Why this session matters to us
Water, sanitation and hygiene in health care facilities is, for a measurement project, an unusually clean case. It is the one corner of the water agenda where the counting has visibly caught up to the problem. A decade ago there was almost no comparable global data on whether the world’s clinics had running water, a working toilet, or a way to wash your hands; today a WHO/UNICEF country tracker spans 107 countries, up from 75 two years earlier.
This side event marked two things at once. A UN General Assembly resolution, adopted by consensus on the Monday two days before, now asks every member state to monitor these services and be held to account for them. And the people who actually collect the numbers spent the hour arguing that the national figures, however much better than they used to be, still hide the places that matter most.
A resolution that turns advocacy into accountability
The Group of Friends, co-chaired by the Philippines and Hungary and launched in 2021, exists to drag WASH in health care facilities from a minor technical concern into a political priority. This week it had its clearest result yet: the General Assembly adopted, by consensus and with more than thirty co-sponsors, a resolution on sustainable, safe and universal water, sanitation, hygiene, waste and electricity services in health care facilities. Its three asks are to integrate these services into health planning and financing, to monitor and review progress and strengthen accountability, and to build the health workforce. The middle pillar is the one this project watches.
The moderator, WHO’s Werner Obermeyer, made the accountability point directly, and it is the reason a resolution about monitoring is more than a procedural footnote.
What the counting shows, and where it stops
The scale of the deficit is now measurable at global level. The Special Envoy on Water, Retno Marsudi, cited 2023 data: about 1.1 billion people were served by health care facilities that lacked basic water services, 1.7 billion by facilities without basic hygiene, and 3 billion by facilities without basic sanitation. She stayed only for the keynote, but her framing set the tone for the practitioners who followed.
The sharpest measurement argument came from the International Rescue Committee’s senior director for health, speaking from the fragile and conflict-affected settings where global averages break down. In the 60 countries classified as fragile, he said, WHO/UNICEF data for 2023 show 37% of facilities lack basic water, 46% lack basic hygiene, and 81% lack basic sanitation. His own organisation’s 2025 assessment, using the WASHFIT digital tool across 833 health facilities in more than 20 countries, found only 33% met the overall infection-prevention-and-control target. Yet in Uganda’s refugee-hosting districts, where investment was concentrated, 85% of the facilities IRC supported met the national target. The lesson he drew is the one at the centre of this whole exercise.
That is the gap between a number that exists and a number that helps. A country can post improving national averages while its fragile districts sit near four-in-five facilities without sanitation, and a clinic counted as served in a good year is not served the month its water supply fails. One data point cut the other way: Hungary’s closing remarks noted that the Secretary-General’s 2025 progress report found 80% of infrastructure programmes now address climate, and 44% of the countries that had updated their standards had integrated climate resilience, a rare place where the trend line and the reporting are both moving.
WaterAid’s Kelly Parsons brought the field into the room, relaying a nurse in Malawi whose health centre had recently gained clean water, sanitation and hygiene.
Parsons put the potential dividend in a single figure from WaterAid’s research: the simple essentials of clean water, toilets and handwashing could cut maternal infections and deaths by at least 50%.
The money is chasing the same alignment problem
The financing story turned on the World Bank’s Water Forward initiative, the same effort that ran through the Forum’s opening SDG 6 review. Its target is water security for one billion people by 2030, with the Bank committing to 400 million of them. The mechanism is a set of government-led country water compacts: 14 announced so far, 48 expected by the end of 2026, sitting under, in the Bank’s words, “full national ownership.” Alongside them run health compacts, 16 launched and about 40 expected by year end. Some are specific: Angola has committed to universal WASH in schools and health facilities by 2032, Tanzania to full coverage by 2031, and the Democratic Republic of the Congo has ring-fenced roughly 10% of its sector budget for WASH in institutions.
The hard part, the Bank’s senior health specialist conceded, is getting the water compact and the health compact to line up in the same geography and the same funding cycle. That alignment problem recurred in every practitioner’s account. Catholic Relief Services put the principle plainly.
CRS reported testing a sustainability framework, weighing governance, finance, technical capacity and climate resilience, in more than 60 health facilities across nine countries; at one Catholic health centre in Kenya a new gravity-fed water system cut neonatal sepsis from about 15% toward zero. World Vision’s Peter Hynes was candid that the coordination failure is not only between governments: getting the WASH team and the health team to talk to each other is hard even inside a single NGO. His practical suggestion, pairing water and electricity at a facility to form a community microgrid, is a reminder that the resolution’s scope, WASH and waste and electricity, is deliberate.
Our read
The quiet victory here is the resolution’s second pillar. For most of the past fifteen years this agenda’s core problem was that almost no one counted; now 107 countries report and a General Assembly resolution makes monitoring a duty. But the most useful thing the session did was refuse to let the national numbers stand alone. The practitioners who work furthest down the system, the IRC in fragile states, WaterAid and CRS in single clinics, all pointed to the same blind spot: the coverage figures thin out precisely where facilities fail, because the data is national and the failures are local. The advance that matters next is not another global headline percentage. It is subnational, disaggregated, fragile-settings data of the kind the IRC is already collecting facility by facility. The test for the new resolution is whether its monitoring pillar funds that granularity, or settles for the average that looks better.
Why it matters for the SDGs
This sits at the junction of SDG 6 (water and sanitation, under in-depth review at this Forum) and SDG 3 (health), with the resolution’s electricity clause reaching into SDG 7. Hungary’s closing made the cross-cutting case explicitly, naming SDG 9 (infrastructure) and SDG 11 (cities), both also under review this year, as goals whose progress WASH in facilities both depends on and drives, and SDG 17 as the partnership machinery holding it together. The measurement angle SDGCounting watches is narrower and sharper than any one goal: a clinic without water that is nonetheless recorded as served is the kind of counting error that lets a health system look more resilient on paper than it is in an outbreak.
Watch & read
- UN Web TV, recording of the side event (15 July 2026).
- WHO/UNICEF country tracker on WASH in health care facilities, the 107-country monitoring base behind the review.
- The Philippines’ account of the Group of Friends resolution on WASH, waste and electricity services in health care facilities.
- World Bank Water Forward country water compacts, the financing mechanism referenced throughout.
- Launching the Global WASH Sector Resilience Index, the companion argument that access counts should give way to resilience counts · The opening and the SDG 6 review · The SDG 9 review.
- Full HLPF 2026 coverage.
Quotations are lightly edited from an automated (Otter.ai) transcript of the UN Web TV recording and should be read as close paraphrase. The date is inferred from the proceedings (speakers place the event two days after the resolution’s adoption on Monday 13 July); the room is not confirmed. Speakers the recording does not name reliably are cited by role and institution, and non-English interventions are summarised rather than quoted. Figures are as speakers and institutions reported them and were not independently verified.