SDG 6 – Transforming institutional dynamics of power and governance to enable universal access to water, sanitation and hygiene (WASH)

By Kathryn Tobin, WaterAid

SDG 6, Ensure availability and sustainable management of water and sanitation for all, represents one of the easiest – and most fundamental – parts of the 2030 Agenda to achieve. Dynamics of power and inequality shape access to water, sanitation and hygiene (WASH) and other basic services, both in terms of tangible metrics (income, nearness and type of family toilet or water source) and because of the unequal distribution of influence over decision-making - the gulf between whose rights and voices count and whose do not. Raising the political leverage of communities facing discrimination in infrastructure and service provision is key in changing the power relationships between users and providers. The preconditions for universal access to WASH at national level must be matched by commitments at international level: to significantly increase official development assistance (ODA), restructure debt, curb illicit financial flows and stimulate new sources of international public assistance through democratic institutions.

Achieving the ambition of “universal and equitable” WASH

SDG 6 calls for “universal and equitable” provision of services, an ambitious and rights-based framing that requires both a holistic approach to SDG implementation and interventions into the political dynamics that determine who has access and who does not. The breadth of SDG 6 encompasses social, environmental and economic concerns, addressing factors of affordability, gender determinants of access and the implications of climate change in increasing pollution, water scarcity and water-related ecosystems. This comprehensive approach – light years beyond the Millennium Development Goals (MDGs) in both scope and ambition – must be matched by integrated implementation through policy, budgeting and programming, at national and global levels.

WASH is an essential enabler for advances in health, education, gender equality, economic participation, decent work, and freedom and safety in public spaces. At the same time, water and sanitation are intrinsically entwined with dynamics of poverty, inequality and the drivers and effects of climate change, conflict and migration. Inequalities in health are related to inequalities in access to WASH. An integrated approach to implementing SDG 6 is therefore central to an overall application of the 2030 Agenda, reflecting its holistic nature and the deliberate intention of the governments who crafted it to address social, environmental and economic drivers of progress and equality simultaneously.

For example, WASH is a critical element of an integrated and holistic understanding of sexual and reproductive health and rights. Women who are most likely to die in childbirth, who don’t have access to sexual health services (which depend on WASH) or the ability to make decisions about their reproductive and sexual lives are also often disadvantaged in terms of political voice and representation in decision-making, as well as in lower income quintiles. The lack of safe, affordable, accessible and available water, sanitation and hygiene is a significant contributor to maternal and newborn deaths, as well as to unsafe abortion and to unmet needs for menstrual health. [fn] WaterAid et al. (2019, forthcoming). [/fn] WASH is essential to ensuring the full spectrum of health-related needs and rights of women, girls, and transgender and gender non-conforming people.

Water and sanitation form part of a package of essential services that should be afforded to all in order to achieve the 2030 Agenda and to fulfil their human rights. Cross-ministerial and cross-sectoral efforts to implement SDG 6 and the 2030 Agenda as a whole are therefore required, particularly around health and education, where WASH is a prerequisite for effective care and learning. This integration should be reflected in the institutions set up to implement the SDGs and to advance national development priorities, which requires transforming the underlying causes of inequalities along lines of income, geography, gender, ethnicity, disability, caste, and so on. Amplifying communities’ claims for equitable access to affordable, quality services is fundamental in transforming the governance conditions that circumscribe this access, especially for those living in greatest poverty or marginalization.

Intersecting inequalities, democratic governance gaps and institutional weaknesses drive or constrain the equitable and inclusive implementation of SDG 6. These factors are equally or more impactful than the funding available to countries to extend WASH access to the entirety of their populations. [fn] For detail on a “systems approach” to ensuring WASH access, see IRC (2019). [/fn] Transforming the political and institutional determinants of access should be a priority for States as duty-bearers as well as for all actors committed to the implementation of SDG 6 – and of the SDGs as a whole.

There is more than enough global wealth to pay for the entirety of the 2030 Agenda and to fulfill the rights of all human beings to health, education, water and sanitation, and all other prerequisites for social, economic and environmental justice. [fn] Oxfam (2019) outlines recent figures on the amassing of global wealth; Center for Global Development (2018) has done a lot of thinking around what achieving the SDGs would cost. [/fn] For WASH, the technology and knowledge required to extend universal access are neither relatively expensive nor particularly complex, so it should have been possible both to reach the MDG on water and sanitation and be on track to easily achieve SDG 6. Why then are there still 844 million people who lack access to safe drinking water, and 2.3 billion without decent sanitation?

