The strategy "WHO water, sanitation, hygiene and waste strategy 2026–2035" sets WHO's direction for using water, sanitation, hygiene and waste management to improve health, strengthen health systems and increase resilience over the next decade. It responds to persistent global WASH inequalities alongside growing pressures from climate change, outbreaks, conflict, migration and constrained development financing. The strategy organizes WHO's work around three strategic results areas: evidence-based norms and regulation, stronger monitoring and data systems, and integration of WASH within health programmes and health systems. It also mainstreams climate resilience, One Health, antimicrobial resistance, gender equality, disability inclusion, menstrual health, migration and displacement.
Key Insights
Unsafe water, sanitation and hygiene continue to contribute to at least 1.4 million preventable deaths every year.
Globally, 2.1 billion people still lack safely managed drinking-water services, including 106 million people who drink directly from untreated surface water sources.
About 3.4 billion people lack safely managed sanitation, including 354 million people who continue to practise open defecation.
WASH deficiencies remain significant within health care facilities: in 2023, 1.1 billion people were served by facilities lacking basic water services, 3 billion lacked basic sanitation services, 1.7 billion lacked basic hygiene services and 2.8 billion were served by facilities without basic waste services.
The strategy is structured around three strategic results areas: norms, risk management and regulation; monitoring and evidence for decision-making; and integration of WASH into health programmes and health systems.
Climate resilience is embedded across WHO's WASH work, including water and sanitation safety planning, health facility improvement tools, monitoring indicators, National Adaptation Plans and Nationally Determined Contributions.
WHO plans to move WASH monitoring beyond access alone by incorporating service resilience, climate risks, inequalities, gender and menstrual health into the WHO/UNICEF Joint Monitoring Programme and GLAAS systems.
WHO positions WASH as essential public-health infrastructure for primary health care, infection prevention and control, antimicrobial resistance, emergency preparedness, cholera control, neglected tropical diseases and One Health.
The strategy aims for all countries to have updated standards, routine monitoring, sufficient financing and inclusive plans for water, sanitation, hygiene, waste and reliable electricity in health care facilities.
The WHO/UNICEF WASH FIT tool is already being used in more than 71 countries to support risk-based and incremental improvements in health care facilities.
WHO estimates that scaling up WASH globally could save more than 9 million lives by 2075, generate a net economic benefit of US$32.7 trillion and return more than US$19 for every US$1 invested.
Benefit-cost ratios cited in the strategy are approximately 11:1 for improved drinking water, 17.6:1 for improved sanitation and as high as 86:1 for hand hygiene under some scenarios.
The strategy emphasizes stronger wastewater and environmental surveillance as a public-health intelligence tool for outbreak detection, pandemic preparedness and monitoring pathogens including those associated with antimicrobial resistance.
WHO's future WASH approach prioritizes systems strengthening over fragmented projects, with greater emphasis on regulation, national institutions, resilient financing, data-driven investment and coordinated action across health, water, environment, climate and finance sectors.
