WaterAid/ Ernest Randriarimalala

Global annual
reportWaterAid/ James Kiyimba

WaterAid/
Guilhem Alandry

Global annual report

WaterAid/ Ernest Randriarimalala

Throughout our global federation
we are igniting lasting change.

We are resolutely focused on making cleanwater, decent toilets and good hygiene
normal for everyone, everywhere.
The world has made huge progress in increasing
access to these essential services. However, 785
million people still don’t have clean water close
to home, 2 billion don’t have a decent toilet of
their own and 43% of healthcare facilities do nothave hand hygiene facilities at points of care.
And climate change, which is already affecting
the communities we work with, is compounding
challenges to building sustainable services.
But we are rising to the challenge. In 2018-19
our global federation – with national members
Australia, Canada, India, Japan, Sweden, the UK
and the USA – reached millions of people bydelivering services directly to homes, schools
and healthcare centres.

Olivia and two friends
washing their hands anddrinking clean water attheir school’s water point
in Analamanga region,
Madagascar.

To make sure services last long after weleave, we focus on building strong water,
sanitation and hygiene (WASH) systems. This
year we continued to work at multiple levels tostrengthen government leadership, institutional
processes and policies, and community
empowerment, and to demonstrate inclusive,
sustainable models that governments can scaleup.
And for an even bigger impact we infiuenced
others who can multiply our contribution,
including governments and global leaders indevelopment, health and the private sector.
Read on to explore highlights of how we havebeen igniting lasting change.
Read our 2015-22 global strategy atwateraid.org/uk/our-global-strategy
WaterAid Global annual report 2018–19/ 2

Discover our reach

Last year, with our partners, we reachedmillions of people through our work in
communities, schools and healthcare centres,
and through our advocacy.

Direct reach
CLEAN
WATER
DECENT
TOILETSGOOD
HYGIENEWe supported communities
to reach the following
numbers of people1:

We supported schools toreach the following numbersof people1:

We supported healthcare
facilities to reach people forthe following numbers ofvisits1:

385,000 with clean water

206,000 with clean water

1,238,000 with clean water

453,000 with decent toilets

182,000 with decent toilets

1
 ,503,000 with goodhygiene695,000 with good hygiene

1
 ,080,000 with decent
toilets

We influenced policies,
strategies and standards
around the world. Last year
we helped secure changes tonational policies, strategies orstandards in 14 countries tobenefit people currently living
without clean water, decent
toilets or good hygiene.

We advocated globallyand regionally. Drawing
on our experience within
individual countries, at
global and regional levels weadvocate the importance of
WASH. See below for details of
our work at the World Health
Assembly around cholera.

991,000 with good hygiene

Influencing

We strengthened local
systems. Much of our work
focuses on building strong
WASH systems at district ormunicipality level to ensure
access lasts and reaches
everyone. Last year, we worked
in more than 90 districts.

1

We count users of the services we provide directly in different ways, according to where
we reach them:• In or near people’s homes – population served by water, sanitation and hygiene facilities.
• Schools – school population plus staff.
• Healthcare facilities – total number of patient visits over one year plus staff.
We count people as having been reached with good hygiene through behaviour change
activities when they have been exposed to those activities at least three times in a year.

WaterAid Global annual report 2018–19/ 3

We work in 34 countries across the world. Here arejust some stories from our work last year.

Country programmes
26 Pakistan
27 Nepal
28 Bangladesh
29 Myanmar
30 Cambodia
31 Timor-Leste
32 Papua New Guinea

WaterAid/
Basile Ouedraogo

Taking change to scale in Mali

We are working to help the new national strategy
make this promise reality, to ensure that morethan 18 million Malians like Nurse Salimata, Kadia
and her baby daughter Sanata (pictured) have thesafe healthcare centres that are their right.

Above: A new examination room at Talo
Health Centre, Mali. Below: Nurse Salimata
with Kadia and her baby daugher Sanata in thecentre’s new maternity ward.

WaterAid/Basile Ouedraogo

Building on experience in Mali delivering water,
sanitation and hygiene facilities in 23 healthcare
centres, we convinced the Government tocommit to scale up these improvements tohealthcare centres across the country.

WaterAid Global annual report 2018–19/ 4

Inspiring 40 countries to fightantimicrobial resistance

They shared our experiences from the front line, and inspireddelegates from more than 40 countries and UN agencies tocommit to improving infection prevention and control throughthese three essentials. Meanwhile, our teams in America andthe UK joined up to publicly commit to the USA-led Global
Antimicrobial Resistance Challenge.
Without water, sanitation and hygiene, doctors like Casmir
Lubango, pictured at Kharumwa Health Centre, Tanzania, cannot
keep infections from spreading. In partnership with Amref
Health Africa, with funding from the Government of Canada, wetransformed facilities at Kharumwa. “Improved access to waterand good hygiene practices in a hospital environment means
infection prevention and control. There are no sepsis cases due toimproved hygiene,” said Dr Lubango.

