHO’s WASH activities are largely dependent on voluntary contributions, and the number of donors has declined in recent years. It is worth recalling that the United States withdrew from the organization in January 2026.
The proposed WHO program budget for 2026–2027 is $4.2 billion, which represents a 21 percent decrease compared to the original proposal. Funding and staffing levels at the organization are currently at an all-time low.
Meanwhile, analysts emphasize that scaling up global WASH efforts could save more than 9 million lives by 2075, generate net economic benefits of $32.7 trillion, and provide a 19-fold return on every dollar invested.
The benefit-to-cost ratio in specific areas of action is as follows:
- 11:1 for improving access to safe drinking water;
- 17.6:1 for improved sanitation;
- as high as 86:1 for hand hygiene interventions.
Regional Challenges for the WHO
The WHO’s new strategy acknowledges the regional variations in water and sanitation shortages in the context of public health. The situation is most critical in Africa, which is entering the post-2025 programming period with significant gaps in access to safely managed WASH services and recurring cholera epidemics, exacerbated by climate shocks and weak governance systems. Diseases related to access to water, hygiene, and sanitation are also on the rise in Southeast Asia, and the risk is heightened by rapid urbanization and increasingly severe climate-related disasters.
Throughout the Americas, regional averages for access to WASH services mask deep inequalities in rural areas, among Indigenous communities, and in suburban areas, as well as disparities related to vulnerability to the effects of climate change and aging infrastructure. Paradoxically, these inequalities are also evident in Europe, where the overall level of access to WASH services is high, but in small supply systems, rural areas, and crisis situations, access to safe water can be difficult and poses a threat to public health.
In writing this article, I drew on:
WHO Water, Sanitation, Hygiene, and Waste Strategy 2026–2035. Geneva: World Health Organization; 2025. https://doi.org/10.2471/B09661
