Water, Sanitation & Hygiene

Our goal
To enable widespread use of safely managed, sustainable sanitation services that contribute to positive health, economic, and gender equality outcomes for the world’s poorest people.
Users with membership cards at a community toilet for women in an urban slum in Pune, India.

At a glance

  • More than 3.5 billion people around the world live without safely managed sanitation.
  • Inadequate sanitation and hygiene are estimated to have caused more than half a million deaths from diarrhea alone in 2016.
  • Safe sanitation is essential to a healthy and sustainable future for developing economies.
  • We focus on accelerating innovations in non-sewered sanitation technology and service delivery, particularly in densely populated areas of South Asia and sub-Saharan Africa.

The latest updates on water, sanitation & hygiene

A reinvented toilet: The waterless, solar-powered Eco-San Toilet, designed at Caltech, is pilot tested at an elementary school in Jiangsu Province, China. 

Advancing sanitation: 10 years of reinventing the toilet for the future

We already have the breakthrough technologies needed to provide safe and affordable sanitation services to the billions of people who are at risk of waste-borne diseases. Building markets and attracting businesses to this emerging sector are the next big challenges.
By Doulaye Kone Deputy Director, Water, Sanitation, & Hygiene, Bill & Melinda Gates Foundation

De-throning “The Throne” at the Reinvent the Toilet Expo in Beijing, China

The Reinvent the Toilet Challenge is driving scientists across the globe to tackle our most pressing sanitation issues.
By Ryan Bell Feature Writer, Bill & Melinda Gates Foundation
Foot with Guinea worm disease

Good news: Guinea worm disease is on the verge of eradication

South Sudan has stopped transmission of Guinea worm—zero cases in 15 months—signifying a major success in efforts to eradicate the disease, a horribly painful parasite that can trap families and entire communities in cycles of poverty.
Our strategy

Our strategy

We collaborate with government leaders, the private sector, and technologists to advance promising new toilet and waste treatment technologies, service delivery models, and policies with the greatest potential to revolutionize sanitation standards and practices at the local and national levels. Our core initiatives include:

  • Promoting policies and practical steps that governments can take now to establish safer sanitation through fecal sludge management—a sanitation strategy that does not require sewers

  • Investing, alongside governments in our priority geographies, in accelerated adoption of safely managed citywide sanitation, particularly in slums and informal settlements that are typically underserved

  • Investing in technologies, such as the reinvented toilet and the omni-processor, that can radically change the way municipalities and households manage human waste affordably, on a large scale, and with little or no need for water and electricity

  • Conducting research to help the sanitation sector develop data and evidence about what works

The burden of inadequate sanitation—and, therefore, the potential for progress—is greatest in sub-Saharan Africa and South Asia, so we focus our efforts in those regions.

  • Sub-Saharan Africa. As African cities and towns continue to grow, especially within informal settlements, governments are acknowledging the need for innovative sanitation solutions that are easier to deploy and less expensive to operate than sewer systems and wastewater treatment plants.
  • South Asia. Sanitation is a significant challenge for most South Asian countries, but many are now aggressively pursuing inclusive national sanitation strategies that emphasize safe sanitation. India, in particular, provides a global model for sanitation reform through the government’s Swachh Bharat Mission and a growing network of sanitation operators and utilities that are implementing fecal sludge management.

  • China. The Chinese government’s Toilet Revolution, which promises the rapid scaling up of safe sanitation approaches for the country, presents a strong opportunity for the adoption of new technologies within China’s rural and public toilet markets, particularly in areas facing water scarcity issues.

Accelerating the development of safe, non-sewered sanitation systems and technologies is our top priority within the water, sanitation, and hygiene continuum because it is where we believe we can catalyze the biggest change by making investments that other partners are unlikely to make. We acknowledge the critical role of clean water and hygiene initiatives, as well as efforts to end open defecation, in improving global health outcomes. We applaud the efforts of other organizations that focus on these areas.

Areas of focus

Areas of focus

We focus our grantmaking in four complementary areas: developing and commercializing transformative sanitation technologies; transforming how cities can provide sanitation as a reliable, inclusive service; policy and advocacy; and measurement, evidence, and dissemination.

Flush toilets and central sewer systems are considered by many consumers and governments around the world to be the gold standard for safe sanitation. However, decentralized sanitation systems that incorporate technologies such as the reinvented toilet present alternatives that can be safer and more resilient, cost-effective, and environmentally friendly.

Since 2011, our foundation’s Reinvent the Toilet Challenge has worked with leading engineers and scientists to design low-cost toilets that do not require connections to the electrical grid, water supply, or sewers. Several designs that debuted at the Reinvented Toilet Expo in 2018 are now commercially available. These toilets work using internal combustion and chemical treatment systems, and they can be set up in areas that are hard to reach with traditional infrastructure. They can deliver the same benefits as toilets connected to sewers, plus wholly new benefits that include the removal of human pathogens and generation of usable water and electricity. Some reinvented toilet models provide sanitation for single homes, while others are designed for public or shared toilet facilities that serve communities.

