Sanitation coverage across many African countries has improved steadily over the last two decades. Toilets, pit latrines and septic systems are more common today than they were at the turn of the century, particularly in urban and peri-urban areas. Yet, despite this visible progress, sanitation-related health and environmental risks remain widespread. Polluted rivers, untreated wastewater and recurring outbreaks of waterborne diseases continue to affect large sections of the population. This persistent gap between sanitation access and sanitation outcomes points to a deeper structural issue: sanitation systems in much of Africa tend to falter not at the point of access, but at the stages of treatment and safe disposal of waste.

This disconnect between progress on paper and risks on the ground is increasingly reflected in quantitative sanitation assessments. According to the World Health Organization (WHO)/United Nations Children’s Fund (UNICEF) Joint Monitoring Programme, while over 40 per cent of the population in sub-Saharan Africa uses improved sanitation facilities, only 26 per cent had access to safely managed sanitation services in 2022, meaning that waste was treated and disposed of safely. This implies that for the majority of households, human waste is either not treated at all or not disposed of safely, demonstrating that the sanitation service chain breaks down after containment.

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