WaterAid/James Kiyimba

At the Second Global Call to Action on Anti-Microbial Resistance,
a global meeting in Accra, Ghana, our advocates from Cambodia
and Ghana, supported by Australian and UK teams, worked
together to convince participants to pay greater attention towater, sanitation and hygiene in healthcare facilities, to curb the
spread of superbugs.

Casmir Lubango, medical
officer, testing the newly
installed piped water systemin the new maternity ward
at Kharumwa Health Centre,
Tanzania.

Supporting sustainable water and sanitationin Uganda

WaterAid/James Kiyimba

Our SusWASH programme to achieve long-lasting clean water,
decent toilets and good hygiene for everyone, everywhere madepositive strides last year. Funded by the H&M Foundation, we
collaborate with and influence our partners, and deliver directly
as well. Doing this means we secure greater improvements than if
we acted alone.
For example, working with the Ugandan Government, wedemonstrated the benefits of inclusive, low water use sanitation
systems. These include reduced water bill costs so schools canbetter maintain their facilities, benefitting more than 3,000
students and teachers. And in the capital, Kampala, we aresupporting the city council and schools to plan and budget for
ongoing maintenance. We are promoting this approach throughpartners to replicate the changes in other countries so together
we change millions more lives.

Pupils at Father Bill
International Junior School in
Kampala, Uganda, collecting
water from their school tap
stand.
WaterAid Global annual report 2018–19/ 5

Changing hygiene behaviourin Mozambique

We trained people in government, local
businesses and schools to promotehandwashing with soap, food hygiene, water
treatment and faeces management to morethan 153,000 people like Alima and her daughter
Atijah (above right), and Vahia Nurdine (below
right), in Mucocorone.

Alima, Atijah and Vahia
using clean water from the new
borehole in Mucocorone village.

WaterAid/Chileshe Chanda

WaterAid/Chileshe Chanda

We completed a two-year project with
Mozambique’s Government, funded by theInternational Vaccine Institute (Korea), to
integrate hygiene behaviour change activities
with cholera vaccination.

Sustaining water and sanitation
benefits in Madagascar

In Sabotsy Anjiro, Madagascar, we built a new water
treatment facility serving more than 8,000 people.
Our local partners SAF/FJKM track water quality
and support maintenance so that services last.

WaterAid/Ernest Randriarimalala

Hasina using her village’s
new tap stand (left and right)
and with her friends at thewater point (centre).

WaterAid/Ernest
Randriarimalala

WaterAid/Ernest Randriarimalala

Together with SAF/FJKM, we are working with
USAID to promote good hygiene, so thatvillagers like Hasina (pictured left) and herfriends can benefit fully from the new cleanwater, decent sanitation and hygiene facilities.

WaterAid Global annual report 2018–19/ 6

We trained 2,200 female health volunteers
in four districts in Nepal to motivate 35,000
mothers like Ambika, pictured with her son
Aayush at the new tapstand near her home,
to practise key hygiene behaviours, on four
separate occasions each. This extension of
our previous pilot project to integrate hygiene
behaviour change into the Government of
Nepal’s routine immunisation programme will
be extended further next year into a nationwide
rollout, benefitting even more families.

WaterAid/Mani Karmacharya

Improving hygiene in Nepal

After we improved water, sanitation and hygiene
facilities in 12 Cambodian healthcare centres,
we ensured the Government will match these
improvements in all 1,100 centres across thecountry.
The Government’s national guidelines are theresult of years of advocacy on a neglected areaof work and will enable doctors like Dr Khem
Sokken to treat patients like Chanthou and herson (right) in more hygienic, safer environments.

WaterAid/ PATH/ Philong Sovan

Boosting healthcare across Cambodia

WaterAid/Tom Greenwood

Ensuring inclusive school facilities
in Papua New Guinea

All schools in Papua New Guinea are now
required to have clean water, decent toilets
and good hygiene thanks to a Department of
Education policy developed and drafted with our
support.
The policy includes a focus on accessibility andfemale students’ needs, so that all pupils, like
Victoria, Joe and Tori, pictured outside WaterAid
toilets at their school in Rigo District, have theessential facilities they need to stay in class.

WaterAid Global annual report 2018–19/ 7

Explore ourpartnership stories

Together with our partners, we have abigger impact. Here are just eight examplesof our partnerships with governments,
businesses and civil society organisations
across the world.

