Water and Sanitation: Why It’s Crucial for Health and Development

Access to clean water and proper sanitation seems like a basic expectation, yet millions of people still struggle to secure both. Behind every glass of safe drinking water and every functioning toilet lies decades of policy work, international agreements, and grassroots effort. Understanding water and sanitation is not just about pipes and pit latrines, it is about human dignity, public health, and the foundation on which development is built.

What do we mean by water and sanitation? 🔗

Water, in a public health context, refers to safe drinking water that is sufficient, accessible, and free from harmful contaminants. Sanitation covers the systems and behaviours used to manage human waste, wastewater, and hygiene, including toilets, sewerage networks, and handwashing practices. When experts and policymakers talk about WASH (Water, Sanitation, and Hygiene), they are referring to these three interlocking pillars that together determine community well-being.

The United Nations defines five key dimensions of the right to water: availability, accessibility, quality, affordability, and acceptability. Each dimension matters because a tap that runs dry, water that is contaminated, or a toilet that is too far away can each undermine health outcomes.

The global focus on water and sanitation 🔗

For most of history, water and sanitation were treated as local engineering problems. That changed in the late twentieth century when the world began to view them as urgent global priorities deserving coordinated action.

The International Drinking Water Supply and Sanitation Decade 🔗

The turning point came in 1977 at the United Nations Water Conference in Mar del Plata, Argentina. Delegates declared the period from 1981 to 1990 as the International Drinking Water Supply and Sanitation Decade (IDWSSD), with the ambitious goal of providing safe water and sanitation to everyone by 1990. The decade focused world attention on a quiet but devastating crisis: at the time, roughly 1.8 billion people lacked clean drinking water and 2.4 billion lacked basic sanitation.

The results, while imperfect, were significant. By the end of the decade, water access had been extended to over 1.2 billion people and sanitation to nearly 770 million. However, rapid population growth and urbanisation meant the gap was far from closed. The World Health Organization’s World Health Assembly Resolution WHA34.25 reinforced that safe drinking water and adequate sanitation were essential elements of primary health care, tying the decade firmly to the broader Health for All movement.

From the MDGs to the SDGs 🔗

The momentum carried into the Millennium Development Goals (MDGs), where Target 7.C aimed to halve, by 2015, the proportion of people without sustainable access to safe drinking water and basic sanitation. Today, the agenda has expanded under Sustainable Development Goal 6, which calls for universal and equitable access to safe and affordable drinking water and adequate sanitation for all by 2030.

Water as a human right 🔗

Recognising water as a human right was a slow but crucial evolution. For decades, water and sanitation were treated as services or commodities rather than entitlements. That framing changed dramatically with one landmark document.

General Comment No. 15 on the right to water 🔗

In November 2002, the United Nations Committee on Economic, Social and Cultural Rights adopted General Comment No. 15, interpreting the International Covenant on Economic, Social and Cultural Rights to include a right to water. The document declared that “the human right to water is indispensable for leading a life in human dignity” and is a prerequisite for the realisation of other human rights.

General Comment 15 also defined the right to water as the right of everyone to sufficient, safe, acceptable, physically accessible and affordable water for personal and domestic uses. The comment placed obligations on states to respect (not interfere with existing access), protect (prevent third parties from interfering), and fulfil (actively take steps to provide access) this right.

Global recognition in 2010 🔗

The next major step came in July 2010, when the United Nations General Assembly explicitly recognised safe and clean drinking water and sanitation as a human right essential to the full enjoyment of life and all other human rights. This shifted government accountability. A country could no longer treat water access as charity or a service to be paid for; it became a legal and moral obligation. The framework has since shaped national water and sanitation policies across the world, including India.

Why water and sanitation matter for health 🔗

The link between water, sanitation, and human health is one of the most thoroughly documented relationships in public health. Poor water and sanitation conditions are direct drivers of disease, malnutrition, and premature death.

Disease transmission and the cost of inaction 🔗

Unsafe water and inadequate sanitation create ideal conditions for the spread of diarrhoeal diseases, cholera, typhoid, hepatitis A, and intestinal worm infections. According to WHO data analysed in 2016, an estimated 829,000 deaths and 49.8 million disability-adjusted life years globally could be attributed to unsafe WASH practices, with the highest mortality rates concentrated in low and middle income countries of South-East Asia and Africa.

Diarrhoea, in particular, is a silent killer. It causes more deaths in young children than AIDS, malaria, and measles combined, and contributes significantly to childhood undernutrition because repeated infections prevent children from absorbing nutrients properly. Chronic exposure to contaminated water can also lead to stunting, cognitive impairment, and reduced school performance, effects that follow a child throughout life.

