"Safe toilets for all by 2030" is one of the Sustainable Development Goal targets. But, with just more than five years to go until 2030, the United Nations says the world is "seriously off-track ... 3.5 billion people still live without safely managed sanitation, including 419 million who practise open defecation". That includes millions of people across Africa.
On 19 November each year the UN marks World Toilet Day. In 2024, people's ability to access safe, hygienic toilets is being disrupted by climate change, war and disaster in parts of the continent affected by flooding, climate-induced migration and conflict. The results: cholera outbreaks, sewage spills, and people continuing to suffer the indignity of going without proper toilets.
The Conversation Africa has published a number of articles explaining the continent's sanitation problems - and potential solutions. Here are six essential reads.
Africa urgently needs more toilets
The lack of proper toilets in many African countries, including Nigeria, Ethiopia, Niger, the Democratic Republic of Congo, Burkina Faso and Chad, means that many people are forced to defecate outside.
Through no fault of their own, communities run the risk of getting diseases spread by faeces lying around outside. Having no toilets and using outdoor spaces also means that faeces can contaminate water sources. This spreads waterborne sicknesses to humans and livestock throughout the water and food chain.
Recent research by industrial microbiologist Helen Onyeaka and public health microbiologist Omololu Fagunwa found that defecating outside can also lead to antimicrobial resistance. Bacteria that are resistant to medications spread and antibiotics become useless.
Read more: There are too few toilets in Africa and it's a public health hazard - how to fix the problem
Toilet shortages have led to cholera outbreaks
Over the past ten years, nearly 20 African countries have been affected by dozens of cholera outbreaks. Thousands of people have died of this disease, which can kill within hours unless properly treated. Cholera is spread by Vibrio cholerae bacteria through contaminated water or food in areas with poor sanitation.
Those who live in crowded camps for displaced people, areas hit by floods and urban informal settlements are most at risk, as they often have no access even to communal toilets or clean piped water. The problem, argues microbiologist and infectious diseases researcher Samuel Kariuki, is that governments in Africa make only mediocre attempts to provide clean drinking water and toilet facilities in crowded areas.
Read more: Cholera: how African countries are failing to do even the basics
In South Africa, a cholera outbreak claimed the lives of 47 people in Hammanskraal in 2023. This, after piped water became contaminated with cholera. This year, the country has edged further towards a sanitation-caused public health crisis. Rivers in the country's industrial heartland province have been flooded with raw sewage by local government authorities following a widespread breakdown of sanitation systems.
Water management expert Anja du Plessis has found that preventing cholera is not a matter of merely encouraging individuals to wash their hands more. Cholera outbreaks will continue to happen unless each person has enough clean water for drinking, bathing, using the toilet, cooking, washing clothes and keeping their home clean. The World Health Organization estimates this bare minimum to be between 50 and 100 litres of person per day.
Read more: Cholera in South Africa: a symptom of two decades of continued sewage pollution and neglect
Nigeria is also plagued by sanitation problems. Many of these stem from outside communal toilets and poor drainage systems, which allow sewage to pile up in the open. Residents in Nigeria's coastal regions have even told town and urban planner Seun Olowoporoku that the lack of toilets is a bigger problem for them than frequent oil spillage, gas flaring, air and water pollution and agricultural land contamination.
Some of the major concerns of residents surveyed for this research were that disease was spreading from open defecation and that it was not safe for them to walk to toilets built outside their homes.
Read more: Oil hazards aren't the main worry of Nigeria's coastal residents: toilets are
How to solve Africa's toilet problems
Some solutions are on the horizon. But they will require government investment and political will. In South Africa, only 65% of the population have flush toilets, while another 32% use pit toilets. And 30 years of austerity measures mean water and sanitation systems that should have been extended and well maintained to serve a growing population have instead been left to collapse.
Together with drought, the water shortages caused by collapsing systems means it makes more sense for the government to roll out non-sewered sanitation, such as dry toilets, which don't need to be flushed. Composting toilets are another example of dry toilets that do not flush.
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Water, sanitation and hygiene research scientist Preyan Arumugam-Nanoolal has found that the more research and development is done into safe and clean toilets that do not need water to flush, the cheaper and more advanced these dry toilets will become over time.
Read more: Flushing toilets aren't the solution to South Africa's sanitation problem
About 570 million people in sub-Saharan Africa live without proper sanitation. Urine-diverting dry toilets could be one solution, found environmental engineers Mooyoung Han and Shervin Hashemi.
These innovative toilets were designed by the researchers specially for crowded cities where toilets are in short supply. They separate urine and faeces, diverting the two forms of waste into tanks where microbes turn it into fertiliser. This does away with the need for flushing toilets that use water which is not always available and expensive wastewater treatment plants further down the sanitation chain.
Read more: Some smart ideas to make toilets fit for purpose in Africa's cities
Anna Weekes, Environment + Energy Editor, The Conversation Africa