Latter-day Saint Charities in Colombia
WaterAid/
Nat Fernandes

With support from Latter-day Saint Charities, we
expanded our work in Colombia to Putumayo, adepartment profoundly affected by decades ofarmed conflict.
Partnering with Action Against Hunger, werebuilt a community water supply system
including a new borehole waterpoint serving
more than 400 people, including a school and ahealth post, laying the foundation to implement
a comprehensive district-wide approach.

WaterAid/Mani Karmacharya

WaterAid/
Mani Karmacharya

Paola and her son Brainer,
at their home in Teteye,
Putumayo, Colombia.

Anglian Water in Nepal
The Beacon project – a long-term partnership
between WaterAid, Anglian Water and partners
in Lahan, Nepal – is designed to deliver the
improved water facilities the community needs –and so much more.
Not only are Anglian Water and their supply
chain partners working together with theGovernment of Nepal to decide Lahan’slong-term water supply strategy, they are alsoplanning how it can be reproduced in othertowns across the country.
Above left: Anglian Water team members visit
the Nepal Water Supply Corporation’s office inLahan. Below left: WaterAid Nepal Country Director
Tripti Rai shakes hands with Mayor Muni Sah after
signing the partnership’s declaration of intent.

H&M Foundation in Bangladesh

The project constructed and renovated 31 public
toilets, reaching millions of people like Rina
Begum and her son (pictured right in Shattola
Pora Basti Slum, Dhaka), and putting sanitation
at the heart of Bangladesh’s public agenda.

WaterAid/Abir AbdullahWith H&M Foundation we celebrated the endof a successful five-year partnership to provide
public toilets across major cities in Bangladesh.

WaterAid Global annual report 2018–19/ 8

WaterAid/James Kiyimba

WaterAid/
James Kiyimba

Global Affairs Canada in Tanzania
Clean water is now flowing in eight healthcare
facilities in Tanzania, thanks to our partnershipwith Global Affairs Canada, serving a total of
444,135 people and helping to reduce infant andmaternal mortality. Together, we continued to
improve the health of women, men and children
by providing clean water, decent toilets andhygiene education.
Our shared vision for gender equality and female
empowerment is actively pursued through theCanadian Government’s Feminist International
Assistance Policy.
Grace Nabenga Lufu, a nurse at Kakora
Dispensary in Geita, Tanzania (pictured withconstruction workers and using a new sink in award) was excited about the improvements at her
dispensary.

Government of Australia in Myanmar,
Papua New Guinea and Timor-Leste
This year we began our partnership with
Water for Women, a £10.07 million
five-year programme funded by the AustralianGovernment that aims to improve the health,equality and wellbeing of communities in Asiaand the Pacific.

WaterAid/Tom Greenwood“Many expectant mothers never wanted to deliver
here because they never trusted the available
facilities. They thought this would put their lives orthat of their babies at risk. Sanitation and hygiene
conditions have greatly improved,” she said.

Our three Water for Women-funded projects in
Myanmar, Papua New Guinea and Timor-Leste
are united in their aims of advancing genderequality and strengthening the local water,
sanitation and hygiene (WASH) sectors. Withstrong local WASH systems, students like thegirls pictured outside the new toilet block at
Ailuli Pre-Secondary School in Timor-Leste will beable to have the lasting facilities they need for a
successful education.

WaterAid Global annual report 2018–19/ 9WaterAid Niger

Improving faecal sludge managementwith the Bill & Melinda Gates
Foundation

Members of WaterAid’s
faecal sludge management
team visiting Niger’s first faecal
sludge treatment site.

Influencing global change with theWorld Health Organization

This year we made continued strides in
influencing sanitation policies and programming
through our global and country-level WASH
advocacy project. The three-year, US$4.5 million
investment from the Bill and Melinda Gates
Foundation supports global (Australia, Canada,
UK and USA), regional (South Asia and West
Africa), and national (Burkina Faso, Mali, Niger,
Bangladesh and Nepal) advocacy to advanceequitable access to sanitation.
As part of this project, in 2018-19 we produceda regional study of faecal sludge management(FSM) in South Asia, looking at laws, policies
and regulations across Bangladesh, Nepal,
India and Pakistan. At the national level, ourBangladesh team was key to the development of
an institutional regulatory framework for FSM,
and continues to be actively involved in rollingout that framework. And in Niger, we supported
the Ministry of Hydraulics and Sanitation and theCity of Niamey with the development and launchof Niger’s first faecal sludge treatment plant,
assisting with capacity building and sensitisationof the stakeholders involved.

We joined with experts to influence
governments to prepare, propose and adopt
the resolution, increasing commitment tocross-sector collaboration. We met seniordiplomats to persuade them to support theresolution, and we advocated cholera to bea public health priority during the Assembly,
supporting Zambia’s and Haiti’s Ministries of
Health to lead the effort. Having passed theresolution, countries are committed to follow a
global plan to fight cholera, including throughsubstantial investment in water, sanitationand hygiene.

