The United States isn’t doing enough to help the 2.6 billion people worldwide who do not have safe water or adequate sanitation, 14 advocacy groups said in a report released Thursday. 

According to the Natural Resources Defense Council, WaterAid, CARE and 11 other organizations, this lack of progress comes despite the Water for the Poor Act, which became law in 2005.  The measure provides aid to address what they describe as the global sanitation crisis, but the groups question whether the U.S. government and U.S. taxpayers are getting the most possible out of their investment,

Instead, “the bulk of U.S. assistance for water and sanitation is going to a handful of politically strategic countries whose populations have relatively good access to these basic services,” said Dr. David Winer, CEO of WaterAid America, in a news release.  “For the U.S. government to have the greatest impact on saving lives and alleviating suffering, it must improve the level of resources that are directed specifically to poor countries.”

The groups blame the problem on a lack of a comprehensive planning strategy; inadequate political prioritization of safe water, sanitation and hygiene issues; and limited programming capacity at the United States Agency of International Development (USAID) and the State Department. 

In a world where two out of five people don’t have access to a safe bathroom, unsafe drinking water and inadequate sanitation disproportionately affect poor children in poor countries, the report notes. Approximately 4,000 children under 5 years old in the developing world die each day from diarrheal diseases.  Diarrhea caused by unsafe water and sanitation kills more children under 5 every year than HIV/AIDS, malaria, and measles combined.  

In the report, “U.S. Implementation of the Senator Paul Simon Water for the Poor Act: Small Steps for a Crisis that Calls for Great Strides,” advocates outline what they want the Obama administration to do to address the global sanitation crisis and why they say it needs to happen immediately.

They also call for Congress to pass the Water for the World Act, which they say will address the shortfalls in implementing  the Water for the Poor Act and set a target for providing 100 million people worldwide with safe water and sanitation.

“Threats from the global freshwater crisis grow each day, from increasing water shortages here at home to the billion people worldwide already living on the brink,” said Rep. Earl Blumenauer (D-Ore.), who introduced the Water for the Poor Act and is a sponsor of the Water for the World Act. “The United States must act swiftly to confront this stunning poverty and insecurity.”

The report, which has support from Action Against Hunger, AMREF, Catholic Relief Services, Global Water Challenge, H20 for Life, International Housing Coalition. Millennium Water Alliance, PATH, PSI (Population Services International), Water for People and, was one of many events recognizing World Toilet Day today, Nov. 19.