Expert consensus identifies five priorities for strengthening global water and sanitation systems

Two billion people wake up without reliable access to clean water. That number—2.3 billion—sits at the center of a new research agenda that emerged from conversations among eighty-one water and sanitation experts across thirty-six countries. These experts were asked a deceptively simple question: what do we most need to know to fix the systems that are supposed to deliver water, sanitation, and hygiene services to the world's poorest communities?

The answer they arrived at, through two rounds of structured deliberation, reveals something important about how development work has matured. It's no longer enough to install a water pump or build a latrine. Those things fail. They break down. They get abandoned. The real problem, experts now recognize, is that the underlying systems—the governance structures, the financing mechanisms, the planning processes, the accountability frameworks—are weak or missing entirely. A pump without a system is just a pump. Eventually it becomes a monument to failed aid.

The research priorities that emerged from this Delphi process, a formal method for building consensus among experts, point toward five interconnected challenges. The first is climate resilience. Water systems must survive droughts, floods, and the unpredictable weather patterns that climate change is intensifying. Yet most countries have not integrated climate risk into their water planning. The second priority is gender equity and social inclusion. Systems strengthening efforts often reinforce existing inequalities by working within structures that were never designed to serve everyone equally. The third is governance, financing, and accountability—the hard institutional work of ensuring that money reaches where it's supposed to go, that officials answer for their decisions, and that regulations actually protect both consumers and the environment.

The fourth priority is measurement. How do you know if a system is actually getting stronger? Current monitoring systems cannot answer this question. They track coverage—how many people have access—but not sustainability, reliability, or whether improvements will last. The fifth priority is political economy: understanding the power dynamics, the competing interests, and the incentive structures that shape whether water systems succeed or fail. A brilliant technical solution means nothing if political leaders have no reason to support it.

The study itself reflects a shift in how the global development community thinks about complex problems. Rather than convening a small group of senior officials to declare priorities, researchers conducted a rapid review of academic literature and grey literature, attended two international conferences to capture the concerns of practitioners and policymakers, and then invited a diverse panel of experts to rate and refine 710 initial research questions. After two rounds of voting and discussion, the panel converged on twenty-five high-priority questions that cut across multiple dimensions of water systems.

What makes this work significant is not just the list of priorities but the recognition embedded in it: that water and sanitation systems are not technical problems with technical solutions. They are political, economic, social, and environmental problems that happen to involve water. A system can have excellent infrastructure but fail because local governments lack the capacity to manage finances. It can have strong governance but collapse when climate change dries up the water source. It can be technically sound but exclude the poorest households because affordability was never part of the design.

The research agenda also reveals gaps in what the sector currently knows. Experts emphasized that many existing research questions focus on individual components—finance, or governance, or infrastructure—rather than on how these components interact. They noted that much of the evidence base comes from rural settings, leaving urban water systems poorly understood. They highlighted that practitioners often lack access to research findings, and researchers often lack understanding of what practitioners actually need to know. The study itself was limited by the fact that most panelists came from NGOs and academic institutions, with fewer voices from government agencies, utilities, and private companies that actually deliver services.

What comes next depends on whether funders and policymakers treat these priorities as a genuine research agenda or as a symbolic gesture. The study was conducted during a period of declining investment in global health and development, when bilateral aid is shrinking and national governments are pulling back from international commitments. In that context, the research priorities identified here become both more urgent and harder to pursue. Answering questions about political economy and governance requires sustained engagement with messy, uncertain, context-specific realities. It requires collaboration between researchers and the people actually running water systems. It requires patience and resources that are increasingly scarce. But without that evidence, the sector will continue to repeat the same failures: building systems that work for a few years, then collapse, leaving communities worse off than before.