WaterAid

Our coordinated global advocacy helped
ensure UN member states passed a resolution
at the World Health Assembly to end cholera.
Governments, the World Health Organizationand civil society pledged to work together to end
the deadly disease, which affects people in theworld’s poorest communities.

WaterAid delegates at theWorld Health Assembly in
Geneva, Switzerland.

WaterAid Global annual report 2018–19/ 10

WaterAid Bangladesh

Momena Khatun, a sewing
operator at a garment factoryin Dhaka, Bangladesh, in whose
home settlement, funded by
HSBC, we renovated water, toilet
and washing facilities.

Making the business case for WASH

In collaboration with Diageo, Gap Inc andUnilever, in 2018 we developed and launched aguide to help strengthen the business case for
improving water, sanitation and hygiene (WASH).
The aim is to help companies understand andmeasure the economic benefits of investingin WASH and to make the case for further
investment.
Last year HSBC committed to pilot test the‘Business case for WASH’ guide in apparel supply
chains in India and Bangladesh. In Bangladesh,
we are working with three ready-made garment
factories to improve the provision of taps andtoilets and to boost hygiene behaviour, both in
the factories and where workers live. This has
already begun to transform their working andliving environments – having access to waterand sanitation facilities has enabled workers
to manage their toilet and washing routines
more effectively in the morning, and access toclean water has reduced illnesses. The factories’
management have seen a decrease in latenessand absenteeism, increased worker productivity
and greater employee retention. We are working
to measure the impacts of these businessbenefits and define a return on investment for
the fashion brand from investing in WASH.
Investment in WASH extends beyond theworkplace, improving the health and quality oflife of workers and their families, while increasing
supply chain resilience and business productivity.

Find out how to partner with us atwateraid.org/uk/corporate-partnerships

Our international partners include:
International institutions
European Commission
UNICEF
World BankWorld Health Organization
Companies and foundations
Anglian Water
Bill & Melinda Gates Foundation
H&M Foundation
The Helmsley Trust
HSBC Holdings Plc
One Drop Foundation
Players of People’s Postcode Lottery (UK)Severn Trent Water
Swedish Postcode Lottery
Sydney Water
Thames Water
Yarra Valley Water
Governments
UK Department for International Development
Swedish International Development Agency
Japan International Co-operation Agency
The Government of Japan

Australian Department of Foreign Affairs and Trade

Global Affairs Canada

United States Agency for International Development

WaterAid Global annual report 2018–19/ 11

Finances and governanceIn 2018-19, our global income was£113.3 million.

Global income 2014-19

Global expenditure

From 2014-15 to 2018-19 our income grew from
£90 million to £113 million.

54% of our spend went to programmes; 4%
to policy and campaigns; 25% to fundraising;
12% to governance, finance, IT, people
and organisational development; 3% tocommunications and 2% to other costs.

Global income

For the year 2018-19, 43% of our income camefrom individuals, 16% came from major donors
and trusts, 16% came from corporate donors and
25% came from institutions and other sources.

These summary accounts are based on audited
accounts for each federation member. Please
see each member’s annual report for details.

Visit wateraid.org/how-were-run

WaterAid Global annual report 2018–19/ 12

Front cover: (Top down)
Hasina uses the new water
point in her village, Sabotsy
Anjiro, Madagascar.
Abibatou Diarra, Midwife,
washes her hands at Diaramana
Health Centre, Mali.
Grace Nabengu, Nurse, infront of the new toilet block at
Kakora Dispensary, Tanzania.

Contact usContact our federation andfederation member offices.

Australia
wateraid.org/au/contact-us
Canadawateraid.org/ca/contact-us
Indiawateraidindia.in/contact-us
Japan
info-japan@wateraid.org
Swedenwateraid.org/se/kontakta-oss
United Kingdom
wateraid.org/uk/contact-us
United Stateswateraid.org/us/contact-us
The WaterAid WaterAid
International Secretariat
wainternational@wateraid.org

WaterAid is a registered charity: Australia: ABN 99 700 687 141. Canada: 119288934 RR0001.
India: U85100DL2010NPL200169. Japan: 特定非営利活動法人ウォーターエイドジャパン(認定
NPO法人) WaterAid Japan is a specified non-profit corporation (certified NPO corporation).
Sweden: Org.nr: 802426-1268, PG: 90 01 62-9, BG: 900-1629. UK: 288701 (England and Wales)
and SC039479 (Scotland). USA: WaterAid America is a 501(c) (3) non-profit organization.

WaterAid Global annual report 2018–19/ 13