Quantify the scale of water contamination (chemical, microbiological, and radiological), assess the adequacy of water treatment and distribution infrastructure globally, and estimate the disease burden attributable to unsafe water and sanitation.

WHO/UNICEF Joint Monitoring Programme (JMP) data across 180 countries combined with World Bank water quality databases. Burden of disease analysis from Global Burden of Disease 2024 for diarrheal disease, cholera, typhoid, and arsenic/fluoride toxicity. Infrastructure age data from national water ministries and OECD water utilities database.

5 billion lack safely managed sanitation. Unsafe water causes 829,000 deaths annually from diarrheal disease alone, plus 180,000 from malnutrition linked to water-borne parasites. In Sub-Saharan Africa, 80% of wastewater is discharged untreated, creating cascading contamination. Groundwater arsenic exposure affects 250 million people in South Asia.

The average water utility in OECD countries has pipe infrastructure over 50 years old — in many systems, water loss to leakage runs 20-50%. Climate change is amplifying both scarcity (droughts) and contamination (flooding). 7 trillion in lost economic productivity from water-related diseases and agricultural productivity loss annually.