More than 40 million people in Southern Africa who should have received access to safe drinking water by 2015 will miss out, and 73 million will go without basic sanitation due to investment shortfalls, according to a report released on Monday.
Only two out of 15 Southern African countries - Botswana and Seychelles - are set to meet their 2015 Millennium Development Goal (MDG) targets to reduce by half the number of people without access to clean water and sanitation, said the report by Water Aid.
The cost of getting those countries that have fallen behind back on track would be $3.6 billion per year, said the international development NGO.
"Southern African governments must meet their past promises on water and sanitation and, together with donors, invest at the levels needed to put an end to the crisis that causes hundreds of thousands of children's lives to be prematurely and needlessly extinguished," Robert Kampala, Water Aid Head of Region for Southern Africa, said in a statement.
Some 120,000 children under the age of five die every year in the region from diarrhoea, which is primarily caused by lack of access to clean water and sanitation.
Almost two thirds of the population, 174 million people, do not have access to sanitation and over 100 million do not have access to safe drinking water.
"The high number of people living in Southern Africa who still do not have access to basic sanitation is a shocking figure," John Garrett, one of the lead authors of the report, told Thomson Reuters Foundation in a phone interview from London. "The social indicators show that challenges in tackling basic services like access to water and sanitation still remain."
Despite a 2008 commitment by African Union countries to spend at least 5 percent of their GDP on sanitation and hygiene, none of the governments has kept the promise.
The report called on governments to dedicate revenue from natural resource extraction towards water and sanitation.
"Botswana in Angola are on track for the MDG (sanitation) target and what they've managed to do is to dedicate a lot of resources that they've captured from their natural resource wealth for basic services like water and sanitation," said Garrett. "There's opportunity for other countries in the region to make better use of their natural resource base in order to expand public spending on water and sanitation.
The report highlighted huge discrepancies in water and sanitation aid in the region and called on donors to target aid according to need. Seychelles, with almost universal access, receives $57.2 of water and sanitation aid per person, while Madagascar and DR Congo receive $0.6 and $1.00 respectively, despite more than half of their populations lacking access to safe water and sanitation.
Garrett urged governments to take action quickly in the remaining few months before next year's MDG deadline.
"There is very little time till 2015, but the little time that remains is for urgent action in order to drive progress on water and sanitation," said Garrett. "The most important thing is to see political priority coming from those countries which have neglected that sector."