Leaving no one behind.

 

“Leaving no one behind” is a key component of the 2030 Agenda. In addition, water and sanitation are formally recognized as human rights. Leaving no one behind in this context therefore means working to extend and sustain access to all. This section focuses on recognizing the human rights to water and sanitation, affordability of WASH services, measures that governments have put in place to reach underserved populations and settings, and issues related to gender and WASH.

In 2010, a United Nations General Assembly resolution formally recognized the human right to water and sanitation, acknowledging that equitable access to safe and clean drinking-water and sanitation is essential to the realization of all human rights (1). In the GLAAS 2024/2025 country survey, 87% of countries (90 of 103) reported recognizing the right to water in their constitution or legislation, and 83% (86 of 103) recognized the right to Sanitation.

Affordability is also expressed within the UN recognition of the human rights to water and sanitation and is an integral element of SDG Target 6.1. Financial schemes such as fee exemptions, subsidies and reduced tariffs contribute to making WASH services affordable for households, especially for rural populations or populations living in vulnerable situations. To support the affordability of WASH services, countries reported they are most likely to have financial schemes in place for urban drinking-water and urban sanitation, and least likely to have schemes in place for rural drinking-water, rural sanitation and hand hygiene (Fig. 9.1). 

Evidence from WASH accounts indicates that households contribute the largest share of expenditure for WASH, the majority of which come from out-of-pocket expenditure, especially on hygiene products. The burden of paying for WASH services is also disproportionate, often most affecting rural and poor populations. For example, WASH accounts results from Bangladesh show that the poorest households spend the highest percentage of their income on WASH in urban and in rural settings (2). Box 9.1 provides more information on WASH accounts. 

Some countries have taken other measures to address affordability. Forty-two per cent of countries (39 of 92) reported having defined the affordability of WASH services in policies or plans. Several countries have identified targets or indicators for affordability. Forty-five per cent of countries (44 of 98) reported having a national target for the affordability of drinking-water and 47% (34 of 72) have national indicators for affordability. In many cases, the targets or indicators reported establish a threshold based on percentage of disposable household income spent on WASH. For example, Lao People’s Democratic Republic reported a monthly water bill for poor households (with two incomes) should not exceed 5% of the monthly household income. Some countries, including the Islamic Republic of Iran, Mongolia, Sri Lanka and Zambia, reported using surveys, such as standard of living surveys or household expenditure surveys, to monitor affordability and implement tariff revisions.

The GLAAS 2024/2025 country survey included questions to understand what measures countries have in place to reach vulnerable populations and settings. These include populations such as people living with disabilities, people who are elderly or Indigenous populations, as well as in settings such as remote or hard-to-reach areas, slums or informal settlements and internally displaced persons and/or refugee camps.

 

For people living in poverty, results indicate that most countries have specific measures in national policies and plans to reach these populations, but monitoring progress and financial resource allocation are often inadequate (Table 9.1)

While the majority of low-, lower-middle- and upper-middle-income countries have measures in policies and plans to improve and extend services to women and girls, fewer countries monitor progress on extending services and even fewer have specific financing measures to target resources to women and girls (Table 9.2).

Another key aspect related to gender and WASH is menstrual health and hygiene (menstrual hygiene management). Sixty-three per cent of countries (62 of 99) reported they include menstrual health and hygiene in their WASH policies and plans (Table 9.3). Menstrual health and hygiene is most often included in policies and plans for WASH in schools and WASH in health care facilities.  

Fifty-eight per cent of countries (42 of 73) that conduct JSRs reported gender is included in JSRs, and 72% of countries (51 of 71) reported menstrual health and hygiene is included in JSRs. While menstrual health and hygiene is included in the majority of JSRs, only 25% of countries (24 of 97) reported having targets for it. Examples of menstrual health and hygiene targets reported in the GLAAS 2024/2025 country survey include the following. 

• Benin has a target of 100% of households adopting hygiene-friendly practices, which aims to break down taboos and transmit information and knowledge to all members of the community, with particular attention to women and girls. • Sierra Leone: The target aims to ensure 70% of women and girls in Sierra Leone have access to adequate menstrual hygiene management by 2030, promoting health, dignity and gender equality. • United Republic of Tanzania: Menstrual hygiene management is included in the definition of basic sanitation facilities in schools where the country has a target to reach 100% of schools with basic sanitation by 2026.