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The document defines non-sewered sanitation systems (NSSS) as reticulation-free systems where human excreta are stored on-site for treatment or disposal. It highlights the economic return of water and sanitation investments, noting a USD 2.5 - 5 return in reduced healthcare costs for every dollar spent. In South Africa, NSSS are presented as solutions to water scarcity, aging infrastructure, and rapid urbanization, with a potential R4.7bn investment opportunity in metropolitan projects and a R3.4bn government allocation for school sanitation over two years. Globally, the document projects that water infrastructure costs will rise from USD 6.7 trillion by 2030 to USD 22.6 trillion by 2050, with Sub-Saharan Africa leading in annual costs to achieve basic and safe sanitation.

The document reports on the status of MDG 7 targets, highlighting a mix of progress and decline. While 98% of ozone-depleting substances have been phased out and protected areas increased by 8.3% to 14% between 1990 and 2012, global CO2 emissions rose from 21,550 to 31,387 million tonnes/year. Water stress affects 30% of the global population, and 29% of 600 monitored marine fish stocks were exploited beyond safe biological limits in 2009. In terms of human settlements, 863 million people live in slums, with 70% of the population in Africa still residing in slums.

The report examines Ethiopia's water-poverty nexus, highlighting that while the country has significant water resources, service provision for water supply and sanitation remains among the lowest globally. It argues that poverty reduction depends on improving rural water access, expanding small-scale irrigation, and enhancing rainwater harvesting to ensure food security. The document evaluates the Government of Ethiopia's Universal Access Programme (UAP) and the challenges of meeting Millennium Development Goals (MDGs), noting a critical need for better operation and maintenance of existing infrastructure and increased private sector involvement.

The report examines how water resources in Senegal intersect with poverty alleviation and the Millennium Development Goals (MDGs). While progress has been made in urban water supply, rural sanitation remains a challenge. The study highlights a heavy reliance on groundwater, the role of the Senegal River Basin in food security, and the vulnerability of coastal zones to sea-level rise. It argues for a more holistic Integrated Water Resource Management (IWRM) approach that includes rainwater harvesting and better local community participation to ensure sustainable development.

The document examines Tanzania's water-poverty nexus, highlighting a significant 'implementation gap' where progressive policies on Integrated Water Resources Management (IWRM) and decentralization are hindered by limited institutional and financial capacity. It emphasizes the critical role of rainfed agriculture, which supports the majority of the poor, and the need to integrate 'green water' flows into management strategies. The report also notes severe challenges in sanitation coverage and the conflict between hydropower and irrigation needs in major river basins.

The report investigates the intersection of poverty and environmental degradation in the Greater Accra Metropolitan Area (GAMA), Ghana. It finds that low-income households suffer from severe deficiencies in water access, sanitation, and waste management, which correlate strongly with high prevalences of childhood diarrhoea and acute respiratory infections. The study highlights that while the city has some advanced infrastructure, extreme crowding and unreliable supply systems negate these advantages for the poor. It concludes that an integrated environmental-health strategy, leveraging both government action and local community organisations, is necessary to improve urban welfare.

The ACWA Platform is a pan-African alliance of 24 organizations and cities launched at COP27 to address water resilience in Africa. It aims to provide 29 million people across 100 cities with improved water services and protection from shocks by 2032. The platform offers a four-level engagement model: widening the discourse through community engagement, providing a resilience toolbox of analysis and planning tools, facilitating a community of practice for knowledge transfer, and operating gamechanger labs for place-based ideation and testing.

The document outlines the challenges of modern urbanization, particularly in the global South, where rapid population growth coincides with low per capita resources. It argues that providing equitable access to core services—such as housing, water, sanitation, energy, and transportation—is essential to avoid cycles of poverty and environmental degradation and to unlock economic productivity.