Safer Water for All: WHO Highlights Unequal Progress in Small-Scale Rural Systems

The WHO’s 2025 report, developed with the German Environment Agency and UNECE, highlights that small-scale sanitation and drinking-water systems are vital for rural Europe but remain underfunded, poorly monitored, and unequal. It calls for stronger regulation, financing, and data-driven management to ensure safe, sustainable water and sanitation access for all.

The 2025 World Health Organization (WHO) report Small-Scale Sanitation and Drinking-Water Supply Systems: Driving Country Action Towards Safer Services, prepared in collaboration with the German Environment Agency (Umweltbundesamt), the WHO European Centre for Environment and Health, and the United Nations Economic Commission for Europe (UNECE), presents a vivid picture of the often-overlooked small-scale systems that sustain millions of rural Europeans. Drawing on national surveys, country reports, and interviews under the Protocol on Water and Health, the study details how these systems, providing water and sanitation for nearly one-fifth of the region’s population, are vital for public health but remain under-resourced, poorly monitored, and frequently unsafe. Since the Protocol came into force in 2005, it has guided governments to set measurable targets and share best practices for improving rural services.

Persistent Inequalities Despite Progress

Data from the WHO and UNICEF Joint Monitoring Programme show that while access to safe water and sanitation has improved across Europe, rural–urban disparities remain stark. In 2024, 85% of rural residents had access to safely managed drinking water compared with 95% in cities, and only 72% of rural dwellers enjoyed safe sanitation against 83% of their urban counterparts. Microbial contamination, particularly from Escherichia coli, remains a pressing concern, ranging from 0.4% to 33% of samples in rural areas compared with up to 4% in cities. Chemical pollutants such as arsenic, lead, nitrates, and fluoride also occur more frequently in rural systems. These statistics, the report warns, mask deeper national inequities that persist despite policy reforms and rising awareness.

Country Actions and Uneven Momentum

Across 35 countries, governments have taken diverse steps to strengthen small-scale systems, though progress is uneven. Many have embraced risk-based management models like the WHO’s Water Safety Plans (WSPs) to proactively manage risks, alongside training programs for local operators, awareness campaigns, and the establishment of data registries. Nations such as Hungary and the United Kingdom have made risk assessments mandatory, while Estonia and Croatia have built national inventories of wells and small supplies. Germany has improved consumer transparency through annual drinking-water reports, and Azerbaijan has invested in decentralized wastewater treatment for rural settlements. Yet the imbalance between water and sanitation persists, 41 actions target drinking-water safety compared with only eight for sanitation. Few countries have advanced in legal reform, financial planning, or data management, areas critical for sustainable progress.

Systemic Barriers and Lost Opportunities

The report identifies several entrenched obstacles. Funding for small-scale infrastructure remains scarce, with governments often prioritizing large urban systems. Responsibilities are fragmented across ministries and agencies, leaving gaps in oversight and accountability. In many places, operators lack training and awareness of existing support mechanisms. Data scarcity, especially on on-site sanitation such as septic tanks, prevents effective monitoring or investment planning. Political neglect and weak coordination between the health and environment sectors perpetuate inefficiencies. The COVID-19 pandemic further disrupted inspections, training, and project timelines, revealing how fragile many rural services remain under stress. Yet, where governments combine community engagement with institutional support, results have been promising, showing that reform is achievable even in resource-limited contexts.

Building Momentum for Change

The WHO and UNECE emphasize that countries making headway share several success factors: practical training for local staff, the use of risk-based tools like WSPs and Sanitation Safety Plans (SSPs), and the creation of comprehensive registries for small-scale systems. Community involvement has proven vital when municipalities and local authorities take ownership, service quality improves, and reforms endure. The Protocol on Water and Health continues to act as a regional catalyst, fostering information exchange and harmonized standards across sectors. The report urges countries to adopt an integrated approach, treating sanitation and water as interlinked services rather than separate policy silos. Coordinating WSPs and SSPs, pooling financial resources, and jointly targeting rural infrastructure would boost efficiency and reduce long-term costs. Strengthened laws, clear institutional responsibilities, and sustainable financing models are essential for stability. Above all, the authors call for a stronger evidence base through system registration and disaggregated data collection, which would guide targeted investments and ensure that underserved communities are not left behind.

WHO’s 2025 assessment portrays steady yet uneven progress toward safe rural water and sanitation. While awareness, training, and management practices have advanced, sanitation lags, and data, financing, and regulation remain weak. The report’s central message is clear: equitable access to water and sanitation must begin in the smallest and most remote communities. The Protocol on Water and Health provides a proven vehicle for uniting health, environment, and water sectors under one regional vision, ensuring that every person, regardless of where they live, can rely on safe, sustainable services.