Pakistan is far ahead of India in improving access to water, sanitation and in eroding inequalities for its citizens, according to a US university study.
While Pakistan was ranked five in the new index developed by The Water Institute at the University of North Carolina on Friday at Chapel Hill's Gillings School of Global Public Health in the US, India occupied an unenviable 92nd position.
High-performing countries for 2015 are those that have achieved significant improvement in recent years compared to their peers.
Low-performing countries are those that showed stagnation or decline in recent years.
El Salvador, Niger, and Pakistan are performing better and Sub-Saharan Africa countries including Mali, South Africa, and Ethiopia are also among the top performers world-wide in spite of modest resources.
"This means that even countries with limited resources can make great strides if they have the right programs in place," said co-author of the report Jamie Bartram, director of The Water Institute at UNC.
"National governments, NGOs, and aid agencies can direct their resources toward building systems and capacity for action in countries that are lagging," Bartram said.
Among the most populated countries in the world, Pakistan, China, and Nigeria were top performers (ranked 5, 11, and 18 respectively). Conversely, Russia, the Philippines and India were bottom performers (ranked 72, 83, and 92), the report said.
Other high performers include El Salvador, Egypt, and Maldives.
India's ranking as a bottom-performer predates the recent launch of the "Clean India Mission" by Prime Minister Narendra Modi.