Safe water and adequate sanitation are vital to individual health, livelihood, and well-being. Yet, more than one out of four people in the world, around 2 billion people, do not have access to basic sanitation services. A lack of access to basic sanitation can lead to transmission of different diseases such as diarrhoea, cholera, and hepatitis A -, and adds to the burden of malnutrition. Better access to water and sanitation could prevent the deaths of 395 000 children under age 5 annually. Poor sanitation reduces human well-being, social and economic development due to impacts such as anxiety, risk of sexual assault, and lost opportunities for education and work. (WHO, 2024[1]). Improving access to water and sanitation contributes not only to better health but also leads to great social and economic benefits, whether through higher educational participation, improved living standards, lower healthcare costs or a more productive labour force. Globally 1.4 million people die each year as a result of inadequate drinking-water, sanitation and hygiene. The vast majority of these deaths are in low- and middle‑income countries (WHO, 2023[2]). The United Nations has set a target of achieving universal and equitable access to safe and affordable drinking water for all, as well as achieving access to adequate and equitable sanitation and hygiene for all and end open defecation by 2030. Furthermore, UNICEF’s strategy for Water, Sanitation and Hygiene (WASH) 2016‑30 seeks to ensure that every child lives in a clean and safe environment, gains access to basic sanitation and safe drinking water in early childhood development centres, school, health centres and in humanitarian situations (UNICEF, 2018[3]).
In 2022, while more than nine in ten people in Asia-Pacific high-income countries and territories had access to basic sanitation, in lower-middle- and low-income countries and territories only two out of three people living in rural areas and about four in five people living in urban areas had access to basic sanitation for adequate excreta disposal (Figure 4.13, left panel). Access was low in rural areas at around 15% in Papua New Guinea and 20% in the Solomon Islands, where open defecation was still common amongst most of the population. In urban areas, only about half of the population had access to basic sanitation in Papua New Guinea and 55% in Bangladesh in 2022.
Over recent years, the proportion of the population using basic sanitary facilities has grown in most Asia-Pacific countries and territories, and faster improvement was observed in rural areas (Figure 4.13, right panel). The progress was particularly rapid in rural areas in Cambodia, India, Nepal and Indonesia, where the proportion of population with access to basic sanitation increased by more than 20 percentage points between 2015 and 2022. In urban areas, Nepal reported a significant increase of 15 percentage points in the proportion of population with access to basic sanitation during the same period. On the contrary, Papua New Guinea and Fiji reported a decrease in the percentage of the population having access to basic sanitation in urban areas from 2015 to 2022.
In almost all Asia-Pacific countries and territories in 2022, more than nine out of ten people had access to basic drinking water in urban areas, while access was limited in rural areas in some countries and territories. In Papua New Guinea, slightly more than 40% of the population had access to basic drinking water in rural areas. Access to basic drinking water was also low in rural areas in the Solomon Islands (59%) and Mongolia (60%) (Figure 4.14, left panel).
During the period of 2015‑22, access to basic drinking water improved in most Asia-Pacific countries and territories. In urban areas, access to basic drinking water increased by more than 5 percentage points in Myanmar and Lao PDR, while decreased by more than 1 percentage point in Pakistan, Nepal and DPRK. In rural areas, Myanmar, China, and Mongolia reported an increase in the population living in rural areas having access to basic drinking water of more than 10 percentage points, whereas Solomon Islands reported the largest decrease of almost 4 percentage points from 2015 to 2022 (Figure 4.14, right panel). In recent years, many countries and territories in the region, including Bangladesh, Mongolia, the Philippines, and Viet Nam established water safety plans, allowing millions to access safer drinking water. Tax-based public subsidies, well-designed water tariffs and strategic use of aid flows to the water sector can assist in ensuring that poor and vulnerable groups have access to sustainable and affordable water services (WHO, 2018[4]).
Poor access to water and sanitation often disproportionately affect women as the burden of water carriage remains significantly heavier for women and girls than for men and boys since they are primarily responsible for childcare and domestic chores in many countries around the world. In addition, over half a billion people share sanitation facilities with other households and emerging data show that among these, women are more likely than men to feel unsafe walking alone after dark. Inadequate WASH services also limit the ability of adolescent girls and women, and other persons who menstruate, to safely and privately manage their periods (UNICEF/WHO, 2023[5]).
