Money Down The Drain: New Report Exposes Billions in Economic Losses from Poor Sewage and Wastewater Treatment

March 12, 2025
Press Release

A new report has uncovered the staggering economic and social costs of untreated wastewater, revealing how poor sewage treatment is depleting food sources, burdening health systems, and costing the global economy billions.

Tokyo, Japan 12th March - A new report has uncovered the staggering economic and social costs of untreated wastewater, revealing how poor sewage treatment is depleting food sources, burdening health systems, and costing the global economy billions.  

Launched at the World Ocean Summit today in Japan, by ocean health initiative Back to Blue, and the Ocean Sewage Alliance, the study calculates the devastating cost of inaction in wastewater management across five low, middle and high-income countries—Brazil, India, Kenya, the Philippines, and the UK. 

Untreated or inadequately treated wastewater released into the environment is a major source of pollution and disease. In the most extreme cases (Kenya), as little as 11% of wastewater is adequately treated, according to the report. As improperly treated wastewater enters rivers, oceans, and drinking water supplies, the consequences are severe. The study found that contaminated water used for irrigation is severely reducing crop yields; fisheries are collapsing due to polluted rivers and coastal waters; and waterborne diseases are burdening healthcare systems.  

Richard Damania, Chief Economist of the Sustainable Development Practice Group at the World Bank stated: “It is no new revelation that untreated wastewater has serious consequences, but it is not often thought of as an economic burden nor as a burden on health systems. Inadequate sewage systems are leaving populations sick and starving, all the while costing the economy billions. Clean water systems drive food security, strengthen livelihoods, and fuel economies.” 

Back to Blue was able to calculate the economic and social costs endured by each sector (agriculture, fisheries and health), in each of the five countries examined. Key findings include: 

Brazil’s agriculture sector suffers the greatest losses, with untreated wastewater leading to decreased yields of staple crops like corn and soybeans. The world’s largest exporter of soy and sugarcane loses a staggering $16 billion annually from these crops jeopardising food security, exports, and sustainability. 

India faces the highest financial losses from fisheries collapse, with contaminated waterways costing its fisheries sector more than $2 billion. As a major seafood supplier, this threatens both domestic food security and export markets. 

The report has also revealed a staggering human toll. Diseases associated with inadequately treated sewage present a significant health risk, resulting in substantial economic losses. While most cases are mild, some can be life-threatening, causing hospitalisations that further strain healthcare systems, incomes and economies. The model indicates India incurs the highest healthcare costs associated with diarrhoea from contaminated drinking water. Despite having a higher wastewater treatment rate (20%) than Kenya (11%), nearly three times as many people are affected, leading to costs of $246 million annually. 

Dr. Amelia Wenger, Conservation Scientist and Water Pollution Program Lead at Wildlife Conservation Society commented: "It is often the local communities that suffer the most from sewage pollution. Lost wages and expensive medical bills put an enormous strain on families. Yet these financial losses caused by poor infrastructure and failed policies are entirely avoidable.” 

She added: “The report puts a clear economic price on these consequences—only then can we create the pressure needed for meaningful change.” 

The cost of inaction is clear. Investing in adequate sewage and wastewater infrastructure is the only viable solution according to the report. In cases where large-scale infrastructure is lacking, decentralised waste-water systems can offer practical alternatives and there are an increasing number of new, high tech innovations. Policymakers that go beyond just investing in the right infrastructure and instead focus also on circularity, can also ensure wastewater is repurposed as organic fertiliser, biogas, or even a source of renewable energy. 

Back to Blue and the Ocean Sewage Alliance are calling on governments, the private sector and policymakers to invest now in their sewage infrastructure for a healthier and more vibrant future for citizens and economies.