Water and sanitation services, and accompanying hygiene behaviours, underpin public health efforts and contribute more broadly to society, the economy and the environment. The WASH sector though stands at a precarious point. The effectiveness of basic WASH interventions is being questioned. Five years into the sustainable development goals, the ambitious target of universal access to safely managed services increasingly appears unattainable.


We are forming the Lancet Commission on Water, Sanitation and Hygiene (WASH) and Health to reimagine and reconstitute WASH as a central pillar of public health but also as a pathway to gender equality, and social and environmental justice.


The Commission was launched in September 2021 and has three priorities set out in more detail in a comment in the Lancet:

1. The Commission will make a clear argument for the necessity and urgency of achieving universal access to at least safely managed services.

2. The Commission will provide a more complete assessment of the potential benefits of achieving universal access to at least safely managed services, the costs of which will be immense.

3. The Commission will make concrete recommendations for reform focused on the establishment of national systems capable of delivering professionalised delivery of services for all, and responding to the challenges of today, including climate change and rapid urbanisation.