* Since the last assessment in 2024, updated information became available that required a change in the baseline and target.
EOB 2024-2025
IMPACT INDICATOR
Mortality rate attributed to unsafe water, unsafe sanitation, and lack of hygiene
Baseline
2019
2.7 deaths per 100 000 population*
Target
2025
2.1 deaths per 100 000 population*
Status
2023
2.58 deaths per 100 000 population
Rating
Right track
This indicator measures the number of deaths from inadequate water, sanitation, and hygiene (WASH) that could be prevented through improved services and practices. It therefore provides important information on the disease burden associated with these risks.
The regional mortality rate has steadily declined across the Americas. The baseline in 2019 was 2.7 deaths per 100 000 population. The rate reached 2.6 in 2023 and is projected to decline to 2.4 by 2025, approaching the target of 2.1. Therefore, the indicator is considered to be on the right track.
Improvements in access to safe water and sanitation, together with reductions in open defecation, have driven the downward trend, supported by climate‑resilient infrastructure and community‑based interventions. Persistent gaps include inadequate infrastructure in rural and peri‑urban areas, vulnerability to environmental challenges including climate change and extreme weather events, and limited data on hygiene practices.
During the period, more than 22 million people gained access to safe water and sanitation services, and 1.37 million people no longer practice open defecation. Thirty‑five climate‑resilient water and sanitation safety plans have been developed, benefiting 8 million people, and WASH actions were integrated into neglected tropical disease elimination programs and community plans in Bolivia, Guatemala, and Honduras. This progress will need to be sustained to achieve the target in future as this indicator continues to be monitored under the PAHO Strategic Plan 2026–2031.
Recommendations
Target interventions to countries and subnational areas that have not achieved the WASH mortality target, addressing disparities in rural and peri‑urban settings.
Invest in climate‑resilient WASH infrastructure and scale up community‑based water and sanitation safety plans, integrating them with health and neglected tropical disease elimination programs.
Strengthen surveillance and monitoring systems to capture data on water quality, sanitation, and hygiene practices, and link these data with health indicators.
Promote intersectoral collaboration and sustainable financing to maintain and expand access to safe water and sanitation, while fostering behavior change through education and community engagement.