OP-ED | The Sanitation Gap in Africa’s Progress, By Julia Baum & Jakkie Cilliers

Behind Africa’s poor sanitation and safe water statistics lies a development crisis—one that is costing billions, stunting futures and demanding urgent policy action.

In much of the Global North, access to clean drinking water and safe toilets is an unremarkable part of everyday life. Conversely, in much of Africa, these seemingly basic services are out of reach for many people. In 2019, only around 57% of African citizens had access to improved sanitation, which hygienically separates human waste from human contact, compared to nearly 90% in the rest of the world.

A lack of clean water and basic sanitation profoundly affects development. Societies face higher disease burdens, lower school attendance and lost economic productivity. Regarding safely managed sanitation (meaning an even higher standard than ‘improved’), the access globally rose by only 7 percentage points from 47% to 54% between 2015 and 2020. In Africa, however, only 27% of the population had access to safe sanitation in 2020. This translates into three in four people on the continent living without safe toilets. 

As with many other infrastructure issues, there are stark regional disparities. North Africa does better than sub-Saharan Africa, while East and Central Africa face a more critical situation. In 2019, 224 million people in the Democratic Republic of the Congo, Ethiopia and Nigeria alone lacked access to basic sanitation. 

Closely related to the sanitation challenge is access to clean water. While slightly better, it also lags behind for African citizens compared to global averages. In 2019, only 79% of Africans had access to drinking water that, by its design and construction, is protected from outside contamination, especially faecal contamination, versus 96% elsewhere.

This translates into millions of Africans being vulnerable to waterborne diseases. Cholera, for instance, has become endemic on the continent, accounting for about 79% of global outbreaks in the last four decades. In comparison, in South Asia, about 74% of people had access to an improved sanitation facility in 2019, and about 95% of the region had access to potable water. 

Africa’s Access to WaSH Infrastructure Lags Far Behind

Progress in Africa is happening, but it is too slow. Using the International Futures forecasting platform (University of Denver), we find that access to improved water on the continent will reach 75% by 2030 on the current trajectory. And only around 58% of Africa’s population will likely have access to improved sanitation services.

This still falls short of the global sustainable development goals to achieve universal and equitable access to safe and affordable drinking water and adequate sanitation by that year. 

These gaps carry weighty consequences as inadequate sanitation costs sub-Saharan Africa about 5% of its GDP annually, equivalent to about US$170 billion. In Nigeria, the losses from poor sanitation are estimated at US$3 billion every year, which is about 1.3% of its national economy. 

Water, sanitation, and hygiene (WaSH) infrastructure is one of the most effective levers for social and economic development. It is tightly linked to broader development goals, including poverty reduction, education and gender equality. Improved WaSH infrastructure generally translates into sizable gains in the overall development of a country as it improves on the human capital contribution to economic growth.

For example, children who do not have adequate access to WaSH facilities are more vulnerable to undernutrition. Malnourished children are not only highly susceptible to infectious diseases, with diarrhoeal diseases being among the most frequent and severe examples, but may also suffer other lifelong effects such as stunting (low height-for-age). 

Stunting impairs both physical and cognitive development. According to the WHO, stunted individuals suffer from ‘poor cognition and educational performance, low adult wages, lost productivity and, when accompanied by excessive weight gain later in childhood, an increased risk of nutrition-related chronic diseases in adult life.’ Insufficient WaSH infrastructure leaves all children vulnerable, but the impacts become especially acute for girls and women.

Lack of menstrual hygiene facilities, for example, contributes to high school dropout rates among teenage girls. This has long-term effects on educational attainment, labour force participation, and ultimately, economic growth.

To close these gaps, African countries must make much more substantial progress in sanitation provision. This push to combat communicable diseases and improve WaSH infrastructure would have significant benefits for human and economic development. By 2043, Africa could see 70% of its population having access to improved sanitation and water services under an accelerated development scenario. 

Access to Improved Sanitation Poor in Low-income Countries

Uganda, for instance, offers a glimpse of what is possible in the long term through coordinated investment. With support from the French Development Agency and the European Union, the country embarked on an ambitious Water and Sanitation Sector Development Program. For the region around the cities of Masaka and Mbarara, for example, an investment of about €120 million will provide access to safe water and sanitation for more than 1 million people by 2040. This is an infrastructure initiative that is both practical and future-oriented.

To accelerate progress, policy reform and prioritisation are critical. The African Sanitation Policy Guidelines (ASPG), developed by the African Ministers’ Council on Water, provide a comprehensive framework for countries to develop and implement effective sanitation policies. The guidelines emphasise good governance, regulation and financing tailored to each country’s context. Such tools are key to scaling what works and need to be accompanied by sufficient investment in infrastructure from national budgets. 

Investment in and policy focus on basic services such as sanitation cannot be an afterthought for Africa if it is to meet its development goals. Access to improved sanitation and water is not only a health concern but an essential component of a functioning society. Focusing on these fundamentals should not be mistaken for moving backwards.

It must happen alongside progress in innovation, such as Artificial Intelligence or other emerging sectors, and in step with international momentum across all areas of development. Sanitation and potable water may not make the headlines or take the spotlight in Africa’s innovation-driven development discourse, but they are clear markers of dignity and societal resilience. Investments in the WaSH sector must be elevated from the margins and treated as mainstream, strategic priorities.

Dr Julia Baum is a Website Consultant at the Institute of Security Studies (ISS’s) African Futures and Innovation (AFI) programme, while  Dr Jakkie Cilliers is the ISS’s Founder and Chair of its ISS Board of Trustees. This op-ed article was originally published by ISS Africa, African Newspage’s publishing partner. The views expressed in it do not necessarily reflect African Newspage’s editorial policy.