The World Health Organization’s Role in Safeguarding Global Water Quality

Access to safe drinking water remains one of the most critical public health challenges worldwide. With an estimated 1.9 billion people still relying on water supplies contaminated with faecal matter, the need for global leadership in water quality management has never been greater. The World Health Organization (WHO) serves as this essential authority, setting science-based standards, developing risk management frameworks, and supporting nations in their efforts to deliver clean water to every household and healthcare facility.

Setting health-based standards and guidelines 🔗

The WHO functions as the global reference point for governments seeking to establish water quality regulations. At the heart of this role are the Guidelines for Drinking-water Quality (GDWQ), which have shaped national water safety policies for over six decades. Now in their fourth edition, these guidelines provide the scientific foundation that countries use when developing their own regulations and standards.

Unlike rigid international standards, the GDWQ operates on a flexible, risk-based framework. The guidelines establish health-based targets and numerical guideline values for various contaminants while allowing individual countries to adapt these recommendations to their local environmental, social, economic, and cultural conditions. This approach recognizes that effective water safety management must account for regional differences in water sources, treatment capabilities, and public health priorities.

Beyond drinking water 🔗

The WHO’s standard-setting extends beyond tap water. The organization publishes comprehensive guidelines covering recreational water quality, wastewater management, and water reuse practices. Each set of guidelines incorporates the same core principle: protecting public health through evidence-based risk management rather than reactive testing alone.

The primary purpose of these guidelines is straightforward-protecting human health. They provide recommendations for managing risks from hazards that may compromise drinking water safety, including microorganisms, disinfectants, disinfection byproducts, inorganic chemicals, organic chemicals, and radionuclides. Countries without the resources to develop their own scientific assessments rely heavily on WHO guideline values as their regulatory benchmarks.

Promoting water safety plans and country support 🔗

In 2004, the WHO introduced a transformative approach to drinking water management: the Water Safety Plan (WSP) framework. This methodology shifted the focus from end-point testing to comprehensive, preventive risk management across the entire water supply chain-from catchment to consumer.

How water safety plans work 🔗

A Water Safety Plan requires water suppliers to systematically identify hazards at every stage of the supply process, assess risks, implement control measures, and monitor their effectiveness. The framework consists of three key components:

System assessment determines whether the entire drinking water supply chain can deliver water meeting regulatory targets. Operational monitoring identifies and tracks control measures throughout the system. Management plans document assessments, define actions for various operational conditions, and establish communication protocols.

The Water Safety Plan Manual, jointly developed by WHO and the International Water Association, guides utilities through 11 implementation modules. This practical resource helps operators of all sizes-from large urban utilities to small community supplies-adapt the WSP approach to their specific circumstances.

Global adoption and proven results 🔗

The impact of this framework has been substantial. By 2017, over 90 countries across every WHO region had adopted some form of WSP implementation. Research from Iceland, one of the earliest adopters, demonstrated measurable improvements in microbiological water quality and regulatory compliance following WSP implementation. The country’s experience showed that the systematic, preventive approach not only improved water safety but also enhanced utility culture around treating drinking water as a public health priority.

The WHO provides direct support to member states developing their regulatory frameworks. This includes technical assistance for drafting legislation, building laboratory capacity, training utility staff, and establishing independent surveillance systems. The organization also offers specialized guidance for small water supplies, which commonly face operational, managerial, and resourcing challenges that larger utilities can more easily address.

Evaluating household treatment technologies 🔗

While piped water systems serve urban populations, billions of people in low-income settings rely on household water treatment (HWT) to make their drinking water safe. Recognizing that many countries lack the laboratory capacity to evaluate these products, the WHO established the International Scheme to Evaluate Household Water Treatment Technologies in 2014.

The three-star rating system 🔗

This evaluation scheme provides independent, standardized testing of HWT products against health-based performance criteria. Products are classified using a tiered rating system based on their ability to remove pathogens from drinking water:

Three-star (★★★) products achieve comprehensive protection, removing at least 4 log10 of bacteria, 5 log10 of viruses, and 4 log10 of protozoa. Two-star (★★) products provide high-level protection with somewhat lower removal rates. One-star (★) products meet the performance targets for at least two pathogen classes.

