2026-03-19 Water Access and Sanitation: A Human Right
Water Access and Sanitation: A Human Right
A mother in rural sub-Saharan Africa walks three hours each morning to collect water from a muddy river, carrying it home on her head in a plastic jerry can. That water will be used for drinking, cooking, and bathing by her entire family. A few thousand miles away, a family in Flint, Michigan opens their tap and watches brown water flow out, knowing it may contain lead levels far exceeding safety thresholds. A child in Bangladesh pumps water from a tube well contaminated with naturally occurring arsenic, unaware of the slow poisoning that will damage organs over years of exposure. These stories are separated by geography and circumstance, but they share a common thread: the failure to guarantee the most basic of human needs. At the Rissover Foundation, we believe that clean water and safe sanitation are non-negotiable foundations of human dignity, and we support the organizations, technologies, and policies working to make universal water access a reality rather than a distant aspiration.
The Global Water Crisis
The scale of the global water crisis is staggering. Billions of people lack access to safely managed drinking water services, meaning water that is accessible on premises, available when needed, and free from contamination. Billions more lack access to safely managed sanitation services. These numbers represent not abstract statistics but daily realities of suffering, disease, lost productivity, and diminished human potential.
The crisis is not primarily one of absolute scarcity. The planet holds more than enough fresh water to meet the needs of every person. The problem is one of distribution, infrastructure, governance, and political will. Water is unevenly distributed across regions and seasons. Infrastructure to capture, treat, store, and deliver water is absent or deteriorating in many communities. Governance systems that should protect water resources and ensure equitable access often fail due to corruption, underinvestment, or neglect. And the political will to prioritize water and sanitation over competing demands is too often lacking, particularly when those most affected by water insecurity are communities with the least political power.
Climate change is intensifying the crisis by altering precipitation patterns, increasing the frequency and severity of droughts and floods, melting glaciers that supply water to millions, and raising temperatures that increase evaporation and water demand. Regions that already face water stress are projected to experience even greater challenges in the coming decades, while areas previously considered water-secure are discovering new vulnerabilities.
Population growth and urbanization compound these pressures. Cities in the developing world are expanding at rates that far outpace the development of water and sanitation infrastructure, creating sprawling informal settlements where millions of people live without piped water or sewage systems. Agriculture, which consumes roughly seventy percent of global freshwater withdrawals, faces growing pressure to produce more food with less water as populations grow and diets shift.
The economic costs of the water crisis are enormous. Lost productivity due to water collection time, waterborne illness, and inadequate sanitation costs the global economy hundreds of billions of dollars annually. Investments in water and sanitation infrastructure, by contrast, generate substantial economic returns through improved health, increased productivity, and reduced healthcare costs. Every dollar invested in water and sanitation generates multiple dollars in economic returns, making these investments among the most cost-effective development interventions available.
Waterborne Diseases and Public Health
The health consequences of inadequate water and sanitation are devastating. Waterborne diseases, including cholera, typhoid, dysentery, hepatitis A, and parasitic infections, sicken hundreds of millions of people each year and kill hundreds of thousands, with young children bearing the heaviest burden. Diarrheal disease alone remains one of the leading causes of death in children under five worldwide, a tragedy made more unconscionable by the fact that most of these deaths are entirely preventable with access to clean water, basic sanitation, and simple hygiene practices.
Beyond acute illness, chronic exposure to contaminated water causes lasting damage to health and development. Children who experience repeated bouts of diarrheal disease suffer from malnutrition and stunted growth, as their bodies cannot absorb nutrients from food while fighting infection. This cycle of infection and malnutrition impairs cognitive development, reducing educational achievement and lifetime earning potential. The effects ripple across generations, as malnourished children grow into adults with diminished capacity to provide for their own families.
Water contaminated with chemical pollutants poses distinct health threats. Arsenic contamination affects tens of millions of people, particularly in South Asia, causing skin lesions, cardiovascular disease, and cancer with prolonged exposure. Fluoride contamination, common in parts of Africa and Asia, causes skeletal and dental fluorosis. Agricultural runoff introduces pesticides, herbicides, and excess nutrients into water supplies, creating health risks that are often poorly understood and inadequately monitored.
