Heads of State Initiatives support presidents and prime ministers worldwide to make water, sanitation, and hygiene a priority of their mandate. These initiatives are tailored to each country's unique context, helping achieve critical goals like making communities more resilient to climate change and solving public health crises such as waterborne diseases or open defecation.

Heads of State Initiatives are different for every country and can take various forms. Examples include national sector compacts, presidential decrees, or royal seals of approval for new sector strategies. Regardless of format, they are comprehensive visions which include increased budget allocations, innovative financing sources, and robust strategies for infrastructure development. They aim to improve public health, enhance climate resiliency, and drive economic growth.