Drinking water supply and sanitation in Pakistan is characterized by some achievements and many challenges. In 2024, 72% Pakistanis, 81% Indians, 62% Bangladeshi had access to the basic sanitation facilities. Despite high population growth the country has increased the share of the population with access to an improved water source from 85% in 1990 to 92% in 2010, although this does not necessarily mean that the water from these sources is safe to drink. The share with access to improved sanitation increased from 27% to 38% during the same period, according to the Joint Monitoring Program for Water Supply and Sanitation. There has also been considerable innovation at the grass-root level, in particular concerning sanitation. The Orangi Pilot Project in Karachi and community-led total sanitation in rural areas are two examples of such innovation.

However, the sector still faces major challenges. The quality of the services is poor, as evidenced by intermittent water supply in urban areas and limited wastewater treatment. Poor drinking water quality and sanitation lead to major outbreaks of waterborne diseases such as those that swept the cities of Faisalabad, Karachi, Lahore and Peshawar in 2006. Estimates indicate that each year, more than three million Pakistanis become infected with waterborne diseases.; cited in: In addition, many service providers do not even cover the costs of operation and maintenance due to low tariffs and poor efficiency. Consequently, the service providers strongly depend on government subsidies and external funding. A National Sanitation Policy and a National Drinking Water Policy were passed in 2006 and 2009 respectively with the objective to improve water and sanitation coverage and quality. However, the level of annual investment (US$4/capita) still remains much below what would be necessary to achieve a significant increase in access and service quality. Pakistan is currently grappling with a critical water crisis, transitioning swiftly from a state of water "stressed" to water "scarce." The annual water availability per person has plummeted below 1,000 cubic meters, possibly surpassing this threshold already. To put it in perspective, this means that the yearly water allocation for each individual in Pakistan would not even fill half of an Olympic swimming pool.

Access

In 2020, according to the World Bank data 68% Pakistanis, 72% Indians, 54% Bangladeshi have access to the basic sanitation facilities.

In 2015, 91% of the population had access to an "improved" water supply. This was 94% of the population in urban areas and 90% of the population in rural areas. In 2015, there were still around 16 million people lacking access to "improved" water. As for sanitation, in 2015, 64% of the population had access to "improved" sanitation. This was 83% of the population in urban areas and 51% of the population in rural areas. There were still around 69 million people lacking access to "improved" sanitation.WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation

In Pakistan, according to the Joint Monitoring Program for Water Supply and Sanitation of the World Health Organization and UNICEF, access in Pakistan to an improved water source increased from 85% in 1990 to 92% in 2010. In the same time, improved sanitation coverage increased from 27% to 48%.

+ Access to water and sanitation in Pakistan (2020) Urban(37% of the population) Rural(63% of the population) TotalWater Safely Managed Drinking Water 40% 33% 36% Basic Drinking Water 53% 55% 54%Sanitation Basic Sanitation 82% 60% 68%Limited Sanitation 17% 28% 25%

According to the Pakistan Social And Living Standards Measurement Survey of 2010–2012, the main source of drinking water was as follows: 32% tap water, 28% hand pump, 27% motor pump, 4% dug well and 9% others. Assuming that other sources are identical to unimproved water sources, access to an improved water source was 91%, almost identical to the 2010 figure estimated by the JMP. For sanitation, the survey estimates that 66% had a flush toilet, 15% a non-flush toilet and 18% had no toilet at all. If all toilets were considered to be a form of improved sanitation, access according to this estimate would be 81%, much higher than the JMP estimate of 48%.

In 2017–18, 94% of Pakistanis had toilet facilities (99% in urban areas, 91% in rural areas), while 6% of the population did not (1% in urban areas, 9% in rural areas).

The Millennium Development Goals aimed at halving the share of people without sustainable access to an improved water source and improved sanitation by 2015 compared to 1990. In 2006 the United Nations Development Programme estimated that concerning urban and rural water supply as well as urban sanitation, the targets will be achieved prematurely, whereas rural sanitation progress was classified to be "on track". According to the 2010 figures of the JMP above, however, the water target had been reached at that time already, while the sanitation target did not look as if it was going to be reached.

According to the National Drinking Water Policy (NDWP) of 2009, Pakistan aims at providing universal access to drinking water in an equitable, efficient and sustainable manner by 2040.In the document, access is defined as the availability of 45 liters per person per day (L/p/d) in rural areas and 120 L/p/d in urban areas. In addition, the total time to reach a public water source and return must not be more than 30 minutes. See: The National Sanitation Policy of 2006 aims to meet the Millennium Development Goal (MDG) concerning sanitation by 2015 and to also reach universal access by 2040.

