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Equitable access to water and sanitation

The Protocol on Water and Health stipulates that "equitable access to water, adequate in terms both of quantity and of quality, should be provided for all members of the population, especially those who suffer a disadvantage or social exclusion". In 2010, the United Nations General Assembly and the Human Rights Council recognized access to water and sanitation as human rights. The 2030 Agenda for Sustainable Development adopted in 2015 makes explicit reference to human rights, equality, and non-discrimination principles and the Sustainable Development Goals framework includes a dedicated goal (SDG 6) for water and sanitation: "ensure availability and sustainable management of water and sanitation for all".
The work on equitable access under the Protocol, co-led by France and Hungary and supported by UNECE, aims at enhancing access to water and sanitation for all, including poor, vulnerable and socially excluded people. It includes:

  • The development of guidance documents and tools to better understand, assess and address the challenges to ensure equitable access to water and sanitation;
  • Support to projects in countries to assess the situation of equitable access to water and sanitation and improve the equity of access;
  • Exchange of experiences at the regional level.

Making water and sanitation affordable for all: Policy options and good practices to ensure the affordability of safe drinking water and sanitation services in the pan-European region 

This policy brief aims to support the efforts of countries in the pan-European region in the progressive realization of the human rights to safe drinking water and sanitation. Specifically, it intends to raise the profile of affordability issues among policymakers, enhance the understanding of how affordability concerns can be addressed, and inspire and promote further action to ensure affordable water and sanitation services.


The publication “No One Left Behind: Good practices to ensure equitable access to water and sanitation in the pan-European region” presents good practices and lessons learnt from throughout the pan-European region on the policies and measures to be enacted to provide equitable access to water and sanitation. It distinguishes three key dimensions of equitable access:  - geographical disparities, - specific barriers faced by vulnerable and marginalized groups, - affordability concerns. It presents a range of available policy options to fight inequities. One of the main messages of the publication No One Left Behind is that current governance frameworks are often "equity blind". Ensuring equitable access requires a results-oriented action plan, building on country situation analysis and context specific indicators.

An analytic tool, the Equitable Access Score-card, was developed to support Governments and other stakeholders to establish a baseline measure of the equity of access, discuss further actions to be taken and evaluate progress in ensuring equitable access to water and sanitation through a process of self-assessment.

The publication The Equitable Access Score-card: supporting policy processes to achieve the human right to water and sanitation contains recommendations on how to plan for the self-assessment and provides concrete examples of the benefits of using the Score-card.
In 2022, the Expert Group on equitable access to water and sanitation started a revision process to update the score card in order to reflect the lessons learned from the COVID-19 pandemic by adding questions and sections assessing the policies’ ability to secure the provision of WASH services in emergency situations. The provisional version which be applied in Montenegro and Albania (2022-2023) is available here.
The Guidance Note on the development of action plans to ensure equitable access to water and sanitation aims to help countries in translating the priorities identified through the self-assessment into actions. Specific Equitable Access Action Plans are needed to guide country (or sub-national entity) efforts to achieve equitable access to water and sanitation by identifying priority actions to be implemented and ways of implementing them. The Note describes the content of Action Plans and their process of development.
These various guidance tools contribute to improve the governance and policy framework needed to develop an inclusive and effective response to epidemics crisis such as the COVID-19 crisis. More information on the importance and relevance of these tools for preparedness and response to the COVID19 is available here.
Since 2011, the work under the Protocol on Water and Health has accelerated national and local efforts to improve equitable access to water and sanitation in the pan-European region.
The publication The Human rights to water and sanitation in practice: Findings and lessons learned from the work on equitable access to water and sanitation under the Protocol on Water and Health in the pan-European region capitalizes on he experiences of the region, and particularly of eleven countries, which have committed to improving equitable access. The publication maps out the lessons learnt from the Equitable Access Score-card based assessments, presents concrete technical and policy actions taken by these countries and examines national experiences with the development of Equitable Access Action Plans, considering the practical steps that can be taken to improve the planning and financing of specific action plans. 

Projects were carried out in eleven countries to develop situation analysis of the equity of access to water and sanitation services, on the basis of the Score-card.

Map of Equitable Access assessments and action plans
Click the image to enlarge.





Country Scale of assessment Project period Lead organizations Country report Country highlights
France Greater Paris Urban area December 2012 - March 2013 Eau de Paris, SEDIF, SIAAP, OBUSASS, Ministry of Social Affairs and Health PDF (pilot) PDF
Portugal National September 2012 - April 2013 ERSAR, National Commission for Human Rights PDF (pilot) PDF
Ukraine National + city of Sebastopol January - May 2013 State Sanitary and Epidemiological Service, NGO MAMA-86, Ministry of Ecology and Natural Resources PDF (pilot) PDF
Republic of Moldova National April - December 2014 NGO Solidarity Water Europe in Moldova, Ministry of Environment PDF PDF
Armenia National November 2015 - October 2016 State Committee on Water Economy of the Ministry of Agriculture and NGO AWHHE



Hungary National October 2014 - End 2016 National Public Health Center and Office of the Commissioner of Fundamental Rights PDF PDF
Azerbaijan National October 2015 - July 2018 Republican Hygiene and Epidemiology Centre under the Ministry of Health, Ministry of Ecology and Natural Resources - PDF
North Macedonia 3 districts (Skopje, Veles and Kumanovo) April 2015 - February 2016 Institute for Public Health and NGO Journalist for Human Rights PDF PDF
Spain Municipality of Castelló de la Plana April - May 2016 Polytechnic University of Catalonia, Jaume I University and City council of Castelló de la Plana PDF PDF

Region of Sumadija and Pomoravlje


July - December 2017 Ministry of Environmental Protection, Regional Economic Development Agency for Sumadija and Pomoravlje PDF PDF
Bulgaria Regional level January - July 2018 Ministry of Healthcare, NGO EarthForever PDF PDF
Belarus Regional level June 2019 - February 2020 Ministry of Health ENG
Montenegro  National level  January 2023 - ongoing Ministry of Health     
Albania  National level  October 2023 - ongoing Water Resources Management of Albania    

 Three countries have developed Equitable Access Action Plans:


Activities on equitable access to water and sanitation in the 2023-2025 programme of work of the Protocol on Water and Health focus on:

  • Support assessments of the situation of equitable access to water and sanitation

  • Foster the adoption and implementation of measures to ensure equitable access to water and sanitation

  • Promote awareness on equitable access to water and sanitation, as well as synergies with relevant global and regional processes, policies and instruments

Last update date: May 24, 2024