Women and girls face particular health risks related to water and sanitation insecurity. The lack of private, safe sanitation facilities exposes women and girls to risks of harassment and violence when they must relieve themselves outdoors or in shared facilities. Inadequate menstrual hygiene management, driven by lack of water, privacy, and sanitation facilities, causes girls to miss school and women to miss work, reinforcing gender inequalities that extend far beyond the immediate issue of sanitation access.
Sanitation Infrastructure and Its Importance
Sanitation infrastructure, including toilets, sewage systems, and wastewater treatment facilities, is fundamental to public health yet remains woefully inadequate in much of the world. Open defecation, still practiced by hundreds of millions of people who lack access to any form of toilet, contaminates water sources, spreads disease, and degrades human dignity. Eliminating open defecation is one of the most important public health interventions available.
The challenge of building sanitation infrastructure in low-income communities is immense. Conventional sewage systems require massive capital investment, reliable water supply for flushing, and ongoing maintenance capacity that may be beyond the reach of many communities. These systems are also poorly suited to informal settlements with narrow, unpaved streets and houses built on terrain that makes underground pipe installation difficult or impossible.
Innovative sanitation technologies are emerging to address these challenges. Container-based sanitation systems provide hygienic toilets that do not require water or sewer connections, with regular collection and treatment of waste by service providers. Decentralized wastewater treatment systems serve neighborhoods or small communities without requiring connection to centralized treatment plants. Composting toilets and biodigesters transform human waste into valuable fertilizer and biogas, turning a sanitation challenge into a resource recovery opportunity.
Behavior change is as important as infrastructure in achieving sanitation goals. Programs that combine toilet construction with community engagement and hygiene education achieve better outcomes than those focused solely on building facilities. The Community-Led Total Sanitation approach, which mobilizes communities to analyze their own sanitation conditions and develop collective solutions, has achieved remarkable success in triggering the elimination of open defecation in thousands of communities across Asia and Africa.
Maintenance and sustainability of sanitation systems are critical challenges that are often overlooked in the rush to build new facilities. Toilets that fall into disrepair, sewage systems that overflow due to lack of maintenance, and treatment plants that operate below capacity due to insufficient funding or technical support all undermine the health benefits that sanitation infrastructure is intended to provide. Sustainable sanitation requires not just construction but ongoing investment in operations, maintenance, and institutional capacity.
Community Water Systems
Community-managed water systems provide drinking water to millions of people in rural and small-town settings around the world. These systems, which range from protected wells and spring boxes to small piped networks with treatment facilities, are often the most practical and affordable way to deliver safe water in areas where centralized utility service is not feasible.
The success of community water systems depends on effective local governance, adequate financial resources for operation and maintenance, and technical capacity to manage the system. Water committees or water user associations typically oversee these systems, making decisions about tariffs, maintenance schedules, and system expansion. When these governance structures function well, community water systems can provide reliable, affordable water service for decades.
However, many community water systems struggle with sustainability challenges. Studies have found that a significant percentage of rural water points in developing countries are non-functional at any given time, often due to mechanical failure, lack of spare parts, or insufficient funds for repairs. Addressing these sustainability challenges requires strengthening local governance capacity, establishing reliable supply chains for spare parts and maintenance services, and ensuring that tariff structures generate sufficient revenue to cover operating costs.
Groundwater is the primary water source for most community water systems and for billions of people worldwide who obtain water from wells and boreholes. Protecting groundwater quality and managing aquifer resources sustainably are essential for long-term water security. Over-extraction of groundwater, which is occurring in many regions, lowers water tables, increases pumping costs, causes land subsidence, and can lead to saltwater intrusion in coastal areas. Sustainable groundwater management requires monitoring, regulation, and community engagement to balance current use with long-term resource conservation.
Rainwater harvesting systems capture and store precipitation for household and community use. These systems are particularly valuable in areas with distinct wet and dry seasons, where they can provide water during dry periods when other sources may be insufficient. Simple rooftop collection systems with storage tanks can be built and maintained at relatively low cost, making rainwater harvesting an accessible technology for many communities.
