A UNICEF-WHO Joint Monitoring Programme (JMP) report on drinking water and sanitation indicates that billions of people will lack access safely managed household drinking water, sanitation and hygiene services in 2030 unless the rate of progress towards meeting sustainable development goal (SDG) goal quadruples.

JMP is the only drinking water and sanitation monitoring mechanism that provides national, regional and global estimates allowing comparison between countries and over time.

The report ‘Progress on household drinking water, sanitation and hygiene 2000 – 2020’ presents estimates on household access to these over the past five years, and assesses global progress toward achieving the SDG-6 targets and indicators under targets 6.1 and 6.2 relating to drinking water, sanitation and hygiene (WASH). For the first time, the report also presents emerging national data on menstrual health.

Report findings

The report states that “five years into the SDGs, the world is not on track to achieve SDG targets 6.1 and 6.2. It estimates that by 2030 only 81% of the world’s population will have access to safe drinking water at home, leaving 1.6 billion without it. Only 67% of people will have safe sanitation services, while 2.8 billion people will be left out. Also, only 78% will have basic handwashing facilities, with 1.9 billion people left without access.

A disaggregated analysis of rural and urban suggests that 8 out of 10 people will be left without basic water services in rural areas. Safely managed sanitation services reached 62% of the world’s urban population, but only 44% of its rural population.

“Least developed countries (LDCs) have the furthest to go and it will be especially challenging to accelerate progress in fragile contexts,” the report says. It estimates that the progress towards SDGs needs to be of the order of 10x in the least developed countries and 23x in fragile contexts.

As regards drinking water, “the proportion of the global population using safely managed services increased from 70% to 74%, urban coverage increased from 85% to 86%, and rural coverage increased from 53% to 60%.” Coverage of basic hygiene services varied widely between countries in 2020 and in India the proportion of the population with basic hygiene services in 2020, stood at 68%.

Globally, in 2020, 16 countries are on track to reach universal access to safely managed services, and 34 countries are on track to reach universal access to at least basic drinking water between 2020 and 2030.

In low- and middle-income countries, data coverage has steadily progressed over the three SDG reports, with large increases in coverage at the regional level as populous countries such as India collected data for the first time.

India responsible for the largest drop in open defecation since 2015

India was among the countries with the greatest progress (15%) in increasing at least basic sanitation during 2015-2020, as per the report. It was responsible for the largest drop in open defecation since 2015, in terms of absolute numbers.

“Within India, open defecation has been highly variable regionally since at least 2006, when the third round of the National Family Health Survey found open defecation to be practised by less than 10% of the population in four states and the Union Territory of Delhi, but by more than half the population in 11 states. By 2016, when the fourth National Family Health Survey was conducted, open defecation had decreased in all states, with the largest drops seen in Himachal Pradesh and Haryana,” says the report.

The pace of reduction picked up after 2016, with open defecation dropping by 14% pts over the period of only five years (2015 to 2020).

At a global level the report states that “in 2020, for the first time, more people used improved on-site sanitation, such as pit latrines and septic tanks, which can effectively contain and treat waste, rather than sewer connections. There is a need for governments to ensure adequate support for safely managed on-site sanitation, including faecal sludge management.”

*The fall in proportion of population practicing open defecation during the period 2006 to 2016*

Progress reported, though not enough

The report notes some progress towards achieving universal access to basic water, sanitation and hygiene (WASH) services globally. Between 2016 and 2020, the global population with safely managed drinking water at home increased from 70% to 74%; safely managed sanitation services grew from 47% to 54%; and handwashing facilities with soap and water increased from 67% to 71%.

Menstrual health

SDG target 6.2 calls for ‘special attention to the needs of women and girls’ and hence WASH programmes are increasingly monitoring menstrual health related needs.

Emerging data show in many countries a significant proportion of women and girls do not have the services they need for menstrual health and there are often substantial disparities between population sub-groups, particularly between sub-national regions and for women and girls with and without disabilities. India was among the 42 countries that in 2020 had nationally representative data at least one of the four menstrual health indicators.

Hand hygiene in times of COVID-19

COVID-19 has highlighted the urgent need for access to good hand hygiene. Latest estimates reveal that 3 in 10 people worldwide could not wash their hands with soap and water at home during the COVID-19 pandemic.

“Handwashing is one of the most effective ways to prevent the spread of COVID-19 and other infectious diseases, yet millions of people across the world lack access to a reliable, safe supply of water,” says the report.

71% of the global population had basiIndic handwashing facilities with soap and water at home. 2.3 billion people lacked basic services, including 670 million people with no handwashing facilities at all. Over half of these people (374 million) live in fragile contexts.

In 16 countries, the gap in basic hygiene coverage between urban and rural areas was more than 20% pts and in 12 countries, the gap between highest and lowest subnational region was more than 50% pts.

Investment in WASH a global priority

Accelerating WASH coverage will require prioritization at the highest levels of decision making by international agencies, governments, civil society and the private sector. “Investment in water, sanitation and hygiene must be a global priority if we are to end this pandemic and build more resilient health systems,” as per the report.

For this to happen, WASH must be a regular fixture on the agenda at high-level political meetings to ensure member states keep track of progress. This is important in the context of the forthcoming mid-term review of the Water Action Decade in 2023 – the first UN conference on water and sanitation in almost 50 years, says the report.

The report also notes vast inequalities with vulnerable children and families suffering the most. “Even before the pandemic, millions of children and families were suffering without clean water, safe sanitation, and a place to wash their hands,” said UNICEF Executive Director Henrietta Fore.

“Despite our impressive progress to date to scale-up these lifesaving services, the alarming and growing needs continue to outstrip our ability to respond. The time has come to dramatically accelerate our efforts to provide every child and family with the most basic needs for their health and well-being, including fighting off infectious diseases like COVID-19,” as per the report.