We have also supported the development of new fecal sludge treatment technologies and funded new types of pit latrine emptying solutions so communities can make existing sanitation systems safer for people and more affordable for private companies, public utilities, and municipalities.

Getting new sanitation products to market and into communities where they can save lives and protect community health will require the leadership of private companies that are excited about building new businesses in the sanitation sector—to manufacture, deliver, and service the reinvented toilet. It is also critical for national and local governments to create policies and regulations that encourage inclusive, innovative sanitation service models, including partnerships with the private sector that can deliver new sanitation solutions and services efficiently and at low-cost.

Explore our partner page and learn about market research available to inform and guide private sector investment in new, non-sewered sanitation solutions.

Providing citywide, inclusive sanitation requires new service models and market structures, as well as different approaches and technologies to serve different community needs and settings. We are working with local governments, service providers, and community-based organizations in select cities to foster environments that support the use of community-responsive, non-sewered sanitation products, delivery methods, and business models. We see particular promise in models that rely on public-sector agencies to provide regulation and oversight, and that allow private-sector providers to deliver sanitation services and profit from byproducts that have market value, including energy and fertilizer. This is a sustainable partnership model that offers natural incentives for innovation and long-term delivery of safe sanitation to communities.

We also support initiatives that help stimulate market and community demand for improved sanitation, to accelerate the development of productive sanitation market conditions. This effort includes working with sanitation providers and partners to help them adopt more evidence-based practices so they can deliver sanitation services that meet people’s needs—especially the needs of women and girls. For example, in India our work includes support for a national campaign to promote incremental shifts in social norms around toilet use that will lead to higher demand for better sanitation products and services as they become available.

We work to improve the policy and regulatory environment for sanitation through partnerships across all levels of governments, multilateral organizations, community-based nongovernmental organizations, service providers, and others. With our network of partners, we advocate for policies and international standards that set guidelines for safe sanitation services at the local and national levels, as well as for adequate funding for these systems to ensure healthy outcomes for people.

As part of this work, we support initiatives that can help accelerate gender equality for women and girls. These include initiatives that can generate gender-disaggregated data to inform the development of programs and products that increase women’s participation in sanitation decision-making at the household and policy level.

We invest in research and evaluation to understand the effectiveness of various sanitation approaches. We use this information to report on our progress, assess the impact of our grantmaking, and share lessons that we learn with our partners. This information is vital for helping national governments meet their targets under the United Nations Sustainable Development Goals, including Goal 6.2, which calls for ending open defecation and providing adequate, equitable, and safely managed sanitation for all people by 2030.

Why focus on water, sanitation and hygiene?

Why focus on water, sanitation, and hygiene?

Unsafe sanitation is a massive problem that is becoming more urgent as our global population increases and trends such as water scarcity and urbanization intensify. About 4.5 billion people—more than half the world’s population—either practice open defecation or use unsafe sanitation facilities and services. To be effective, sanitation must be carefully managed at all stages, from waste collection and containment to transport and treatment. If there are gaps or breaks at any stage, harmful human waste flows into surface waters that people use for drinking and bathing and onto fields where children play and people live.

Poor sanitation, which is widely accepted as a chief contributor to waterborne diseases, causes the deaths of more than 1,200 children under age 5 every day—-more than from AIDS, measles, and tuberculosis combined. Inadequate sanitation and hygiene caused more than half a million deaths from diarrhea alone in 2016. Despite the indisputable connection between poor sanitation and human health risks, sanitation models and services aren’t improving quickly enough. According to the World Health Organization and UNICEF, sanitation rated as “safe for people” increased by only 3 percent worldwide over the past five years.

Creating sanitation infrastructure and public services that work for everyone and keep human waste out of the environment is difficult—and it isn’t a one-size-fits-all proposition. The toilets, sewers, and wastewater treatment systems that made sense in the past aren’t necessarily the best solutions for the future, especially in poor countries. These types of systems require vast amounts of land, energy, and water and are extremely expensive to build, maintain, and operate, even by the standards of wealthy countries. They are particularly difficult to introduce as new infrastructure into dense urban settings and informal settlements, where the impact of unsafe sanitation on people is the greatest.

Solving the sanitation challenge in the developing world will require breakthrough innovations in technologies as well as systems that are practical, cost-effective, and replicable on a large scale. Building and proving these new models is difficult, but the potential benefits to human health and dignity and economic growth are enormous. These benefits include increased human productivity, improved infrastructure, new jobs, and expanded entrepreneurial opportunities.

Lack of proper sanitation costs the world an estimated US$223 billion every year. At the same time, every dollar spent on sanitation is estimated to provide at least five dollars in economic return. And market research shows that the annual market value for new sanitation technologies designed for low-resource settings, such as the reinvented toilet, could potentially reach more than US$6 billion globally by 2030.

Strategy leadership

Strategy leadership

Program resources

Program resources