Lack of access to toilets kills. Unsafe drinking water and sanitation services too. In Africa, according to the World Health Organization (WHO), 8% of deaths are due to diarrhea triggered by the presence in the water of bacteria, parasites and contagious bacilli. It’s more than malaria. Even South Africa, the continent’s wealthiest and most industrialized country, was caught up in an unprecedented cholera outbreak in May and June that claimed dozens of lives amid dilapidated water utilities. plagued by corruption.

Eating also involves some risk since the WHO estimates that at least 10% of the world’s population is exposed to food from crops irrigated with untreated or poorly treated wastewater. Half a billion people around the world practice what the United Nations calls “open defecation”, a veritable weapon of mass destruction of living waters: rivers, lakes and coastlines are polluted by communities in need of toilets and discharges of waste water or sludge from septic tanks.

In West and Central Africa alone, 120 million people are forced to relieve themselves in the open, representing a third of global practice. In rural areas, people still go to the bush to defecate, while in the streets of African capitals, it is not uncommon to see someone drop their pants behind bushes or above the wide water collecting canals. of rain, often clogged with plastic waste. The rainy season adds to the cesspool of streets invaded by nauseating reflux.

In many schools on the continent, most often public, where resources are sorely lacking, children are asked to hold back for lack of clean and safe toilets, or to relieve themselves as best they can. Girls, more exposed to violence and isolated by the persistent taboo on menstruation, return home and do not necessarily return to study. Serious, or even fatal, accidents involving children falling into deep pit toilets are in the news in several countries, such as in March at a rural South African school.

Priority on infrastructure

“On access to drinking water, progress on the continent has been major, but on sanitation, the situation is not promising. And in schools, it is catastrophic,” summarizes Guy Mbayo, a civil engineer by training and “water, hygiene and sanitation” adviser for the Africa region of the joint WASH program of WHO and UNICEF. According to the latest Unicef ??report published in early July, 73% of households now have access to running drinking water but only 57% to safe sanitation (2022).

Cumulative losses of “human capital” and economic development are valued by the World Bank at several points of GDP for countries without adequate sanitation services. So much so that the major international players, in the front line to make up for the shortcomings of States, are pushing for priority to be placed on the urgent development of infrastructure before even tackling the ills of the continent’s health services, very shaken by the Covid-19 crisis.

The pandemic, which had nevertheless reminded the world that washing your hands carefully saves lives, had prompted a start from governments which, three years later, is struggling to materialize. The Sanitation and Water for All (SWA) partnership estimates the continent’s investment gap at $50 billion a year (€45.9 billion): one in four Africans still do not have access to clean water and more than one in two is not connected to any safe sanitation system.

“Conflicts, which have caused huge displacements of populations, climate disruptions and Covid have jeopardized decades of progress, explains Guy Mbayo of the WHO. And even when States commit, they are confronted with a lack of reliable data to plan public policies that are really adapted in the long term, which poses real problems of continuity of these essential missions. »

Change practices

In fact, megacities, which are attracting more and more people looking for work and should be home to half of Africa’s population by 2035, are growing faster than their sanitation infrastructure. Like Abidjan, which has nevertheless launched major works to rehabilitate the emblematic bay of Cocody, develop its network and renew kilometers of public pipelines, but whose population has more than tripled in twenty years to exceed 6, 4 million inhabitants in 2021. The public service delegate has so far only managed to connect 40% of Abidjan residents to mains drainage.

Medium-sized cities (up to 300,000 inhabitants), the number of which has exploded since the 1970s, are also concerned and must adapt at a forced march. Senegal, which raised the new town of Diamniadio from the ground in 2015 to relieve congestion in Dakar, had to work on creating modern infrastructure from scratch, but with the means of a low-income country. An equation with several unknowns in the long term as the city with brand new neighborhoods plans to welcome 350,000 inhabitants by 2040.

However, over the past twenty years, much has been done to improve Africans’ access to basic services and to change practices, particularly in rural areas, without necessarily waiting for the arrival of mains drainage. Like in Madagascar, where Unicef ??sets up “all-in-one” equipment in villages that manage to abandon open defecation despite the difficulty of obtaining water.

A resource also in short supply in many areas of the continent and which in 2011 had prompted the Bill and Melinda Gates Foundation (partner of the World Africa) to launch the international competition Reinvent the Toilet and to get engineers from all over the world to work to invent toilets of the future without water or electricity and recovering human waste.

Development challenges

Innovations that have brought out a market driven by private companies that replace overwhelmed states. Thus in the township of Mukuru, in Nairobi, where a system of cabinets which transforms waste into fertilizer and animal protein for livestock has revolutionized the daily lives of thousands of Kenyans.

But it will take more to enable the continent of 1.26 billion people, with the fastest growing population in the world, to clean up its cities and countryside. And for governments to realize the wishes of the Dakar Declaration, which concluded the 9th World Water Forum in the Senegalese capital in March 2022. Planning challenges must urgently become national priorities, real opportunities for potential to generate up to 21 times more value than expenditure, according to Vivid Economics.

The McKinsey group’s consulting agency also estimates the net benefits of modernizing existing services at several tens of billions of dollars by 2040. With the imperative of adapting them to recurring flood episodes aggravated by climate change. which trigger service cuts and damage to structures.

The key is considerable benefits in terms of population health, lower infant mortality, education, productivity, job creation, preservation of an increasingly scarce resource. And respect for a fundamental, universal, human right, enshrined in international texts for almost fifty years.