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Almost a third of all the bank’s projects in recent history have been water-related, and a total of $54 billion was spent financing them, the report said. Some, of course, have been controversial, since dams, irrigation projects, flood prevention and watershed-management projects often benefit one group at the expense of others. Also, many projects fail, once built, because the host country is not wealthy or sophisticated enough to maintain them.

Most countries with severe water problems are also so poor that they are “not creditworthy enough to borrow their way out of water crisis,” the report noted.

It detailed several recommendations from the bank’s independent evaluation group for factors to consider in new project proposals.

First, the bank should look for plans that keep water flowing to the most people. It should also “manage the demand” — many projects it supports have raised prices, imposed quotas and tried to stop theft of water, but there has been little success in getting projects to pay for themselves.

It should look for projects that preserve groundwater and restore the environment — although, the report noted, it is not necessary to get landscape back into a pristine state to get major benefits. And it should pay more attention to low-cost plans for toilets and waste disposal to stop sewage from fouling drinking water. Only 10 percent of all bank projects have had health as an objective, the report said.