“Healthcare facilities are where the vulnerable seek healing. Yet, without adequate water, sanitation and hygiene, for too many people, expected care can become inadvertent harm,” said Dr. Hans Kluge, the World Health Organization (WHO)’s Regional Director for Europe.

Emphasizing that healthcare is “being tested as never before”, Dr. Kluge insisted that bolstering them is an investment in withstanding crises.

As part of this work, a UN-led meeting in Budapest this week has resulted in more than 40 countries adopting a programme to build more resilient and equitable water, sanitation and hygiene systems, often referred to collectively as WASH.

The 7th session of the Meeting of the Parties to the Protocol on Water and Health is co-led by the UN Economic Commission for Europe (UNECE) and the UN health agency.

The Protocol on Water and Health remains the only legally binding international treaty explicitly linking environmental protection, water governance and public health. It has helped countries translate commitments into concrete improvements, such as expanding safe drinking water, protecting biodiversity, and boosting disease surveillance.

Yet major challenges remain. In addition to the 118 million people in Europe whose healthcare facilities lack basic sanitation, another 70 million lack access to safely managed drinking water and 185 million do not have safe sanitation. These vulnerabilities are only deepening as droughts, floods and cyber threats increasingly disrupt services.

“The Protocol is an example of how multilateral cooperation impacts our everyday lives, but we still have much work ahead,” said UNECE Executive Secretary Tatiana Molcean.

Practical tools, global relevance

The Protocol provides a toolbox of evidence-based resources, such as an equitable access scorecard and water safety planning, already in use in more than 30 countries. The international agreement has supported at least 1,500 facility assessments and helped inform policies in schools, hospitals and urban planning.

Countries across the pan-European region have pledged to ensure safe water and sanitation for all, through commitments like the Budapest Declaration and the Sustainable Development Goals (SDGs), “but no one tells you how to do it. That’s what the Protocol has to offer,” stressed Marta Vargha, Vice-Chair of the Protocol.

Concrete measures under the Protocol include efforts to ensure safe water, sanitation and menstrual hygiene in schools; to monitor wastewater for dangerous viruses including COVID-19; to tackle the spread of Legionella bacteria in domestic water systems and to develop plans for carbon-neutral water services.

Ahead of the UN climate summit in Brazil, UNECE urged governments to put water and sanitation systems at the core of climate resilience – a message highlighted by Secretary-General António Guterres in a message to the meeting: “Progress on water and sanitation supports progress across multiple Sustainable Development Goals.”