Research has shown that many African countries are still struggling to meet development targets on access to safe water at a time when countries like China and India with a combined population of about 2.5 billion have met global MDGs on access to clean water.

At the African Union (AU)/African Ministers Council on Water-which coincides with the 4th Africa Water Week-holding in Cairo, Egypt, ahead of the June 2012 AU Heads of State Summit – it has been observed that safe water gaps remain in Africa with 19 out of 25 countries globally with least access to safe water being African. It has also been found that in 30 African countries including Nigeria, Ethiopia, Tanzania, DRC, Kenya, Sudan and Mozambique, between 30% and 70% of populations have no access to safe water. (See attached scorecard).

Consequently diverse water-related diseases are ravaging African countries due to poor environmental, water and health management affecting tens of millions. These include Diarrheal Diseases, Malaria, Dengue Fever, Intestinal Helminths, Schistosomiasis, Trachoma, Dracunculiasis, Poliomyelitis, Trypanosomiasis, Bancroftian, Filariasis, and Onchocerciasis.

An estimated 160 million people are infected with schistosomiasis/bilharzia (a parasitic disease from flatworms) alone, causing tens of thousands of deaths yearly; An estimated 500 million people are at risk of trachoma of which about 146 million are threatened by blindness, and 6 million are visually impaired (


25 countries globally with least access to safe water (19 of them African) dominate the top 50 countries with highest child mortality. Between 23% and 59% of children in these countries suffer stunted growth arising from malnutrition and disease. Between 43% and 91% of overall populations in these 19 African countries have no access to improved sanitation; and between 18% and 68% of their populations live below the poverty line.

In addition to safe water for domestic use, water management for agriculture is a huge challenge. Globally Agriculture accounts for roughly 70% of water consumption. Countries without long term sustainable water resources development and management plans including efficient irrigation, are more vulnerable to drought and famine, as seen in the Horn of Africa, and a second developing tragedy across the Sahel in West and Central Africa – where hunger, starvation, disease and displacement have combined to devastating effect to affect about 14 million people.

Poor or none existing management of water resources also means Africa is heading towards multiple conflicts based on intra and cross border tensions over water: Daily drinking water requirement per person is 2-4 litres, The UN estimates each person needs 20-50 litres of water a day to ensure basic drinking, cooking and cleaning, and it takes 2,000 – 5,000 litres of water to produce a single person’s daily food. The doubling of Africa’s population from present 1 billion to 2 billion by 2050 without corresponding improvement in clean water supplies, and improved cross community/border water management will likely lead to increase in disease and conflict.

A further combination of any of drought, floods, water scarcity, poverty, poor leadership and weak governments will contribute to social tension and instability that could result in failure of some states.

In developing countries, 50 – 70 per cent of industrial, commercial and human waste is dumped untreated into waters, seriously polluting an already inadequate water supply.

Lack of sustainable access to clean water, sanitation and hygiene costs Sub-Saharan African more in lost GDP than its countries receive in development aid. Depending on the country and region, economic benefits for each dollar invested in clean water and sanitation have been estimated to range from $3 – $34.

Poor water resource management and lack of sustainable access to clean water has a further negative impact on women’s development: Where water is not available and has to be fetched, women/girls are about two and a half times more likely than men/boys to be main water carriers for families, and it is estimated that women in low-income countries spend about 40 billion hours annually fetching and carrying water from sources that may not even provide clean water, with overall negative impact on women’s and young girls education and productivity.

The Africa Public Health Alliance has expressed concern over apparent poor multi sectoral development planning, and calls on Water Resources Ministers and related sectors to adopt urgent Population based Integrated and Multi Sectoral Policy and Investment Plans – as the only path to truly sustainable development, and as core basis of Africa’s Post MDGs Agenda on Health, Human and Social Development.

Commenting on the scorecard and research findings which underline Africa Public Health Alliance’s Multisectoral Strategy and its transition to the Africa Health Human and Social Development Alliance, its Coordinator Rotimi Sankore stated:

“The cumulative negative domino effect of lack of clean water, and poor water resources management across Africa is leading to multifaceted mortality and morbidity costing millions of lives, and entrenching a cycle of poverty. The centrality of water resources to everything from agriculture, food security and nutrition; sanitation, hygiene and overall health; industry; human settlements and displacement; and development in general means it has to be brought to centre stage of the African human security and development agenda” 

This tragic situation in which hundreds of thousands die every year from preventable diarrhoeal diseases, and malnutrition, majority of which are children under 5 years old highlights the gap in coordination between sectors of government. In Sub-Saharan Africa treating largely preventable diarrhoea consumes an estimated 12 per cent of health budgets”  

Sankore expressed deep concern, stating that “The child mortality numbers are just mind boggling: 861,000 under 5’s die a year in Nigeria; 465,000 a year in DRC; 271,000 a year in Ethiopia; 143,000 a year in Sudan and South Sudan; 133,000 a year in Tanzania; 122,000 a year in Kenya; 121,000 in Angola; 120,000 in Mali. If we did not know better, it would seem as if there is a morbid competition to see which country can finish of its next generation the quickest.”



Lack of clean water, sanitation, malnutrition, poor water resources and environmental management, are also seriously undermining incredible efforts – sometimes by the same governments – to mitigate impact of infectious diseases such as HIV, TB and Malaria.



On this week’s 10th Anniversary of the first African Ministerial Conference on Water, the Abuja Ministerial Declaration on Water, and 4 years since 2008 Sharma El Sheikh Heads of State and Government AU Summit Commitments for accelerating achievement of Water and Sanitation Goals, African countries should have made far more progress than they currently have.” 

Underlining the tragedy of drought and famine in the Horn of Africa, which has impacted on 13 million people, and the second situation in the Sahel that now threatens a further 1 million lives, he stated further that: 


“We can’t prevent a full scale drought, but we can prepare for lack of rain through better management of water, agricultural and food resources – stressing that “Lack of forward planning is not a natural disaster” 



Acknowledging the invaluable and often unrecognised work of dozens of African and global inter-governmental organisations, governments, UN, development agencies, and relief organisations he emphasised that: “some of this information is not brand new, but we are trying to bring them together in way that helps demonstrate that, although many governments have made some important progress, not enough has been done, and most of Africa’s health, human and social development planning has remained in silos, rather than being Multisectoral”










Additional information, statistics could be obtained from

Africa Public Health.Info is the Research and Publications Department of the Africa Health, Human and Social Development Alliance, a joint project of the Africa Health Human & Social Development Trust, & The African Social & Human Development Foundation.


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