Water Affordability and Access in Wealthy Nations
The water crisis is not limited to developing countries. Within wealthy nations, millions of people struggle with water affordability, aging infrastructure, and contamination issues that disproportionately affect low-income communities and communities of color. The assumption that water access is a solved problem in developed countries obscures significant disparities that demand attention.
Water affordability has become a growing concern as utilities raise rates to fund infrastructure replacement and regulatory compliance. For low-income households, water bills can consume a significant percentage of household income, forcing difficult choices between water, food, housing, and other necessities. Water shutoffs for nonpayment affect hundreds of thousands of households annually in the United States alone, creating public health risks that extend beyond the affected families to entire communities.
Rate assistance programs, lifeline rates that provide a basic amount of water at reduced cost, and percentage-of-income payment plans are among the tools available to address water affordability. Some municipalities have implemented moratoriums on water shutoffs, recognizing that disconnecting households from water service creates health hazards and imposes costs on the community that exceed the unpaid bills. Federal assistance programs exist but are often underfunded relative to the scale of need.
Aging water infrastructure in developed countries poses risks to both water quality and system reliability. Many cities in the United States and Europe rely on water mains, treatment plants, and distribution systems that are decades or even a century old. These aging systems are prone to breaks, leaks, and contamination events that compromise water quality and waste treated water. The investment needed to replace and upgrade this infrastructure runs into the trillions of dollars, a cost that must be shared across levels of government and borne over decades of sustained investment.
Rural communities in wealthy nations face their own water access challenges. Small water systems serving rural populations often lack the financial resources, technical expertise, and regulatory oversight needed to ensure safe, reliable service. Private wells, which serve millions of rural households, are generally not subject to the same testing and treatment requirements as public water systems, leaving homeowners responsible for monitoring and addressing contamination on their own.
Lead Contamination and Environmental Justice
The lead contamination crisis in Flint, Michigan brought national attention to a problem that extends far beyond a single city. Lead service lines, the pipes connecting water mains to individual buildings, remain in use in millions of homes across the United States, posing ongoing risks of lead exposure that are particularly dangerous for young children. Lead is a potent neurotoxin with no safe level of exposure, and childhood lead exposure causes irreversible damage to brain development, resulting in reduced IQ, behavioral problems, and diminished lifetime achievement.
The distribution of lead contamination risk follows the contours of racial and economic inequality. Older housing stock, which is more likely to contain lead service lines, lead solder, and lead paint, is disproportionately located in low-income neighborhoods and communities of color. These communities often lack the political power and financial resources to demand and fund infrastructure replacement, leaving residents exposed to lead risks that wealthier communities addressed years ago.
Federal programs to replace lead service lines have expanded significantly in recent years, but the scale of the problem is enormous and the pace of replacement remains slow. Millions of lead service lines remain in use, and full replacement will require sustained investment over many years. In the interim, corrosion control treatment, point-of-use filters, and public education about lead risks can reduce exposure, but these are interim measures rather than permanent solutions.
Environmental justice considerations extend beyond lead to encompass the full range of water quality challenges that disproportionately affect marginalized communities. Industrial contamination, agricultural runoff, inadequate wastewater treatment, and legacy pollution from defunct facilities concentrate in communities that lack the resources and political influence to demand remediation. Addressing these disparities requires not just technical solutions but fundamental changes in how environmental protection decisions are made and how the costs and benefits of water infrastructure investments are distributed.
WASH Programs and International Development
Water, Sanitation, and Hygiene programs, commonly known as WASH, form a cornerstone of international development efforts aimed at improving health, reducing poverty, and promoting dignity in low-income countries. Effective WASH programs recognize that water supply, sanitation, and hygiene behavior are interconnected and must be addressed together for maximum impact.
WASH programs have evolved significantly over the decades, moving away from top-down infrastructure projects toward participatory approaches that engage communities in planning, implementing, and maintaining their own water and sanitation systems. This shift reflects hard lessons learned from projects that built infrastructure without community ownership, resulting in systems that fell into disrepair shortly after donor funding ended.
