The World Bank has raised alarm over the growing global sanitation crisis, warning that nearly two out of five people worldwide lack access to safe sanitation, with dire consequences for public health, economic growth, and the environment.

The global financial institution also raised an alarm that Africa is losing as much as $200 billion annually in economic gains, due to poor sanitation, warning that the continent’s GDP could rise by up to five per cent with adequate investment in water and sanitation services.

This was contained in a report titled “The Global Sanitation Crisis: Pathways for Urgent Action,” released by the World Bank on Tuesday.

Sanitation remains one of the most pressing global development challenges. According to United Nations estimates, around 3.5 billion people still lack access to safe sanitation facilities, contributing to preventable diseases such as cholera, diarrhoea, and typhoid, which collectively cause hundreds of thousands of deaths annually, especially among children under five.

In Africa, the challenge is compounded by rapid urbanisation, poverty, and weak infrastructure. Informal settlements in major cities often lack proper sewage systems, forcing residents to rely on unsafe alternatives that contaminate water sources.

The World Health Organisation, WHO, has repeatedly stressed that poor sanitation not only fuels disease but also limits economic productivity by keeping children out of school and adults away from work.

Global bodies, including the UN and World Bank, have tied improved sanitation to the Sustainable Development Goals, particularly Goal 6, which calls for “clean water and sanitation for all” by 2030. However, progress has been slow, with funding gaps, weak policy frameworks, and climate pressures further widening the divide between developed and developing nations.

The Bretton Wood United States-based institution’s  report warned that the burden is particularly heavy in low and middle-income countries. It further noted that worsening climate threats are compounding the challenge.

The report partly reads, “The Global Sanitation Crisis: Pathways for Urgent Action”, examines the risks that poor sanitation poses to people, economic growth, and the environment. It outlines practical steps that cities and countries can take to accelerate progress toward universal access to resilient, safely managed sanitation—promoting healthy communities, sustainable environments and reduced greenhouse gas emissions, thriving economies, resilient cities, job creation, and greater human productivity.

“There is a global sanitation crisis with nearly 2 out of 5 people across the world lacking access to safe sanitation. In low- and middle-income countries, one third of urban residents face a ‘triple burden’ of inadequate sanitation, poverty, and climate risks—leaving them especially vulnerable to disease, water scarcity, disasters, and economic hardship.

“Escalating climate-related threats—such as flooding, drought, and rising sea levels—are putting increasing strain on already fragile sanitation systems, resulting in significant GDP losses, especially in low – and middle-income countries. By investing in smart and resilient urban sanitation now, countries can turn this vicious cycle into a virtuous one, where sanitation services withstand extreme weather and disasters, protect human health, boost economic growth and create jobs, reduce pollution, and transform cities.”

On the economic front, the World Bank highlighted the cost-benefit of sanitation investments. It added that stronger sanitation systems would also protect the environment.

It also linked improved access to sanitation with better educational outcomes.

“Investment in water supply and sanitation yields significant returns. Every US$1 spent in Africa returns US$7 – adequate funding in the sector could boost the GDP by 5 per cent, resulting in an annual economic gain of US$200 billion in Africa alone.

“Resilient sanitation reduces emissions and pollution from unsafe waste treatment, protecting the environment and global ecosystems. That means a reduction of up to 10% in global methane emissions and cleaner, more reliable drinking water.

“Improved access to sanitation in schools has been linked to increased enrollment in primary schools in India, including a substantial increase in the enrollment of adolescent girls when provided with sex-specific latrines. In Brazil, there has been an increase in completed school years,” the report added.

The World Bank recommended urgent action by governments and stakeholders. It stressed that investing in climate-resilient, citywide, inclusive sanitation would deliver long-term benefits.

“Recommendations for Action: Governments, cities, service providers, and communities must work together toward three goals: Prioritise sanitation policy and funding at the local and national levels. Design inclusive, integrated urban sanitation infrastructure and services that can withstand climate impacts and contribute to water-secure cities. Support technological innovation, gather data, share knowledge, and train workers to build and manage new systems.

“Investing in climate-resilient, citywide, inclusive sanitation ensures the safe management of human waste across the entire sanitation service chain. This protects vulnerable communities and the environment while strengthening urban resilience and water security.

“It also supports circular economy approaches by transforming faecal sludge and wastewater into valuable resources—reducing pollution, generating energy, creating jobs, and enabling water reuse. These benefits collectively enhance the resilience of urban ecosystems, “the report said.