The Sanitation Ranking released by the Trata Brasil Institute highlights Manaus as the fourth Brazilian capital that invests the most in basic sanitation. This recognition marks the city's best position since the operation of Águas de Manaus, the local sanitation concessionaire, started in 2018. Manaus has made noteworthy progress, jumping from the 98th position in 2018 to 82nd in the latest ranking, reflecting an upward trend in the quality of sanitation services provided to residents.

Between 2020 and 2024, Manaus invested a total of R$ 1.4 billion in sanitation projects, which places it in the company of major Brazilian cities such as São Paulo, Rio de Janeiro, and Fortaleza. The investments are significant as they show a commitment to improving sanitation infrastructure after a historically low ranking. Within the North region, Manaus stands out as the leader in sanitation investment, surpassing the combined investments of the other six capitals in the region, which totaled R$ 1.3 billion during the same period.

This achievement has crucial implications for public health and quality of life in Manaus, as improvements in sanitation can lead to better environmental conditions and a reduction in diseases related to inadequate sanitation. As Manaus continues to rise in the rankings, it illustrates the potential positive impacts of strategic investment in infrastructure and may serve as a model for other cities aiming to enhance their sanitation systems and overall public health.