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The water ladder: what “access” really means

The WHO and UNICEF Joint Monitoring Programme, which tracks progress for the UN, ranks drinking water on a ladder. Most of the people counted as lacking safe water are not drinking from ponds; they are on the middle rungs.

Rung	What it means
Safely managed	An improved source on the premises, available when needed and free from contamination
Basic	An improved source, such as a protected well or public tap, where collecting water takes no more than 30 minutes for a round trip, including queuing
Limited	An improved source where the round trip takes more than 30 minutes
Unimproved	An unprotected dug well or unprotected spring
Surface water	Water taken directly from a river, dam, lake, pond, stream or canal

By 2024, 2.1 billion people, one in four, still lacked safely managed drinking water. Sanitation and hygiene lag further behind: 3.4 billion people lacked safely managed sanitation, 354 million still practised open defecation, and 611 million had no handwashing facility at home at all (WHO and UNICEF, 2025).

Who carries the water

About 1.8 billion people live in households without water on the premises. In seven out of ten of those households, women and girls are mainly responsible for collecting it, and among children under 15, girls are almost twice as likely as boys to be the ones fetching water (WHO and UNICEF, 2023). In many countries in sub-Saharan Africa and South Asia, women and girls spend more than 30 minutes a day on it. The Community Well Project funds solar-powered pumps in villages where women and girls currently walk several hours a day for water.

School toilets matter for the same reason. Only 39% of schools worldwide provide education on menstrual health, and in sub-Saharan Africa only about one school in eight provides menstrual products (WHO and UNICEF, 2024). A study in India found that building separate latrines for girls in schools raised enrolment among girls reaching puberty (Adukia, 2017). The School Sanitation Block Fund builds separate toilets for girls in Nigerian public schools.

Why so many handpumps break

A 2020 review of handpump data by Foster and colleagues estimated that about 26% of handpumps in sub-Saharan Africa were not working at any given time, roughly 175,000 pumps. Rates varied widely, from about 19% in Uganda to over 40% in Nigeria. Pumps failed more often as they aged and in deep wells that are harder to repair, and where spare parts were hard to get and nobody was clearly responsible for fixing and paying for repairs.

That is why funding repairs and the people who carry them out can be as valuable as drilling a new well. The causes we list include handpump repair and maintenance training for village water committees through the Village Handpump Repair Fund, well rehabilitation in drought-hit Afghan villages, repairs to damaged pumping stations in Syria where families are returning home, and technical help and operator training for small US towns whose ageing water systems are too costly for their tax base.

What safe water does for children: the evidence

• Fewer child deaths. A meta-analysis of 18 randomized trials by Kremer and colleagues (NBER working paper, 2023) found that water treatment reduced the odds of death among children under five by about 24–27%, at low cost per year of healthy life gained.
• Handwashing works too. A Cochrane review found that promoting handwashing in communities in low- and middle-income countries cut episodes of diarrhoea by about a quarter (2021).
• The cost of doing nothing. WHO estimates that unsafe water, sanitation and hygiene caused about 1.4 million deaths in 2019, including about a million from diarrhoea.

Water in crises and a changing climate

Water is often the first thing to fail in a war or a disaster. In Gaza, UNICEF reported in May 2026 that 82% of families were water-insecure; the Gaza WASH Emergency Response funds water trucking and fuel for desalination units, and the Community Water Quality Fund funds water quality monitoring and repairs to wells, cisterns and small networks. Elsewhere, causes fund water trucking and latrines in Somali displacement camps, and boreholes in Ethiopian regions where consecutive failed rainy seasons have dried up traditional sources.

Climate change is raising the pressure. UNICEF notes that around 74% of natural disasters between 2001 and 2018 were water-related, including droughts and floods. Causes we list respond with raised, flood-resistant latrines in Bangladesh, rainwater storage where saltwater has spoiled wells in Vietnam’s Mekong Delta, typhoon-resistant water storage in the Philippines, groundwater recharge in parts of India where water tables have dropped sharply, protected springs in Guatemala’s highlands, and river monitoring and community water testing downstream of polluted rivers in Indonesia.

Questions to ask a water charity

Every Water & Sanitation cause we list

Wells, repairs, toilets and emergency water: each cause names the partner organization that does the work and when we last verified it.

Common questions

Is it better to fund a new well or repair an existing one?

It depends on the village. New boreholes bring water where there is none; repairs restore water points that already serve a community, often at lower cost. Our list includes both.

Why does sanitation matter as much as water?

Without safe toilets and handwashing, water sources and hands become contaminated, spreading diarrhoea and cholera. Clean water alone doesn’t stop that.

Do water causes help girls’ education?

They can. Girls often fetch water, and a lack of private toilets at school can keep girls at home. Our list includes separate school toilets for girls in Nigeria.