Africa Health and WaSH Futures: Thematic Futures

The report examines the critical intersection of health and WaSH services in Africa, highlighting how underinvestment, colonial legacies, and external dependencies undermine human development. It details severe infrastructure gaps, such as the lack of safely managed water for 959 million people, and warns that the closure of USAID in 2025 could result in 1.8 to 2.5 million additional deaths annually through 2030. The document argues that these systems are foundational for economic productivity and resilience against climate-related disasters, but current trajectories are insufficient to meet 2030 Sustainable Development Goals.

• Africa's health systems are characterized by low per capita spending, severe staffing and infrastructure shortfalls, and significant urban-rural disparities in service delivery.
• Heavy reliance on external donor funding creates systemic vulnerability; specifically, the 2025 closure of USAID is projected by The Lancet to cause approximately 1.8 to 2.5 million additional deaths per year between 2025 and 2030.
• Significant gaps in WaSH infrastructure persist, with 959 million people lacking safely managed water and over one billion lacking safely managed sanitation as of 2023.
• Inadequate WaSH and health systems directly impede educational and economic outcomes, contributing to school dropouts among girls due to menstrual hygiene issues and reducing overall workforce productivity.
• Current progress in health and WaSH is insufficient to meet the 2030 Sustainable Development Goals, leaving the continent vulnerable to pandemics and climate-related disasters.

APA

Cilliers, J. (2026). Africa Health and WaSH Futures: Thematic Futures. Institute for Security Studies. https://futures.issafrica.org/thematic/guide.pdf?thematic=05-health-and-wash&topic=01-introduction

Chicago

Cilliers, Jakkie. Africa Health and WaSH Futures: Thematic Futures. Institute for Security Studies, 2026. https://futures.issafrica.org/thematic/guide.pdf?thematic=05-health-and-wash&topic=01-introduction.

Wikipedia

{{cite report |last1=Cilliers |first1=Jakkie |title=Africa Health and WaSH Futures: Thematic Futures |publisher=Institute for Security Studies |date=29 March 2026 |url=https://futures.issafrica.org/thematic/guide.pdf?thematic=05-health-and-wash&topic=01-introduction |access-date=17 August 2026 |via=Climate Insights Directory}}

BibTeX

@techreport{cilliers2026africa, author = {Cilliers, Jakkie}, title = {{Africa Health and WaSH Futures: Thematic Futures}}, institution = {Institute for Security Studies}, year = {2026}, month = mar, url = {https://futures.issafrica.org/thematic/guide.pdf?thematic=05-health-and-wash&topic=01-introduction}, urldate = {2026-08-17}, note = {Indexed by Climate Insights Directory} }