Access to safe water, sanitation, and hygiene services plays an important role in protecting the health, security, resilience, and economic potential of individuals and communities around the world. The lack of WASH is not just a symptom of poverty, it is a driver of poverty and loss of life.
WASH efforts have the potential to prevent 6.3% of annual deaths worldwide and 9.1% of the global disease burden,  yet 785 million people still lack access to basic drinking water services, and 2 billion don’t have a toilet. Additionally, two in five schools in the world lack access to basic hand-washing facilities with soap and water  and 45% of healthcare facilities in low- and middle-income countries lack basic water services. This lack of access places lives and livelihoods at risk for disease, curtails the ability of people and communities to meet the most basic needs for advancement and opportunity, and deepens inequity.
WASH is one of the first lines of defense in slowing the spread of most infectious disease outbreaks such as the flu, diarrhea, coronaviruses, and Ebola, as well as protecting communities, patients, and health workers over the long-term.
Health and development efforts are more effective and sustainable over the long term if they address WASH, as WASH is a key to maternal and child health, HIV/AIDS, neglected tropical diseases, food and nutrition security, and other global health security issues.
Ensure that funding for WASH programming is increased, and integrate WASH financing across multiple development sectors. Congress should provide robust funding for Development Assistance and Economic Support Funds accounts, both of which fund the U.S. Agency for International Development water and sanitation programs, and support and leverage the integration of WASH in global health programs and global health responses in emergencies and humanitarian crises. In addition, Congress should support vital Centers for Disease Control and Prevention work done to increase the global capacity for preventing and responding to water-related health risks.
Support initiatives and measures that include measurable WASH goals for success. This includes legislation on maternal and child health, food and nutrition security, outbreak and humanitarian disaster response, climate resilience, global health security, primary health care, and health systems strengthening.
Improve aid effectiveness by supporting the integration of WASH components within development and humanitarian programming, conducting oversight, and leveraging the work done under the Senator Paul Simon Water for the World Act, which coordinates WASH goals across government agencies and links indicators to positive health outcomes. Give increased attention to the needs of women and girls, the disabled and other marginalized communities, who are disproportionately affected by lack of WASH.
Photo Credit: WaterAid, Dennis Lupenga
Photo Credit: WaterAid, Sam James
The U.S. government and Congress have shown bipartisan leadership in the effort to improve safe WASH access globally. U.S. investments in WASH provide access to these basic services for millions and help to reduce morbidity and mortality from WASH-related illness and other infections across Africa, Asia, and Latin America. Since 2008, WASH programs at USAID have led to 53.7 million people gaining access to improved drinking water services and 38 million people gaining access to an improved sanitation service. These investments also build water management practices that lead to stability, self-reliance, and economic growth and prosperity.
The Water for the World Act of 2014 requires USAID and the Department of State to release a whole-of-government global water strategy, which focuses on decreased mortality and morbidity linked to lack of WASH and strengthened ties to the health goals of other government initiatives, such as the Feed the Future initiative, programing around nutrition, and integration within the Global Health Security Agenda.
The health, development, and economic gains made possible by coordinated WASH efforts can be tremendous. Increased WASH support contributes to the achievement of other U.S. global health priorities. Scaling up woman- and girl-friendly WASH facilities in communities and expanding menstrual health and hygiene programming supports women’s health and efforts to promote gender equality. U.S. investments can mean that children and vulnerable populations no longer get sick or die from dirty water or poor sanitation, fewer days of work and school are missed, income and productivity levels increase, gender equality is advanced, and accrued household savings can benefit the health and education of entire families.
COVID-19 emphasizes the critical role of WASH for global health security, pandemic response and recovery, including infection prevention and control. Hand hygiene, safe sanitation and WASH within healthcare facilities and communities are some of the most important lines of defense against COVID-19. However, access to basic hand-washing facilities and supplies remains a challenge. The pandemic has shown the disparity in sanitation facilities for female health workers on the frontlines and it continues to place extraordinary strain on households and the solvency of utility companies and the inputs they rely on, such as soap and chlorine. Areas of high transmission continue to affect health care supply chains for soap, alcohol-based hand rubs, and cleaning supplies. While the world waits for the manufacturing and distribution of a vaccine, WASH is the main way in which we can curb the spread of COVID-19.
 “Global WASH Facts,” CDC. https://www.cdc.gov/healthywater/global/wash_statistics.html
 “Progress on Household Drinking Water, Sanitation and Hygiene 2000-2017: A Focus on Inequalities,” WHO, 2019. https://www.who.int/water_sanitation_health/publications/jmp-report-2019/en/
 “Progress on Drinking Water, Sanitation and Hygiene in Schools: Special Focus on COVID-19,” WHO and UNICEF, 2020. https://washdata.org/sites/default/files/2020-09/JMP-2020-WASH-schools.pdf
 “WASH in Healthcare Facilities,” WHO and UNICEF, 2019. https://washdata.org/sites/default/files/documents/reports/2019-05/jmp-2019-wash-hcf-highlights-1.pdf
 “Global Water and Development: Report of Water and Sanitation Activities, FY 2018/2019” USAID, 2020. https://www.globalwaters.org/sites/default/files/gwd_report_fy_2018-2019_final.pdf
HEADER PHOTO CREDIT: WaterAid, Jordi Ruiz Cirera