Weak institutions, unequal voice: constraints to WASH access

Even where ‘coverage’ with WASH infrastructure or services exist, barriers to access arise through internal and external dynamics of the sector, in terms of institutions, coordination, planning, monitoring, financing, delivery, accountability, water resource management, user demand and behaviour. [fn] WaterAid (2018). [/fn] Working across national governments, municipal authorities and utilities/service providers on ‘sector strengthening’ is fundamental to the achievement of SDG 6 – especially where the underlying cause of insufficient access is a lack of capacity on the part of providers. Through participatory processes and supporting institutions responsible for WASH delivery, we work in partnerships to enable the WASH sector to capably respond to increasing demand and provide long-term services.

Where access is stymied not because of a lack of capacity but because of a lack of will, it is important to assist communities in efforts to secure their rights, mobilizing to claim services and hold duty-bearers to account, thereby seeking to transform the status quo of exclusion and the norms and attitudes that underpin it. Remote communities’ relative lack of access to WASH, for example, is caused by their distance not only from established infrastructure but from centres of power and decision-making. Creating a political cost for ignoring the rights of remote communities by raising their political leverage is key in changing the power relationship between service providers and users, as concrete steps towards ensuring universal access.

But the underlying causes of lack of capacity, lack of will or both must also be addressed along with their locally specific manifestations. It is not enough to determine that a given country has vast disparities in access to sanitation, for example, because its WASH sector is weak and it lacks sufficient funds to pay for upgrading infrastructure upgrades and extending services to its hardest to reach populations. The analysis must also acknowledge how structural adjustment, unsustainable debt burdens, trade regimes that trap developing countries in primary commodity export while flooding markets with cheap foreign goods that disincentivize local production, and a global push towards privatization and public-private partnerships (PPPs) have shifted the focus away from social protection and quality services. [fn] For a discussion of the structural economic transformation away from primary commodity production required to enable development (with particular focus on agriculture in sub-Saharan Africa), see Hormeku-Ajei (2018). The recent report of the UN Special Rapporteur on Extreme Poverty and Human Rights, Philip Alston, outlines comprehensive research on the effects of widespread privatization of public goods on deepening poverty and violating human rights (2018); a useful summary was posted by the Bretton Woods Project (2018). [/fn]

The question why a sector-strengthening and empowerment approach is necessary – and why gaps in service provision are being filled by international NGOs – hinges on global inequalities and historical trajectories of colonization and imperialism, still played out today through neo-colonial economic structures and inequitable global decision-making.

Upending global structural drivers of discrimination in access to WASH

Achieving SDG 6 will not happen without a democratic ‘enabling environment’ at national level. But the fundamental preconditions at national level (transparency, participation of people facing discrimination in determining the priorities of their local and national budgets, adequate expenditure funneled to where it is supposed to go) must be matched by commitments at international level. Transforming national paradigms of voice and access requires international echoes in decision-making and resources.

As with national-level interventions, this requires transforming the structural paradigms that cause inequalities in the first place, and replacing them with a vibrant and equitable multilateral system that sets and enforces rules for the governance of trade, debt, financial flows, taxation and international public assistance through democratic institutions.

In this context, it is important to underline the role of ODA-- an obligation grounded in historical responsibility and continuing neocolonial economic structures. The corporate wealth that so enriches the economies of donor countries is generated through the raw materials and cheap labour sourced in the developing world, so the exponential increase of ODA in line with actual economic realities must be part of any discussion of how to finance the SDGs, along with the right to development. ODA is also the missing piece of the current triangle around Financing for Development, which tends to emphasize the role of private/blended finance (despite lack of evidence of its contributions to advancing the SDGs or national development priorities) and domestic resource mobilization, while ignoring the reality that without significant inflows of public, grant-based assistance, most lower-income or fragile states will never be able to finance their full implementation of the SDGs through either taxing their citizens or incentivizing corporate investment. [fn] ODI (2018). [/fn]

Advocating for grant-based financing is also essential because levels of external debt are again reaching unsustainable levels in many developing countries. Forty percent of low-income developing countries (LIDCs) are now in or approaching a state of debt distress. [fn] IDA (2018). [/fn] Servicing high levels of debt prohibits countries from spending domestic resources on the kinds of public services that reduce inequalities, improve people’s lives and achieve sustainable development – with particular impact on women and girls, who are then forced to take up the drudgery of care and household work that would otherwise be ameliorated. [fn] IDS (2016). [/fn] WASH provides a prime example of the need to link discussions of service provision to broader structural questions of government spending, such as women’s and girls’ responsibilities in acquiring water, boiling or otherwise ensuring its safety for use in cooking and drinking, and caring for family members who fall ill due to the lack of sanitation – as well as their own gender-specific WASH needs regarding menstruation, pregnancy and childbirth, and (peri)menopause. [fn] Gender and Development Network (2016). [/fn] Debt relief should therefore be part of a new commitment to increasing international public assistance for the SDGs, ensuring it translates to conditionality-free increases in LIDC government coffers.

