Africa cannot whiteWaSH water and sanitation crisis
Declining donor support is pushing investment in essential services to the centre of Africa’s economic resilience and development sovereignty.
The African Union (AU) 39th summit, held in Addis Ababa in February, placed water and sanitation at the centre of the continental agenda. The theme was ‘Assuring sustainable water availability and sanitation systems to achieve the goals of Agenda 2063’. This emphasis reflects growing recognition that water security underpins Africa’s economic, health and development trajectory.
Water stress could cost some African regions up to 6% of gross domestic product (GDP) by 2050, according to FP Analytics, due to reduced agricultural output and impacts on health. Foresight studies reinforce that water, sanitation and hygiene (WaSH) is central to Africa’s long-term development. In the African Futures and Innovation (AFI) demographics and health high-investment scenario, accelerated access to health services and WaSH infrastructure reduces the burden of communicable and non-communicable diseases.
Water security is ultimately job security
The investments could raise GDP per capita by US$207 in the current path (business-as-usual scenario) by 2043. Extreme poverty would fall by two percentage points, lifting an additional 41 million people out of poverty. In economic terms, 70% to 80% of jobs in low-income African countries depend on water: water security is ultimately job security.
Access to water and sanitation
Current access levels remain far from sufficient. In 2023, only 29.5% of Africa’s population had access to safely managed WaSH facilities, while 14.1% still resorted to open defecation. Change is likely to be slow, with safely managed access rising to 39.5% by 2043 in the current path. By comparison, the rest of the world had a safely managed access rate of 64.2% in 2023, rising to 75% by 2043. African access to safely managed water stood at 35.2% in 2023, compared to 78.6% in the rest of the world. By 2043, average access will still be below 50% in Africa, while the rest of the world will reach nearly 90%.
Beneath the surface of poor water and sanitation access lies the hidden cost of an economic crisis. AFI research shows that Africa loses annually 5% of its GDP, about US$200 billion, through inadequate WaSH access. The impact is a loss of productivity, especially for women and girls, with an estimated 40 billion hours spent collecting water in sub-Saharan Africa, reducing the hours available for work, school or income-generating activities.
Poor sanitation and hygiene also contributes to preventable diseases such as cholera and diarrhoea, increasing healthcare costs, weakening workforce participation and undermining educational outcomes and future earnings. In countries such as Malawi and the Central African Republic, the time women spend fetching water can equal 10% of their monthly earnings. Hence, improving WaSH yields stronger economic returns: studies have shown that for every US$1 invested, the return on investment is about US$4 to US$7. In other words, WaSH investment could regain its GDP loss ― closing this gap is not just a social imperative but an economic strategy.
Against this backdrop, the AU summit discussions signal a high-level commitment to WaSH as a driver of development and tie its theme directly to Agenda 2063: clean water and sanitation are prerequisites for achieving the ‘Africa we want’. The theme calls on AU member states to develop an African water policy that enables inclusive, climate-resilient water security.
Water stress could cost some African regions up to 6% of GDP by 2050
Through the African Ministers’ Council on Water, African leaders have adopted a long-term strategy, the Africa Water Vision 2063, positioning water as the continent’s most strategic asset for prosperity and peace. Water, as a result, should be viewed as an enabler of inclusive growth, a bridge of cooperation and a foundation of resilience against climate change.
Perrenial constraints
These structural challenges are rooted in history. Africa’s current WaSH infrastructure issues stem largely from a past in which colonisers prioritised Europeans when spending on health. They expanded healthcare services to indigenous populations haphazardly, influenced by local perceptions of colonial healthcare measures, individual administrators’ priorities and unique political and economic contexts across colonies. In addition, colonial administrations turned to imported biomedical solutions, such as vaccines and antibiotics, to control outbreaks of disease, forgoing investment in infrastructure to provide clean water and safe sanitation services.
As a result, Africa’s cities grew rapidly without a concurrent increase in infrastructure. The trend, which manifested through the 1950s and 1960s, when governments of newly independent states faced myriad challenges and depended heavily on international aid to finance their health systems, persists to this day. African governments have failed to scale up investment adequately over the past 25 years to meet the growing demands for safe WaSH infrastructure caused by rapid urbanisation and population growth.
In 2001, the AU ― as part of its Abuja Declaration on HIV-Aids, tuberculosis and other infectious diseases ― set a target of 15% for domestic general government health expenditure as a share of general government expenditure. By 2023, no African government had reached 7% and the continental average had risen only from 1.4% in 2000 to 1.9%. On a per capita basis, the average spend increased US$51.6 over the period to US$142.9, but progress has largely stalled since 2013.
Clean water and sanitation are prerequisites for achieving the ‘Africa wee want’
To achieve the ambitious Sustainable Development Goals targets of universal and equitable access to safe drinking water and adequate sanitation, African governments would need to increase per capita spending to between US$249 and US$270. In 2023, only 10 countries met that threshold. Importantly, not all this spending has been expended on water and sanitation supply. To fill the gap, governments have continued to rely heavily on international donors for investment in infrastructure and systems.
Gaps in donor funding
Official development assistance earmarked for WaSH peaked in 2019 at US$3.6 billion, falling to US$3 billion by 2024. This downward trend is being driven by key Development Assistance Committee countries, such as the United Kingdom, the United States, Germany and the Netherlands, which have scaled down their contributions. France and Japan have increased their contributions, but the rest of the committee’s countries have decreased their investment by nearly 16% over the past five years. This shortfall for critical WaSH infrastructure, education and training, administrative systems and waste disposal will exacerbate the already precarious situation facing Africa’s populations.
Several countries are already adapting to the changing financing landscape. Nigeria, for instance, has been heavily aid-dependent, with more than US$1 billion in United States aid received in 2023. Yet, the sudden 90-day freeze on this aid in 2025 prompted a transition plan, with Nigeria committing US$1 billion of its own funds to health sector reforms, plus an extra US$3.2 million to procure HIV medications. Ghana also faced a sharp withdrawal ― US$78 million ― after which its government prolonged a domestic finance strategy that asserts financial sovereignty over its development.
Wayforward
African institutions such as the Africa Centres for Disease and Control and Prevention and the AU have operationalised an African Epidemic Fund to provide rapid, flexible financing for health crises. Pan-African financial institutions are also backing the shift to self-reliance: in 2025, the African Development Bank unveiled a US$6 billion investment plan to transform Africa’s health sector.
All these shifts contribute to a post-donor paradigm, centred on building a sovereign health and WaSH system that African countries themselves finance, govern and sustain, with external partners playing a supporting rather than primary role. Africa is not seeking charity but solidarity and co-investment, strong African health systems being a global public good.
The goal is not fewer partnerships but better ones, with new partnerships geared to capacity building rather than substitution. With the foundations shifting, the challenge now is to turn this momentum into durable systems that can outlast political cycles and donor trends. The AU’s 2026 focus creates a political window to translate ambition into sustained domestic investment and institutional reform. Whether this moment becomes a turning point will depend less on declarations than on financing and implementation in the years ahead.