The scheme evaluates various treatment methods including chemical disinfection, solar and ultraviolet treatment, and ceramic and membrane filtration. Results help UN procurement agencies and national governments make informed decisions about which products to recommend or purchase. This is particularly valuable in emergency response situations where rapid deployment of effective water treatment is essential.

Collaborating on WASH in healthcare facilities 🔗

Healthcare facilities present unique water and sanitation challenges. Inadequate WASH services in hospitals and clinics can lead to healthcare-associated infections, putting vulnerable patients at risk and undermining treatment outcomes. In 2018, the United Nations Secretary-General issued a global call to action specifically addressing WASH in health care facilities, recognizing these services as fundamental to quality care.

The WASH FIT tool 🔗

Working with UNICEF, the WHO developed the Water and Sanitation for Health Facility Improvement Tool (WASH FIT). First published in 2018, this risk-based quality improvement tool helps healthcare facilities assess and strengthen their water, sanitation, hand hygiene, environmental cleaning, and health care waste management services.

WASH FIT provides a practical framework for facilities to identify gaps, prioritize improvements when resources are limited, and systematically enhance services over time. The tool brings together hospital administrators, water engineers, health officers, and community groups to share responsibility for maintaining safe conditions.

The second edition of WASH FIT, released in 2022, expanded to include indicators for climate resilience, gender equality, and infection prevention and control. As of 2025, WASH FIT is being used in nearly 70 countries, from small clinics in rural Africa to major hospitals in Asia and Latin America.

Why this matters for public health 🔗

The stakes are significant. According to WHO and UNICEF data, up to 70% of infections in healthcare settings can be prevented through proper WASH services. Yet globally, one-third of health care facilities lack adequate hand hygiene facilities where care is provided. In fragile contexts, only about 19% of healthcare facilities have basic sanitation services. WASH FIT provides a structured pathway for facilities to address these gaps and maintain improvements over time.

Building capacity for the future 🔗

Beyond publishing guidelines and developing tools, the WHO invests in building lasting capacity within member states. The WHO Academy offers online courses on water safety planning, making technical training accessible to utility staff and regulators worldwide. Training videos, sanitary inspection packages, and regional workshops complement these resources.

The organization also tracks global progress through the WHO/UNICEF Joint Monitoring Programme, which publishes regular updates on WASH coverage in households and healthcare facilities. This monitoring helps identify gaps, measure progress toward Sustainable Development Goals, and hold governments accountable for their commitments.

As climate change intensifies pressures on water resources and population growth strains existing infrastructure, the WHO’s role in water quality management becomes increasingly vital. The organization’s comprehensive approach-combining scientific standards, practical management tools, technology evaluation, and direct country support-provides the foundation for sustainable improvements in water safety worldwide.

What do you think? How might the Water Safety Plan approach be adapted to address emerging challenges like microplastics contamination or the effects of extreme weather events on water sources? And in what ways could digital technologies help small community water supplies implement the risk management practices that larger utilities already use?

References

1. https://www.who.int/publications/i/item/9789240045064
2. https://www.who.int/teams/environment-climate-change-and-health/water-sanitation-and-health/water-safety-and-quality/recreational-waters
3. https://www.who.int/teams/environment-climate-change-and-health/water-sanitation-and-health/water-safety-and-quality/water-safety-planning
4. https://www.who.int/publications/i/item/9789240067691
5. https://pubs.acs.org/doi/10.1021/es300372h
6. https://www.who.int/publications-detail-redirect/9789240088740
7. https://www.who.int/tools/international-scheme-to-evaluate-household-water-treatment-technologies
8. https://www.unicef.org/documents/who-unicef-water-and-sanitation-health-facility-improvement-tool-wash-fit
9. https://www.washinhcf.org/wash-fit/