Impact of inadequate sanitation The economic impact of inadequate sanitation has been estimated at 344 billion Rupees (US$5.7 billion), equivalent to almost 4 percent of GDP. 87% of the impact is on health, 5% on increased costs of water supply and 8% are other impacts. The main health impacts are premature mortality and productivity losses, followed by treatment costs. Water supply costs include higher costs for the supply of piped water, higher expenses for bottled water and the cost of household water treatment. Other costs include the cost of increased time for open defecation and the use of shared toilets, and a relatively small cost of lost tourism revenues. Many intangible costs were not included in the estimate, such as the lack of privacy, security, status and dignity. The cost of environmental conditions stemming from poor sanitation was also not included in the estimate.

Service quality Water supply service quality is often insufficient in Pakistan. One document criticizes the MDG's methodology for only taking into account coverage figures, without giving attention to adequate service quality. Continuity of supply and water quality are two important elements of drinking water service quality. The treatment of collected wastewater is one element of sanitation service quality.

Continuity of supply

Intermittent water supply is common in urban areas. For Pakistani cities, the Asian Development Bank (ADB) indicates continuity rates of 1 to 10 hours (Karachi), 11 to 15 hours (Rawalpindi) and 16 to 23 hours (Lahore) per day.The ADB abstracted the figures from unaudited data, collected from utilities for the SAWUN Benchmarking Database; see: During a 2005 workshop, similar figures were reported except for Rawalpindi for which a shorter duration of only 8 hours was reported.Reported by officials from the respective cities at a 2005 workshop in Karachi; see: Consequently, consumers use on-site storage mechanisms like ground or roof tanks, or they purchase water from lorry tankers or use shallow wells and rivers. Many privately operated lorry tankers are licensed by water utilities and benefit from the discontinuous water supply.

+Hours of water supply per day in major Pakistani cities Karachi Lahore Faisalabad Rawalpindi Multan Peshawar 4 17 8 8 8 9

Drinking water quality According to a survey on behalf of the Pakistan Council of Research in Water Resources published in 2012, 88% of the functional water supply schemes in Pakistan provide water that is unsafe for drinking because of microbiological contamination.

Increased arsenic, nitrate and fluoride contamination was detected in drinking water in various localities in Pakistan, according to an official government document., section 10.3. Generally, water pressure is low in Pakistani supply systems. Together with leaky pipes, this leads to infiltration of contaminated water. A survey of drinking water samples in Karachi in 2007/08 found that, of 216 ground and surface water samples collected, 86% had lead levels higher than the WHO maximum acceptable concentration of 10 parts per billion (ppb). The mean lead concentration was 146 ppb in untreated ground water and 77 ppb in treated tap water. In 2012, according to Rafiq Khanani, professor and pathology chairman at the Dow University of Health Sciences, water-borne Naegleria fowleri have killed at least 10 people in Karachi in three months. The infection does not occur by drinking water infested with the amoeba, but if water enters the nose. The amoeba then attack the brain and cause primary amoebic meningoencephalitis. Newspapers reported that drinking water was provided without any treatment or disinfection, which facilitated the spread of the amoeba. As a reaction to the findings, a citizen of Karachi submitted a court petition asking the Karachi Water and Sewerage Board to fulfill its duty to provide clean water. In October 2012, the Sindh High Court issued a notice to the Board asking it to comment on the petition.

In Rawalpindi water quality improved after a new managing director of the local utility made it a priority in 2007 as part of a broader performance improvement strategy. Within a year the share of samples that showed that water was unfit for drinking declined from 64 to 26 percent.

Wastewater treatment The Pakistani Ministry of Water and Power reported in 2002 that only 1% of the domestic and industrial wastewater receives treatment. According to the Pakistan Water Situational Analysis, there are three wastewater treatment plants in Islamabad, of which only one is functional. Karachi has two trickling filters, where effluents generally receive screening and sedimentation. Lahore has some screening and grit removal systems, but they are hardly functional. In Faisalabad, there is a wastewater treatment plant, in which wastewater receives primary treatment, but it treats only 7 percent of the collected wastewater in the city. Multan, Rawalpindi and Gujranwala have no wastewater treatment plants at all. In rural areas, wastewater treatment is nonexistent, leading to pollution of surface and groundwater.

History and recent developments

For the first decades of Pakistan's modern history, in the largest cities City Development Authorities and their Water and Sanitation Authorities (WASAs) were responsible for water supply and sanitation. In towns and villages water supply facilities were built and operated by the provincial governments through their Public Health Engineering Departments (PHEDs). This was initially done without much participation by local government and communities in decision-making. However, in 1992 the federal government launched a Social Action Plan, which emphasized user participation, hygiene promotion and the use low-cost technologies in water supply and sanitation. A shift of sector responsibility then took place under the 2001 Local Government Ordinance (LGO). Under the LGO, three tiers of local governments were created: 120 District about 500 tehsils about 5,000 local governments governed by Union Councils of Pakistan