Swachh Bharat's next test is making safety and public health central

India's Swachh Bharat Mission has transformed urban cleanliness, but gaps in water safety and public health show why sanitation rankings must evolve from visible cleanliness to urban resilience

Sanitation reform in Indian cities has delivered visible gains, yet its deepest challenge remains invisible: Aligning the pursuit of cleanliness with the harder task of protecting public health and environmental safety. 

Swachh Bharat Mission-Urban (SBM-U) is one of the country’s most visible and successful urban programmes, and yet one that increasingly reveals the limits of outcome-agnostic cleanliness metrics. The scale of the effort is commendable. What began in 2016 as a survey of cities with 73 million-plus people has now expanded into the world’s largest urban cleanliness assessment, with Swachh Survekshan 2024-25 ranking 4,589 cities across population categories. 

This expansion has institutionalised sanitation as a core urban service rather than a peripheral welfare concern. However, the real question facing Indian cities today is whether the mission’s architecture is evolving fast enough from cleanliness and sanitation to systemic urban safety.

 

The strength of SBM-U lies in how it reshaped incentives within urban local bodies (ULBs). Through a competitive ranking framework, sanitation outcomes were no longer buried in municipal files but placed at the centre of political and administrative attention. Under the 2024 Swachh Survekshan framework, sanitation performance is assessed through a comprehensive 12,500-point scoring system, of which a 10,000-mark core assessment spans 10 major thematic sections — from visible cleanliness and waste management to used-water management, and sanitation worker welfare. This granular design has nudged cities to invest in door-to-door collection systems, material recovery facilities, dumpsite remediation, and faecal sludge treatment plants, which historically received minimal funding. 

The mission’s scale and behaviour-change ambition have been noted by multilaterals. An Asian Development Bank (ADB) programme document on SBM-U 2.0 argues that Swachh Survekshan has become an effective national tool for transforming city performance, and points to measurable shifts, such as ULB wards with 100 per cent source segregation rising from 15 per cent in 2021 to 89 per cent in 2023, and waste processing increasing from 18 per cent in 2014 to 76 per cent in 2023. Indore’s repeated top rankings have been underpinned by near-universal door-to-door waste collection, decentralised wet waste processing, and a strong feedback loop between citizens and the municipality.  

Yet Indore also exposes the mission’s blind spots. In late December 2025 and early January 2026, residents in  Bhagirathpura, Indore, reported mass illness after consuming sewage-contaminated drinking water. This episode did not stem from a lack of sweeping or aesthetic upkeep where Indore scores exceptionally well, but from deeper failures in urban water safety, source protection, and wastewater management. It forces an uncomfortable reckoning: Cleanliness rankings do not automatically translate into public-health resilience. 

The newer Swachh Survekshan indicators attempt to address this gap by incorporating used water management, stormwater drains, and water bodies into the assessment matrix, allocating 10 per cent of total marks to wastewater and reuse outcomes. On paper, this represents an important shift from cosmetic sanitation to environmental sanitation. In practice, however, the emphasis in many cities still tilts towards infrastructure presence rather than performance under stress. 

Sewage treatment capacity can exist on paper but operate inconsistently; informal sewage connections, leakages and cross-contamination risks can persist even in “high-performing” jurisdictions; and the most dangerous failures are often the least visible until morbidity spikes. 

Another structural weakness lies in the mission’s data architecture. The Survekshan framework relies heavily on monthly self-reported data uploaded by ULBs and subsequently validated through sampling and third-party inspections. While penalties for data mismatch have been introduced — explicit negative marking when field assessments deviate from claims — the system still incentivises compliance with indicators rather than long-term risk reduction, particularly for outcomes that are technically complex, slow to finance, and hard to communicate. 

Cities learn quickly what is measured and rewarded. Sweeping schedules, bin placement, and beautification projects are easier to demonstrate than invisible investments in underground sewer integrity, chlorine residual monitoring, or proactive risk mapping of cross-connections. This creates a skewed reform trajectory where form can precede function, and where a city’s “rank” may feel like an achievement even when it is not a robust guarantee of safety. 

At the same time, the mission has fundamentally altered citizen expectations. Clean streets, functional public toilets, and regular waste collection are no longer viewed as privileges but as basic urban rights. International and government-linked frameworks increasingly describe the next step as moving from asset creation to service outcomes. For instance, a 2025 World Bank-ADB knowledge framework developed with Indian counterparts argues for shifting incentive mechanisms beyond infrastructure creation towards customer-oriented services, including reliable supply of safe drinking water. Within SBM-U’s own ecosystem, recent government reporting claims door-to-door waste collection at 97 per cent and waste processing at 80.31 per cent by December 2025, signalling continued performance consolidation on the solid-waste side even as new risks emerge elsewhere . The challenge now is to deepen this evolution. Cleanliness must be reframed not merely as visual order but as urban safety, encompassing drinking water integrity, flood-resilient drainage, and the prevention of disease outbreaks. 

What should come next is not a retreat from rankings but their recalibration. Water-quality testing outcomes, incidence signals for water-borne disease clusters, and emergency response capacity should progressively find space within the sanitation narrative, not as an afterthought but as a defining measure of habitable and sustainable cities. 

Cities should be rewarded not just for the absence of garbage but for the presence of robust, audited systems that prevent contamination before it becomes fatal. The  Bhagirathpura episode should serve as a national warning that India’s sanitation journey has entered a more complex phase, where the margins of error are thinner and the consequences of failure far more severe. SBM-U has succeeded in making cleanliness visible, measurable, and politically salient. Its next test is whether it can make safety, resilience, and public health equally central. Only then can India’s cities truly claim to be not just clean, but liveable.

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The author is chair, Institute for Competitiveness. X:@kautiliya. With inputs from Meenakshi Ajith