Rural Water Security in Asia and the Pacific: New Insights from AWDO 2025

The Asian Development Bank launched its flagship report, the Asian Water and Development Outlook (AWDO) 2025, at the IWA World Water Congress and Exhibition in Bangkok in December 2025. The University of Oxford led the analysis of Key Dimension 1 (KD1) on Rural Household Water Security, co-authored by Professor Katrina Charles, Dr Sonia Hoque and Irina Gribanenkova. 

When we started looking at how countries were progressing on rural water security, it quickly became clear that the task would not be straightforward. How do we meaningfully assess the water security of hundreds of millions of people living in fast-changing economies, with persistent inequalities, ageing infrastructure, and growing climate pressures, especially when national-level data are limited? Our approach centred on a simple question: what must rural water services deliver to protect people’s health and wellbeing? 

To answer this, we updated earlier AWDO methods to reflect a shift in global WASH thinking. Instead of focusing only on access to infrastructure, we looked at the quality, reliability and resilience of water, sanitation and hygiene services, and whether these services actually reduce disease burden.  

Our methodology is based on three key data sources: (1) WASH Infrastructure, using WHO/UNICEF Joint Monitoring Programme data to assess access to water, sanitation, and hygiene services; (2) Health Outcomes, measured through the Global Burden of Disease data on contribution of diarrhoeal diseases to deaths in children under five and to Disability Adjusted Life Years (DALYs) in school-aged children; and (3) Climate Resilience, evaluated through analysis of National Adaptation Plans (NAPs), which indicate whether countries are addressing the sustainability of rural WASH services in the face of climate change. 

This approach moves beyond counting taps or toilets. It focuses on whether services work every day, whether the water is safe, whether systems can cope with floods or droughts, and whether governments are planning for the climate pressures already affecting rural communities. It offers a broader, more realistic picture of rural water security, centred on public health. 

Progress is visible, but gaps remain 

Across the region, access to water, sanitation and hygiene services has generally improved since 2013. Most rural households now have basic water services, though sanitation and hygiene have progressed more slowly. On average, 13 per cent fewer rural residents have basic sanitation than basic water.  

However, health outcomes are not improving as quickly as infrastructure. More than half of the countries with relatively strong WASH scores still show poor performance on child diarrhoea. This suggests that many systems are not delivering safe or reliable services consistently.  

Countries with higher service levels tend to have better health outcomes. Access to piped water, safely managed water and sanitation, and hygiene services were all higher in countries with lower diarrhoeal disease.  

The largest gaps we found relate to climate resilience. Only a minority of countries have detailed plans for adapting rural WASH systems to climate risks, making it difficult to assess how well prepared they are for rising temperatures, floods, droughts, salinity intrusion or more unpredictable weather. Where policies and plans exist, there is an implementation gap due to lack of sustainable financing and weak monitoring. 

Figure 1. Rural water security across 42 countries in Asia and the Pacific region in 2025

Three priorities for the years ahead 

Our findings highlight three actions that governments, donors and implementing organisations should prioritise over the next decade. 

Focus on service quality, not infrastructure counts. 

Building infrastructure is important, but health benefits come from safe, reliable, well-managed services. Countries need systems that can maintain infrastructure, manage water safety, handle faecal sludge, and ensure affordability. 

Integrate rural WASH into climate adaptation planning. 

Climate change is already affecting water security. Without strong rural WASH commitments in national adaptation plans, infrastructure remains vulnerable. Bangladesh and Nepal have shown what is possible with clear goals, budgets and monitoring frameworks. 

Expand WASH access beyond the household. 

Schools, health centres and public spaces are critical for preventing disease. If these facilities lack safe water and sanitation, rural communities cannot achieve the full health benefits of household-level services. Addressing inequalities, especially for remote and low-income households, remains essential. 

Connecting AWDO 2025 to real-world solutions 

The findings from AWDO 2025 reinforce what we have learned through the 100 Million Initiative at Oxford, which aims to bring safe drinking water to 100 million rural people by 2030. A leading example is the SafePani model in Bangladesh, where the government has committed to deliver safe drinking water to rural schools and healthcare facilities through a results-based funding model. 

SafePani shows clearly that infrastructure on its own does not deliver safe services. It works only when there are clear institutional roles, performance-linked contracts, regular monitoring of water safety and reliability, and sustainable financing.  

By combining our regional assessment with practical models like SafePani, we offer governments and development partners a roadmap for transforming rural WASH services.  

Full AWDO 2025 report is available here.