Tackling Water, Hygiene, and Sanitation Crisis: The Alarming Issue in the African Region
By: Wai Phyo Thant, Lydia Nobert, and Serge Bataliack
Water sanitation and hygiene (WASH) are necessary for human health and well-being. Access to safe water and better sanitation can prevent disease incidents such as cholera, diarrhoea, dysentery, hepatitis A, typhoid, and polio.
The state of WASH in Africa is alarming; WASH issues must be addressed immediately. Many people in the region do not enjoy the benefits of having safe drinking water and proper sanitation. Many homes, healthcare facilities, and schools do not yet have soap and water for handwashing. The lack of simple sanitation practices creates favourable conditions for the transmission of diseases that are preventable by safe WASH.
Poorly managed wastewater from urban, industrial, and agricultural areas contaminates the drinking water of millions of people. Long-term exposure to chemical pollutants (pesticides, fertilizers, and heavy metals) can cause several health problems in people. Having access to safe WASH services is a basic human right and everyone should deserve to live healthier. WASH is part of the Sustainable Development Goals (SDG) indicators measuring progress globally.
Key facts about the situation in the African Region
In 2020, only 32.4% of the population in Africa (363 million people) had access to safely managed drinking water services and only 22.6% (253 million) to safely managed sanitation services.
In 2019, 73.3% of all diarrhoeal deaths were attributed to unsafe WASH services, and 377 000 people died from diarrhoea due to unsafe WASH (with 45% aged under five years).
Between November 2022 and January 2023, 95,763 cholera cases and 2317 deaths (case fatality ratio = 2.4%) occurred. The mortality rate attributed to exposure to unsafe WASH services (per 100,000 population) increased to 45.8. According to 2023 SDG dashboards (Figures 2.20 and 2.21), only two countries (Mauritius and the Seychelles) are on track for clean water and sanitation. Most countries remain to address the significant challenges.
The recent cholera outbreak data showed that African countries are still behind in making progress in safe WASH. In Malawi, a widespread cholera outbreak happened in all 29 districts.
The best solution is to prevent the disease before the outbreak happens. The World Health Organization leads global efforts to prevent water and sanitation-related diseases, advising governments and the Ministry of Health (MOH). WHO works closely with UNICEF and other partners to improve the conditions of water, sanitation, and hygiene in healthcare facilities, schools, and public facilities
WHO Responses on WASH in the African Region
• Development of health-based guidance and standards documents that help the countries implement the best WASH practice and set rules and regulations at the national level.
• WHO leads global efforts to prevent water and sanitation-related diseases.
• In collaboration with UNICEF, In 2015, WHO jointly developed WASH FIT (Water and Sanitation for Health Facility Improvement Tool).
• Since WASH requires a multisectoral approach, WHO builds the capacity of governments, practitioners, and partners from the health and WASH sectors.
• WHO offers a reliable WASH data repository to inform policies and programs, document the WASH risk factors and disease burden, and progress towards the relevant WASH-related SDG targets.
• Coordination and Advocacy for WASH Strategies: WHO leads the role of coordination, engages global and regional partners, and advocates for WASH strategies and political commitments.
• Integration of WASH with Health Programmes: WHO encourages the countries to integrate several health programs: disease-controlled programs (cholera and neglected tropical diseases (NTD), emergency programs, nutrition programs, and antimicrobial resistance programs.
For more information visit
WHO fact sheet on Drinking-water
iAHO_WASH_Regional_Factsheet.pdf (who.int)
Sustainable Development Report 2023 (sdgindex.org)
Cholera - Malawi (who.int)
Water, sanitation, and hygiene (WASH) (who.int)