Water and sanitation are critically important to the health and survival of Pakistan’s communities. But, do decision-makers adequately prioritize and invest in the sector? The answer, in far too many parts of the world, is a resounding no. As an international community, we are too often blind to the huge cost of failing to serve so many people with the most basic but crucial of services. Globally, there are still 2.2 billion people without access to safe drinking water and 4.2 billion who don’t have a safe place to go the toilet. Over 40% of Pakistani homes do not have access to at least basic sanitation, and 138 million do not have access to safely-managed water services, according to a 2017 WHO/UNICEF report based on national data. Despite millions of people gaining access to a toilet since 2000, over 20 million still suffer the indignity of defecating in fields or other places outside. This continues to be a real challenge, as human waste near waterways and houses spreads diseases quickly and puts children and their families at risk. Yet, reaching all of these people with sustainable services will take much more than physical infrastructure. Investments need to grow — by three times, to an annual $114 billion, according to the World Bank — to meet the scale of the challenge. However, this is not a plea for charity, this is a wake-up call. The current global water and sanitation crisis is a story of colossal, rapidly increasing, unmet demand leading to colossal, rapidly increasing costs. Meeting Sustainable Development Goal 6 – water and sanitation for all by 2030 – is not a burden but a massive opportunity. If finance ministers fail to help prioritize water and sanitation, the consequences could affect societies for generations. To find concrete solutions to the financing gap, the partnership Sanitation and Water for All – a global platform for achieving the water, sanitation and hygiene (WASH)-related targets of the SDGs — is organizing three Regional Finance Ministers’ Meetings during November and December. The Ministers will focus on the opportunity for economic growth and sustainable development, through the expansion of water and sanitation services. With the right level of investment, benefits could include an estimated 1.5% growth in gross domestic product, and a $4.30 return for every dollar invested. This is due to the likely reduced health care costs and potential for increased productivity. That’s a rate of return that any investor would wish for. Affordable, reliable, easily accessible water and sanitation services prevent thousands of children from preventable diseases, such as diarrhea and cholera. Healthier children absorb nutrients properly, develop stronger brains and bodies, get better school results, and end up making a fuller contribution to society. And we have seen how quickly a pandemic like COVID-19 can spread when people are not able to wash their hands with water and soap. Without further investment, girls and women are forced to continue the time-consuming, back-breaking work of fetching water, and are left exposed to the indignity and dangers of going to the toilet in fields and streets. Water and sanitation services in schools and workplaces have the power to ensure girls and women can manage their personal hygiene while not missing out on obtaining an education or earning an income. Adequate investment would reduce disease burden and epidemic risks, and slow down fast- moving killers such as cholera. Improved hygiene — through water and soap — is critical in the fight against COVID-19, for example. Yet one in four — 24% — of health care facilities lack basic water services, one in ten — 10% — have no sanitation service, and one in three — 32% — lack hand hygiene facilities at points of care. Data has shown that even where there is adequate WASH facilities, frontline health care workers can be 12-times more likely to test positive for COVID-19 compared with individuals in the general community. Unless further investments are made, the level of workforce productivity will be capped. An estimated three out of four jobs that make up the global workforce are either heavily or moderately dependent on water. But, access to water and sanitation can also free up time that would otherwise be spent collecting water. UN-Water estimates that improved sanitation gives every household an additional 1,000 hours a year to work, study, care for children, and so on. Women’s productivity is particularly affected, as they are the main caretakers and manager and users of water. The bottom line is that economic growth rests on improving educational achievement and public health — two things that are impossible without access to WASH. None of this is news. Since the early days of the industrial revolution, we have known the transformative economic and social benefits of access to WASH, and the horrific consequences of inaction. If finance ministers fail to help prioritize water and sanitation, the consequences could affect societies for generations. Financial decision-makers must create an enabling environment by investing in institutions and people, and mobilizing new sources of finance, such as taxes, tariffs, transfers, or repayable finance. In the end, well-resourced, well-run WASH systems are catalysts for progress in every sector from gender, food, and education, to health, industry, and the environment. By nature of their work, finance ministers must use evidence to make smart decisions that will help their countries flourish. In the case of WASH, the evidence is clear: continuing to neglect these services will only continue to stunt the growth of our economies, populations, and societies. Catarina de Albuquerque, Chief Executive Officer, Sanitation and Water for All partnership