School-based WASH programs have proven particularly effective in promoting health and education outcomes. When schools have clean water, functioning toilets with privacy, and handwashing facilities, student attendance improves, particularly among girls. Menstrual hygiene management programs that provide education, supplies, and private facilities enable girls to attend school during menstruation, reducing a significant barrier to educational achievement.
Healthcare facility WASH is a critical but often overlooked component of health system strengthening. Hospitals and clinics that lack clean water, adequate sanitation, and waste management systems pose risks to patients and healthcare workers alike. Infections acquired in healthcare facilities, many of which are preventable with adequate water and hygiene, cause significant morbidity and mortality, particularly in maternity and neonatal care settings.
Emergency WASH response provides water, sanitation, and hygiene services in humanitarian crises including natural disasters, conflicts, and disease outbreaks. Rapid deployment of water treatment systems, emergency latrines, and hygiene supplies can prevent the disease outbreaks that often follow population displacement and infrastructure destruction. Building community and institutional capacity for emergency WASH response before crises occur improves the speed and effectiveness of humanitarian interventions.
Handwashing and Hygiene Education
Handwashing with soap at critical moments, particularly after using the toilet and before handling food, is one of the most effective and cost-efficient public health interventions known. Proper handwashing can reduce diarrheal disease incidence by up to forty percent and respiratory infections by nearly a quarter. Yet despite its simplicity and effectiveness, consistent handwashing practice remains far from universal.
Hygiene education programs that promote handwashing behavior change have been shown to produce lasting improvements in health outcomes when they are well-designed and sustained. The most effective programs go beyond simply telling people to wash their hands. They use behavior change techniques including social marketing, peer education, environmental nudges such as conveniently located handwashing stations, and emotional appeals that link handwashing to nurturing and protecting children.
School-based hygiene education reaches children at an age when health habits are being formed, and children often serve as change agents who carry hygiene messages home to their families. Programs that combine education with the provision of handwashing facilities and soap in schools create environments where healthy behavior is both taught and practiced, reinforcing habit formation through daily repetition.
Community health workers play a vital role in promoting hygiene practices at the household level. These trusted local health providers conduct home visits, demonstrate proper handwashing technique, explain the connections between hygiene and health, and support families in adopting improved practices. Community health workers are particularly effective because they speak local languages, understand cultural contexts, and maintain ongoing relationships with the families they serve.
The global experience with handwashing promotion during the COVID-19 pandemic demonstrated both the potential and the limitations of hygiene behavior change. Handwashing frequency increased dramatically worldwide in response to public health messaging, demonstrating that behavior change is possible at scale when motivation is high and infrastructure is available. However, the pandemic also exposed the reality that billions of people lack access to basic handwashing facilities, making compliance with hygiene recommendations impossible regardless of motivation.
Technology Innovations in Water and Sanitation
Technological innovation is expanding the toolkit available for addressing water and sanitation challenges. Advanced water treatment technologies, including membrane filtration, ultraviolet disinfection, and electrochemical treatment, are becoming more affordable and compact, enabling deployment in settings where conventional treatment plants would be impractical.
Solar-powered water purification systems provide off-grid water treatment using renewable energy, making clean water accessible in remote locations without reliable electricity supply. These systems range from small household units to community-scale installations that can serve hundreds of people. Declining solar panel costs have made these systems increasingly cost-competitive with alternatives that rely on fossil fuels or grid electricity.
Sensor technology and the Internet of Things are enabling real-time monitoring of water quality, system performance, and usage patterns in community water systems. Remote monitoring allows maintenance teams to detect problems early, optimize operations, and respond quickly to contamination events or system failures. Data analytics applied to monitoring data can predict when equipment is likely to fail, enabling preventive maintenance that reduces downtime and extends system life.
Desalination technology, which removes salt from seawater or brackish water to produce fresh water, has advanced significantly in recent years. Reverse osmosis desalination, the dominant technology, has become more energy-efficient and cost-effective, making it a viable option for coastal communities facing freshwater scarcity. However, desalination remains energy-intensive and produces brine waste that must be managed carefully to avoid environmental damage, limiting its applicability as a universal solution.
