WASH stands for Water, Sanitation and Hygiene — the three interconnected elements of environmental health that most powerfully determine infectious disease burden. Safe water prevents waterborne diseases (cholera, typhoid, hepatitis A). Adequate sanitation prevents faecal-oral disease transmission. Handwashing with soap breaks transmission chains. Together, they underpin child survival, school attendance, gender equity and dignity.

How many people lack access to safe water?

WHO/UNICEF JMP 2023 data: 2 billion people lack access to safely managed drinking water; 3.6 billion lack safely managed sanitation; 2.3 billion lack basic handwashing facilities with soap. The gap is widest in Sub-Saharan Africa (730 million without safely managed water) and South Asia (440 million). Progress is being made but is far too slow for SDG 6.

What diseases does unsafe WASH cause?

Unsafe WASH is linked to: diarrhoeal diseases (the second leading infectious killer of children — prevented by 48% with safe water and 47% with handwashing); cholera (prevented by safe water and sanitation); typhoid fever (prevented by safe water); hepatitis A (faecal-oral, prevented by sanitation); schistosomiasis (contact with contaminated water); soil-transmitted helminths (from open defecation); and trachoma (faecal-oral, prevented by face washing).

What is the SDG 6 target?

SDG 6 targets universal access to safely managed drinking water and sanitation by 2030. "Safely managed" means on premises, available when needed, and free from contamination (water) or safely disposed of (sanitation). At current rates of progress, 1.6 billion people will still lack safely managed water by 2030 and 2.8 billion safely managed sanitation — requiring a 6-fold acceleration. WASH financing is chronically underfunded, particularly in the lowest-income countries.

Why is handwashing so effective?

Handwashing with soap removes pathogens mechanically and chemically — reducing diarrhoeal disease by 47%, respiratory infections by 23% and COVID-19 transmission substantially. It costs almost nothing and requires only soap and water. Yet 2.3 billion people lack basic handwashing facilities and 3 billion lack soap at home. School handwashing programmes, healthcare worker hand hygiene and community behaviour change campaigns are evidence-based interventions.

What is open defecation and how is it ended?

Open defecation — practising outside latrines or toilets — affects approximately 400 million people globally, primarily in rural South Asia and Sub-Saharan Africa. It contaminates soil and water, spreads faecal-oral diseases and is undignified and unsafe (particularly for women and girls at risk of violence). Community-Led Total Sanitation (CLTS) — a participatory approach triggering community-wide behaviour change — has achieved Open Defecation Free (ODF) status in thousands of communities, particularly in South and Southeast Asia.

What is WASH in health facilities?

Approximately 30% of health facilities globally lack basic water services on site — meaning healthcare workers cannot wash their hands and patients cannot be provided basic hygiene. 39% of facilities lack adequate sanitation. Poor WASH in health facilities contributes to healthcare-associated infections, unsafe childbirth, and deters people (especially women) from seeking care. WHO and UNICEF's "WASH in HCF" programme targets universal water and sanitation in health facilities by 2030.

How does WASH relate to gender?

WASH has profound gender dimensions: women and girls disproportionately bear the burden of water collection (global average 40 minutes per trip; up to 6 hours in some areas), depriving them of education and economic opportunity. Lack of sanitation at schools — particularly absence of separate, private toilets for girls — drives girls to drop out at puberty. Violence against women is associated with unsafe sanitation. WASH investments have among the highest returns for gender equity of any development intervention.

How does climate change threaten WASH?

Climate change degrades WASH access through: flooding (contaminating water sources and destroying sanitation infrastructure); drought (reducing available water); sea level rise (salinising coastal water supplies); and extreme temperatures (increasing water demand while reducing supply). Climate-resilient WASH infrastructure — elevated water points, improved drainage, climate-adaptive water management — is a core adaptation priority for vulnerable communities.

What is the WHO/UNICEF JMP?

The Joint Monitoring Programme (JMP) for Water Supply, Sanitation and Hygiene is the official UN mechanism for tracking WASH access globally — producing annual updates from national household surveys across 200+ countries. JMP introduced the "safely managed" service level tracking (adopted 2015 for SDG 6 monitoring), providing far more granular data than previous "improved" metrics. JMP reports are the global reference for WASH progress toward SDG 6.

How does Georgia's WASH situation compare?

Georgia has good urban water coverage but persistent rural water quality challenges, particularly in remote mountain communities. Agricultural water use, irrigation infrastructure and seasonal variation affect water safety in some regions. PHIG supports WASH integration into health system planning as part of its One Health approach.

