Water and Sanitation

The Challenge

Unclean water and a lack of basic sanitation are undermining efforts to end extreme poverty and disease in the world's poorest countries. Sub-Saharan Africa faces some of the worst deficits- 328 million people in the region lack access to clean water and 546 million lack access to proper sanitation facilities.  People living in rural areas continue to be disproportionately underserved, as eight out of ten users of unimproved sanitation facilities live in rural areas.

Together, unclean water and poor sanitation are a leading cause of child mortality: an estimated 4,100 children die daily from diarrheal diseases, which are spread through poor sanitation and hygiene.  As with many challenges in development, women and girls are disproportionately impacted by scarcities of clean water and adequate sanitation.  Women are more than twice as likely as men to be responsible for water collection.  On average, women in the developing world walk six kilometers each day to collect water, time which could be spent in school or at work.  And studies show that more than half of girls who drop out of primary school in sub-Saharan Africa do so because of a lack of separate toilets and easy access to safe water.  The effects of lack of access to water and sanitation have a macroeconomic impact as well.  In total, the World Health Organization estimates that 40 billion working hours are spent collecting water each year in Africa - comparable to a year's labor for the entire workforce of France.

As part of the Millennium Development Goals, developing countries and donor governments committed to halving the proportion of people without sustainable access to safe drinking water and basic sanitation by 2015.  Sub-Saharan Africa is lagging dangerously behind on achieving both these goals.  If current trends continue, the region will miss the water target by 25 years and the sanitation target by 61 years.

Water and sanitation scarcities will be exacerbated as new challenges such as climate change and urbanization emerge.  Projections indicate that by 2020, an additional 75 to 250 million people will not be able to meet their water needs in sub-Saharan Africa because of climate change.  At the same time, water and sanitation systems in African cities will struggle to provide for an urban population that is expected to double between 2000 and 2030.  Past experience demonstrates the stress that this increased demand will place on water and sanitation services: between 1990 and 2004, Africa saw an 85% increase in its urban population and a doubling in the number of urban dwellers without access to water and sanitation.

The Opportunity

The links between a lack of water and sanitation access and development goals are clear, and the solutions to the problem are known and cost-effective.  Universal access to improved sanitation alone could reduce diarrhea-related morbidity by more than one third.  If the Millennium Development Goal (MDG) targets on water and sanitation are met, there will be 203,000 fewer child deaths in 2015 and 272 million school days would be gained with the subsequent reduction in diarrhea.  The benefits of improving access to water and sanitation go beyond any one sector.  Meeting the water and sanitation MDG would have a total annual economic benefit of $22 billion for the continent.  It is estimated that every $1 spent on water and sanitation generates returns of $8 in saved time, increased productivity and reduced health costs.  If the MDG targets on water and sanitation are met by 2015, national governments in sub-Saharan Africa could save about 12% of annual public health expenditures.

Donor funding will be critical to speed progress towards the MDG targets on water and sanitation.  In 2006, the UN estimated that development assistance flows would have to double to bring the targets within reach.  Though the G8 made a commitment both in 2003 and 2005 to increase funding for the water sector, they set few concrete funding targets for donors.  As a result, funding since 2004 has only grown at a quarter of the needed rate.