Additionally, taxation must be re-envisioned at a global level, to complement national-level emphasis on domestic resource mobilization. Financial transaction taxes and carbon taxes can be important components of this, supporting financial stability and the transition to a zero-carbon economy. This vision must also include, through a UN-led global tax body, the introduction of new taxes on technology and on high net-worth individuals. New global rules should govern the reform and restructuring of the taxation paradigms around extractive industries and other corporate investment in developing countries, to prevent a ‘race to the bottom’ and ensure countries have both policy space and public finances to pay for their development objectives.

Finally, curbing tax evasion and avoidance, and stopping illicit financial flows (IFFs) are essential to enable countries to finance SDGs implementation. Taking action on tax havens—estimated to store wealth equivalent to 10 percent of global GDP—addressing transfer mispricing by transnational corporations, and supporting improvements in governance and transparency to tackle corruption are prerequisites. What prevents countries from allocating sufficient resources to sustainable development is just as important as what enables them to do so. [fn] Garrett/Tobin (2018). [/fn] The OECD Base Erosion and Profit Shifting (BEPS) process is a start, but a truly multilateral, democratic process with global South government ownership is essential in carrying forward the momentum of the Stop the Bleeding campaign around the Mbeki Panel on IFFs, [fn] See [/fn] for example, and moving towards meaningful action to address IFFs and tax havens internationally.

These components of global financial governance should lead, in the immediate term, to economic transformation at the national level. Together, these measures should form a new financing compact that re-emphasizes the public over the private, to enable the prioritization of basic services and human rights. Only this level of tectonic shift will enable countries to address the compounding crises of climate change, commodity price volatility and rising inequalities – and to have any chance of achieving the vision set out in the SDGs.

Towards structural transformation of and through the 2030 Agenda

The 2030 Agenda, while in some ways a watered-down, ‘least common denominator’ version of the sweeping and interlinked transformative framework envisioned by many of its original proponents, is profoundly political in terms of the systemic, topline decisions it implies of national and multilateral actors. Any honest attempt to achieve it, at country and global level, requires engaging with structural questions of how the economy functions and the institutions through which advances in service provision, infrastructure, regulation, and legislation are shifted and remade in order to carry out its directives.

Without addressing these issues, the international community will spend another 10-15 years tinkering around the edges, not meeting any but the easiest-to-reach SDG targets. Ending inequalities in sanitation (and diseases of poverty resulting from its lack), social protection, violence against women - the elements of the 2030 Agenda that depend on power relations – will continue according to current trends or devolve further as global crises become more urgent and trends towards unilateral and xenophobic decision-making proliferate.

There are only a few years left to make sure the SDGs are meaningful – which requires engaging in the institutional governance to guarantee human rights, and transforming underlying inequalities that determine access, participation and voice – at national and global levels.

Kathryn (“Katie”) Tobin is Advocacy Coordinator at WaterAid, and has worked on sustainable development and human rights in and around the UN since 2011. The views expressed here are those of the author and not of the institution.


Bretton Woods Project (2018): IMF and World Bank’s support for privatisation condemned by UN expert. In Bretton Woods Observer, winter 2018. London: BWP.

Casey, Vincent/Crichton-Smith, Hannah (2018): Taps and toilets aren't enough: designing WASH programmes that strengthen the system. London: WaterAid.

Donald, Kate/Moussié, Rachel (2016): Redistributing Unpaid Care Work – Why Tax Matters for Women’s Rights. Brighton: Institute for Development Studies.

Gender and Development Network (2016): Achieving gender equality through WASH. London: GADN.

Hormeku-Ajei, Tetteh (2018): Agriculture, Rural Livelihood and Structural Economic Transformation in Africa. In Reimagining Regionalism: Heterodox and Feminist Policy Proposals from Africa and the Caribbean. Berlin: Friedrich-Ebert-Stiftung.

Huston, Angela/Moriarty, Patrick/Lockwood, Harold (2019): All systems go! Background note for the WASH systems symposium. The Hague, The Netherlands: IRC.

Garrett, John/Tobin, Kathryn (2018): Ambitious Agenda, Ambitious Financing? UNGA Shows a Long Way Still to Go for SDGs. In: IPS News, 5 November 2018.

International Development Association (2018): Debt Vulnerabilities in IDA Countries. Washington, DC: IDA.

Manuel, Marcus/Desai, Harsh/Samman, Emma/Evans, Martin (2018): Financing the end of extreme poverty. London: Overseas Development Institute.

Oxfam International (2019): Public Good or Private Wealth? Briefing paper. Oxford.

Plant, Mark (2018): SDG Arithmetic. Washington, D.C.: Center for Global Development (blog, 18 June 2018).

UN General Assembly (2018): Report of the Special Rapporteur on extreme poverty and human rights. New York (UN Doc. A/73/396).

WaterAid (2019, forthcoming): Exploring the role of water, sanitation and hygiene (WASH) in comprehensive sexual and reproductive health and rights (SRHR). London.