Mobile technology and digital payment systems are transforming how water services are delivered and paid for in developing countries. Prepaid water dispensers that accept mobile payments enable utilities to recover costs while providing affordable water access. Water ATMs and smart meters allow pay-as-you-go pricing that is accessible to low-income users while generating revenue for system operation and maintenance. Data from these digital systems provides valuable information for service planning and improvement.
Wastewater recycling and reuse technologies recover valuable water from sewage and industrial effluent, transforming waste streams into water resources. Treated wastewater can be used for irrigation, industrial processes, and even drinking water after advanced treatment. As freshwater resources come under increasing pressure, water reuse will become an increasingly important component of sustainable water management in both developed and developing countries.
Community Advocacy and the Right to Water
The recognition of water and sanitation as human rights by the United Nations General Assembly in 2010 established an important normative framework, but translating that recognition into enforceable rights at the national and local level requires sustained advocacy and legal action. Communities around the world are organizing to demand their right to clean water and hold governments and corporations accountable for failures to protect water resources and ensure equitable access.
Grassroots water justice movements have achieved significant victories in recent years. Communities affected by industrial contamination have won legal settlements and regulatory enforcement actions. Coalitions of residents and advocacy organizations have blocked water privatization schemes that threatened to raise costs and reduce access for low-income households. Indigenous communities have asserted water rights rooted in treaties and traditional law, winning court rulings that recognize their sovereign authority over water resources within their territories.
Youth-led water advocacy is a growing force. Young people who have grown up with awareness of the water crisis are organizing campaigns, conducting community water testing, and pressuring elected officials to invest in water infrastructure. These young advocates bring energy, creativity, and a sense of urgency that complements the sustained work of established water organizations.
Faith communities are increasingly engaged in water advocacy, drawing on the moral and spiritual significance of water in religious traditions to mobilize support for water justice. Interfaith water coalitions bring together diverse religious communities around a shared commitment to ensuring that all people have access to the water they need to live with health and dignity.
The Path Forward
Achieving universal access to clean water and adequate sanitation requires sustained commitment, increased investment, and coordinated action across sectors and scales. The United Nations Sustainable Development Goals include targets for universal access to safe drinking water and sanitation by 2030, but progress toward these targets has been insufficient, and acceleration is urgently needed.
Financing the water and sanitation gap requires mobilizing resources from multiple sources, including national government budgets, international development assistance, private sector investment, and innovative financing mechanisms such as green bonds and blended finance structures. Current spending on water and sanitation falls far short of what is needed, and closing the gap will require both increased funding and more effective use of existing resources.
Strengthening water governance at all levels is essential for ensuring that water resources are managed sustainably and equitably. This includes strengthening regulatory institutions, improving transparency and accountability in water management decisions, ensuring meaningful participation of affected communities in planning and oversight, and addressing the power imbalances that allow some communities to monopolize water resources at the expense of others.
Climate adaptation must be integrated into water and sanitation planning. Infrastructure designed for historical climate conditions may be inadequate for the droughts, floods, and temperature extremes that climate change is bringing. Building climate-resilient water systems requires investing in diversified water sources, redundant infrastructure, nature-based solutions such as watershed protection, and adaptive management approaches that can respond to changing conditions.
The Rissover Foundation supports efforts to advance water access and sanitation as fundamental human rights, investing in organizations that build sustainable water systems, promote hygiene behavior change, advance innovative technologies, and advocate for the policy and funding commitments needed to close the water and sanitation gap. We recognize that water is not merely a resource to be managed but the foundation upon which health, dignity, education, and economic opportunity are built.
The water crisis is ultimately a crisis of priorities. The knowledge, technology, and financial resources needed to provide clean water and safe sanitation to every person on the planet exist today. What has been lacking is the collective will to treat water access as the non-negotiable human right that it is and to invest accordingly. When communities have clean water, children survive and thrive. When families have safe sanitation, disease retreats and dignity advances. When schools have functioning WASH facilities, girls stay in school and futures open. The path forward is clear. What remains is the commitment to walk it, together, until every person in every community can turn on a tap and drink without fear.
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