United Nations World Toilet Day: A Call for Clean Water and Sanitation for All

November 19th marks United Nations World Toilet Day, a global observance aimed at raising awareness about the critical importance of sanitation and hygiene for health, dignity, and sustainable development. Clean water, sanitation, and hygiene (WASH) are basic human rights, yet millions of people around the world still lack access to these essential services, contributing to a range of public health challenges, environmental degradation, and economic setbacks.

While the issue may seem distant for those in wealthier nations, including the United States, the reality is that clean water and sanitation are challenges that exist even within its borders. The United Nations’ Sustainable Development Goal (SDG) 6 — ensuring availability and sustainable management of water and sanitation for all — is not only a global mandate but one that requires action at all levels, including within the United States.

Global Perspective: The Sanitation Crisis

Globally, around 2 billion people do not have access to safely managed drinking water. As a result, severe consequences exist in public health which links poor sanitation and unsafe water to the spread of diseases like cholera, dysentery, and typhoid. According to the World Health Organization (WHO), inadequate sanitation is the cause of around 432,000 deaths each year, with many of these deaths affecting children under the age of five.

World Toilet Day, therefore, is not only an opportunity to discuss the role of sanitation in protecting health but also to emphasize the need for coordinated, multi-level efforts to improve access to safe, clean facilities for everyone, everywhere.

Sanitation and Water in the United States

In the United States, access to clean water and sanitation is often taken for granted, but disparities exist — particularly in rural areas and in communities that are disproportionately affected by poverty. According to the 2024 Environmental Performance Index, the U.S. ranks 15th globally on SDG 6 (Clean Water and Sanitation). While much of the country has made significant strides in ensuring clean water access, certain regions continue to lag, and many communities face challenges related to aging infrastructure, contamination of water sources, and the affordability of water and sanitation services.

Key Statistics and Challenges

Water Quality and Safety:

• According to the United States Mission to the United Nations, more than 2 million people lack access to clean drinking water, and many more are exposed to unsafe water due to contamination issues. The Environmental Protection Agency (EPA) reports that, in some states, drinking water systems are plagued by lead pipes, which affect thousands of communities, particularly in urban areas such as Flint, Michigan.
• The crisis in Flint, which began in 2014, brought national attention to the risks of lead contamination, but many other U.S. communities continue to experience similar challenges, especially in rural and underserved areas.

Sewer Infrastructure:

• Approximately 20% of Americans, mainly in rural areas, rely on septic systems for sanitation. These systems, when poorly maintained or outdated, can leak or overflow, contaminating both local water sources and the surrounding environment.
• Aging infrastructure in large cities is another growing concern. In places like New York City and Chicago, parts of the sewage system are over 100 years old, which leads to frequent sewage overflows, especially during heavy rains. This creates public health hazards and exacerbates environmental pollution.

Rural Communities and Indigenous Populations:

• Access to sanitation services in rural and indigenous communities in the U.S. often lags behind urban areas. According to the Rural Community Assistance Partnership (RCAP), nearly 2.4 million rural Americans lack reliable access to modern sanitation services. This number includes many Native American reservations, where infrastructure challenges are compounded by economic hardship and underfunded governmental programs.

Disparities Across States:

• States with larger rural populations, such as Mississippi, Alabama, Arkansas, and West Virginia, have some of the lowest rankings in terms of access to safe drinking water and sanitation services.
  • For example, referenced in A Nation Action Plan, Dig Deep and the US Water Alliance stated about Winterville, Mississippi, a Delta town of less than a hundred residents, that people try to use the bathroom as infrequently as possible, because more likely than not water will not drain out of toilets and tubs. The Delta’s high-water table and plentiful rainfall make it difficult to get wastewater down the drain. Many homes also have leaking septic systems or cesspools. These states often face higher levels of poverty, infrastructure challenges, and aging systems that impede efforts to improve public health and hygiene.
• By comparison, wealthier states like California, New York, and Massachusetts generally have better infrastructure, though they are not immune to challenges such as drought, contamination, and inequalities in access, especially for marginalized communities.

The Role of World Toilet Day in the U.S.

World Toilet Day provides a crucial opportunity to highlight these disparities and push for improvements. There is growing recognition that improving sanitation and access to clean water is not only a matter of health but also a human rights issue. Sanitation directly impacts dignity, economic development, and the environment, and it is essential for achieving the United Nations Sustainable Development Goals.

In the U.S., this means advocating for:

• Investment in Infrastructure: Upgrading aging water and sewage systems, particularly in rural and underserved areas, to ensure all Americans have access to safe, clean water and sanitation.
• Addressing Disparities: Focusing on vulnerable communities, including rural, indigenous, and low-income urban populations, to ensure that no one is left behind in the fight for equitable access to sanitation.
• Environmental Sustainability: Implementing strategies to address water contamination from industrial waste, agriculture, and urban runoff, while prioritizing conservation efforts in states facing water scarcity, such as California and Nevada.

Conclusion

On World Toilet Day, we are reminded that access to clean water and sanitation is not just a matter of convenience, but a fundamental human right. While many parts of the world struggle with sanitation crises, the United States also faces significant challenges — from contamination of drinking water to outdated infrastructure and disparities between regions. By working together to address these challenges, we can ensure that everyone, both at home and abroad, has access to the essential services needed for health, dignity, and a sustainable future.

The time to act is now! Clean water and sanitation for all must become a reality, not just a goal. To learn more on what you can do, please join your local United Nations Association of the United States of America (UNA-USA) at www.unausa.org visit www.un.org/sustainabledevelopment/water-and-sanitation and educate yourself on the Water Action Decade.