Globally, 829 000 people are estimated to die each year from diarrhoea as a result of unsafe drinking-water, sanitation and hand hygiene.
In the WHO European Region, 14 people die every day due to diarrhoeal disease associated with poor water, sanitation and hygiene (WASH).
Diseases with the highest number of reported outbreaks are viral gastroenteritis, hepatitis A, E. coli diarrhoea and legionellosis. Published data indicate that nearly 1/5 of all investigated outbreaks of infectious diseases in the Region were attributable to water.
WASH interventions can reduce diarrhoeal diseases by 25–35%, and significantly reduce other water-related diseases.
Drinking-water, sanitation and hygiene services for communities
Over the last decade, promising trends have been observed in access to basic and safely managed drinking-water and sanitation services in the Region, indicating progress towards achieving Sustainable Development Goal (SDG) targets 6.1 and 6.2.
In 2017, 92% of over 900 million people living in the Region used safely managed drinking-water services, which are improved water sources located on premises, available when needed, and free from contamination.
Across the Region, 16 million people still lack access to basic drinking-water services, of which over 3 million rely on surface water for direct consumption.
Of the population in the Region, 68% used safely managed sanitation services and 73% used sanitation facilities connected to sewers.
More than 31 million people in the Region lack access to basic sanitation, including 314 000 that still practice open defecation.
Geographic, economic and social inequalities exist; progress is uneven, primarily focused on urban areas; and rural dwellers and the poorest are the most disadvantaged. For instance, differences in access to basic drinking-water and sanitation services between urban and rural populations can be up to 4-fold in some countries in the Region.
Data on asset-based wealth quintiles of households indicate a declining inequity gap between the poorest and richest population groups in 2000–2017, in the majority of countries in the Region.
WASH in schools and health care facilities
Data from the Region indicate that in 2016, 95% of schools used basic drinking-water, 92% used basic sanitation and 90% used basic hygiene services. These averages, however, mask differences between and within countries. In some countries, access to basic drinking-water services is as low as 51%, to basic sanitation services 34%, and to basic hygiene services 26%. About 3.3 million pupils do not enjoy basic drinking-water services at school and over 5 million pupils attend schools that lack basic sanitation facilities, such as toilets or latrines.
There is a substantial data gap on WASH in health care facilities in the Region. World Health Assembly resolution 72.7 on WASH in health care facilities calls for strengthening national monitoring.
WASH enabling environment
Data from 15 countries of the Region that participated in the UN-Water Global Analysis and Assessment of Sanitation and Drinking-Water (GLAAS) 2018–2019 indicate that a majority of countries have recognized the human rights to drinking water and sanitation in their legislation and constitutions, and have developed national policies, targets and plans addressing water and sanitation. However, the implementation of these policies and plans is constrained by major financing gaps, in particular for rural sanitation and drinking water.