The economic toll 🔗

Beyond suffering, poor sanitation is enormously expensive. Research has shown that the impact of improper sanitation alone cost roughly 2.44 trillion rupees every year, equal to 6.4 percent of India’s GDP in 2006. The losses come from healthcare costs, lost productivity, premature deaths, and the time that women and girls spend collecting water or seeking private places to relieve themselves.

The crisis in urban slums 🔗

Nowhere is the failure of water and sanitation more visible than in the rapidly growing slums of major cities. As urbanisation accelerates, the pace of housing and infrastructure development has not kept up, leaving millions of people in dense settlements without basic services.

Why slums are vulnerable 🔗

Slums concentrate every risk factor for waterborne disease. Households are packed closely together, drainage is often non-existent, garbage piles up near water sources, and shared toilets, if they exist at all, may serve dozens of families. Many residents rely on contaminated water sources shared among multiple households, turning them into transmission hotspots for cholera, typhoid, and dysentery.

The problem is not always the absence of safe municipal water. Studies have shown that even when piped water reaches slum areas, point-of-use contamination, where water becomes polluted during storage or handling at home, remains a major driver of diarrhoeal disease in children. This is why water, sanitation, and hygiene must work together; clean water alone is not enough without safe storage and good handwashing practices.

The gendered burden 🔗

Women and girls bear a disproportionate share of the costs. In households without piped water, they typically walk long distances to fetch water, losing hours that could be spent in school or earning income. The lack of safe, private toilets affects menstrual hygiene, school attendance for adolescent girls, and exposes women to harassment when they relieve themselves in the open after dark.

India’s policy response 🔗

India has taken significant strides to address its water and sanitation gap, though challenges remain. Two flagship missions illustrate the scale of the effort.

Swachh Bharat Abhiyan 🔗

Launched in 2014, the Swachh Bharat Mission set out to end open defecation and improve solid waste management. The campaign built over 10 crore toilets across the country and used twin-pit designs that allow in-situ treatment of faecal sludge. Phase two of the mission now focuses on grey water management, plastic waste, and faecal sludge treatment, recognising that toilet construction alone does not deliver complete sanitation.

Jal Jeevan Mission 🔗

Announced in August 2019, the Jal Jeevan Mission aims to provide every rural household with a Functional Household Tap Connection (FHTC) delivering at least 55 litres of safe water per person per day. Coverage rose from around 16.8 percent of rural households in 2019 to nearly 80 percent by early 2025, a dramatic expansion in a short period. The mission also emphasises source sustainability through rainwater harvesting, groundwater recharge, and grey water reuse.

Despite this progress, gaps in water quality monitoring, the availability of accredited testing labs, and uneven performance across states remain significant concerns. Providing a tap is one thing; ensuring that what flows from it is consistently safe is another challenge altogether.

The bigger picture: water, sanitation, and development 🔗

Water and sanitation are not standalone issues. They sit at the intersection of health, education, gender equality, economic growth, and environmental sustainability. A child who avoids repeated diarrhoea stays in school longer. A woman freed from the burden of fetching water can pursue work or learning. A community with safe sanitation experiences lower healthcare costs and higher productivity. Investing in water and sanitation is therefore one of the highest-return investments any country can make in human development.

Climate change adds urgency. Erratic rainfall, depleting groundwater, and rising contamination from industrial and agricultural runoff threaten to undo decades of progress. The next phase of action will demand smarter infrastructure, behaviour change, community ownership, and an unflinching commitment to treating water and sanitation as the human rights they have been recognised to be.

What do you think? Should access to clean water and sanitation be enforceable in courts as a fundamental right, or is steady policy progress through schemes like Jal Jeevan Mission a better path? And in your own city or town, where do you see the biggest remaining gap in water or sanitation services?

References

1. https://www.ohchr.org/en/water-and-sanitation/about-water-and-sanitation
2. https://en.wikipedia.org/wiki/International_Drinking_Water_Decade,_1981%E2%80%9390
3. https://www.who.int/publications/i/item/wha34.25
4. https://www2.ohchr.org/english/issues/water/docs/CESCR_GC_15.pdf
5. https://sustainabledevelopment.un.org/topics/waterandsanitation
6. https://pmc.ncbi.nlm.nih.gov/articles/PMC7006955/
7. https://pmc.ncbi.nlm.nih.gov/articles/PMC8892530/
8. https://pmc.ncbi.nlm.nih.gov/articles/PMC4825451/
9. https://borgenproject.org/waterborne-diseases-in-urban-slums/
10. https://academic.oup.com/jid/article/224/Supplement_5/S573/6433799
11. https://www.ibef.org/government-schemes/swachh-bharat-mission
12. https://forumias.com/blog/jal-jeevan-mission-significance-challenges-explained-pointwise/