How does GMJ News cover WASH?

GMJ News covers WHO/UNICEF JMP data, SDG 6 progress, WASH in health facilities, climate resilience and the diarrhoea-WASH nexus. WASH is a direct public health priority for PHIG and a recurring theme in the Georgian Medical Journal's environmental and child health coverage.

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Water, Sanitation and Hygiene

GMJ News knowledge hub · last reviewed September 2026 · Georgian Medical Journal

Summary Statistics Glossary GMJ news FAQ Documents Organizations Research

Access to safe water, sanitation and hygiene (WASH) is a fundamental human right and the most impactful public health intervention for preventing infectious disease: 2 billion people still lack access to safely managed drinking water and 3.6 billion lack safely managed sanitation (WHO/UNICEF 2023). Unsafe WASH contributes to 1.7 million deaths per year — predominantly from diarrhoea, cholera, typhoid and schistosomiasis. SDG 6 targets universal WASH access by 2030; current progress is so far off-track that achieving it would require a 6-fold acceleration.

Key messages

A human right — widely denied

2 billion people lack access to safely managed drinking water; 3.6 billion lack safely managed sanitation; 2.3 billion lack basic handwashing facilities. WASH is a human right under UN Resolution 64/292 (2010), yet it remains out of reach for billions.

1.7 million deaths attributable to unsafe WASH

Unsafe WASH contributes to an estimated 1.7 million deaths per year — predominantly from diarrhoea, cholera, typhoid and hepatitis A in children, plus soil-transmitted helminths and schistosomiasis in all ages (WHO).

SDG 6 is severely off-track

SDG 6 targets universal safely managed WASH by 2030 — but current progress is so slow that achieving it would require a 6-fold acceleration. At current rates, 1.6 billion people will still lack safely managed drinking water by 2030.

Handwashing is the single best hygiene intervention

Handwashing with soap at key moments — after using the toilet and before eating — reduces diarrhoeal disease by 47% and respiratory infections by 23%. It is one of the most cost-effective public health interventions. Yet 3 billion people lack soap at home.

Climate change threatens WASH

Climate change is undermining WASH infrastructure: flooding contaminates water sources; droughts reduce water availability; extreme weather damages infrastructure. WASH resilience is a central climate adaptation priority.

WASH in health facilities

Approximately 3 in 10 health facilities globally lack basic water services on site — creating infection risks for patients and healthcare workers. Universal WASH in health facilities is a prerequisite for safe childbirth and surgical care.

Key statistics

without safely managed drinking water

WHO/UNICEF 2023

3.6B

without safely managed sanitation

WHO/UNICEF 2023

2.3B

without basic handwashing facilities

WHO/UNICEF 2023

1.7M

deaths/year from unsafe WASH

WHO

3 in 10

health facilities lack basic water

WHO/UNICEF WASH in HCF

acceleration needed to achieve SDG 6

WHO/UNICEF JMP

People without safely managed drinking water by WHO region (millions) — JMP 2023

Source: WHO/UNICEF Joint Monitoring Programme for Water Supply, Sanitation and Hygiene (JMP) 2023.

Glossary of key terms

JMP
WHO/UNICEFJoint Monitoring Programme for Water Supply, Sanitation and Hygiene — the UN system for global WASH monitoring, producing country-level data and global/regional estimates through household surveys.

Safely managed water
JMPDrinking water from an improved source located on premises, available when needed, and free from contamination. The SDG 6 standard — stricter than the previous "improved" water source metric.

Open defecation
WHO/UNICEFDisposing of human faeces in fields, forests or water bodies rather than a designated latrine or toilet. Still practised by approximately 400 million people, primarily in rural South Asia and Sub-Saharan Africa.

ODF (Open Defecation Free)
UNICEF/JMPA community where no one defecates in the open — achieved through community-led total sanitation (CLTS) approaches. ODF certification requires verification that all households use a sanitation facility.

WASH in health care facilities (HCF)
WHO/UNICEFWater, sanitation and hygiene in hospitals and clinics. 3 in 10 health facilities globally lack basic water services — creating infection risks for patients and healthcare workers. WHO targets universal WASH in HCF by 2030.

SDG 6
UNSustainable Development Goal 6: Ensure availability and sustainable management of water and sanitation for all. Target 6.1: universal safely managed drinking water; 6.2: universal safely managed sanitation and hygiene. Current progress is severely off-track.