The study, released on Monday ahead of the historic UN Water Conference, reviewed household access to WASH services, the burden of WASH-attributable deaths among children under five, and exposure to climate and environmental hazards, revealing where children face the biggest threat, and where investment in solutions is desperately needed to prevent unnecessary deaths.

“Africa is facing a water catastrophe. While climate and water-related shocks are escalating globally, nowhere else in the world do the risks compound as severely for children,” said UNICEF Director of Programmes Sanjay Wijesekera.

“Devastating storms, floods, and historic droughts are already destroying facilities and homes, contaminating water resources, creating hunger crises, and spreading disease. But as challenging as the current conditions are, without urgent action, the future could be much more bleak.”

Crises compounded by armed conflict

The triple threat was found to be most acute in Benin, Burkina Faso, Cameroon, Chad, Côte d’Ivoire, Guinea, Mali, Niger, Nigeria, and Somalia, making West and Central Africa one of the world’s most water-insecure and climate-impacted regions, according to the analysis. Many of the worst-affected countries, particularly in the Sahel, are also facing instability and armed conflict, further aggravating children’s access to clean water and sanitation.

Across the 10 hotspots, nearly one-third of children do not have access to at least basic water at home, and two-thirds do not have basic sanitation services. A quarter of children have no choice but to practise open defecation. Hand hygiene is also limited, with three-quarters of children unable to wash their hands because of lack of water and soap at home.

As a result, these countries also carry the heaviest burden of child deaths from diseases caused by inadequate WASH, such as diarrhoeal diseases. For example, six of the 10 have faced cholera outbreaks over the past year. Globally, more than 1,000 children under five die every day from WASH-related diseases, with around two out of five concentrated in these 10 countries alone.

Accelerated action is needed to ensure safe drinking-water, sanitation and hygiene for all.

Vulnerable to climate threats

These hotspots also rank within the top 25 per cent of 163 countries globally with the highest risk of exposure to climate and environmental threats. Higher temperatures – which accelerate pathogen replication – are increasing 1.5 times faster than the global average in parts of West and Central Africa. Groundwater levels are also dropping, requiring some communities to dig wells twice as deep as just a decade ago. At the same time, rainfall has become more erratic and intense, leading to floods that contaminate scarce water supplies.

 All 10 countries are also classified by the Organisation for Economic Cooperation and Development (OECD) as fragile or extremely fragile, with the stresses of armed conflict in some countries threatening to reverse progress toward safe water and sanitation.

For example, Burkina Faso has seen a ramping up of attacks on water facilities as a tactic to displace communities. Fifty-eight water points were attacked in 2022, and more than 830,000 people – over half of whom are children – lost access to safe drinking water in the last year.

The call comes amid reports that the situation in Haiti is deteriorating by the day, with citizens facing spiralling violence, human rights, and food emergencies, as well as a cholera epidemic.

The influence of armed gangs is growing exponentially in the capital, Port-au-Prince, and beyond, reaching the Department of Artibonite, the country’s breadbasket. Armed violence – including kidnappings and sexual violence against women and girls – is also surging.

The six senior officials, representing UN aid agencies and international NGOs, met with people who need humanitarian aid, as well as with local and international partners.

They also held talks with Prime Minister Ariel Henry and other senior Government officials, and met with community representatives from areas controlled by, or under the influence of, armed gangs.

“The humanitarian needs in Haiti are unprecedented,” said Sara Bordas Eddy, Chief of the Humanitarian Field Support Section of UNICEF, at the end of the two-day trip. “The suffering of a Haitian child today is not comparable to the suffering of a Haitian child a few years ago. As humanitarians, we are finding ways to reach those in need including in gang-controlled areas. For that to happen in a sustainable way, we also need the donor community to not give up on Haiti.”

Despite the difficulties, the UN and NGO officials noted that the humanitarian response continues to be scaled up, and committed even more support to aid workers on the ground.

“The population feels desperate, but I also saw the resilience and potential of the women and girls who want to help build a better future for their country, communities and families,” said Shoko Arakaki, Director of the Humanitarian Response Division of the UN Population Fund (UNFPA). “They need urgent health and psychosocial support, but also livelihood and economic empowerment for recovery.”

This year, the UN and its partners will need $715 million to help more than three million people in Haiti. This is more than double the sum appealed for last year, and the highest amount since the 2010 earthquake.

Also taking part in the visit were Tareq Talahma, the Acting Director of the Operations and Advocacy Division of the UN Office for the Coordination of Humanitarian Affairs (OCHA), Osnat Lubrani, the Acting Director and Head of the Humanitarian Section of UN Women’s Geneva Office, Dominic MacSorley, the Humanitarian Ambassador for Concern Worldwide, and Mark Smith, Vice President of Humanitarian and Emergency Affairs of World Vision.

“More than just humanitarian assistance, what the people of Haiti need is peace, security and protection,” said Mr. Talahma “We cannot let Haiti become a forgotten crisis.”

Martin Griffths, the UN Humanitarian Affairs and Emergency Relief Coordinator, briefed ambassadors on the eve of the expiration of the Black Sea Grain Initiative, which has allowed nearly 25 million metric tonnes of foodstuff from Ukraine to reach global markets. 

The accord was signed in Türkiye in July 2022, in parallel with a Memorandum of Understanding on Russian food and fertilizer exports. 

“It is vital for global food security that both of these agreements continue and will be fully implemented,” he said. 

Feed the world 

Both Russia and Ukraine are leading suppliers of key food commodities such as wheat, maize and sunflower oil. Russia is also a top global exporter of fertilizer.  

Mr. Griffiths said the world relies on these supplies and has done so for many years. 

“And so, too, does the United Nations to help those in need: The World Food Programme (WFP) sources much of the wheat for its global humanitarian response from Ukraine,” he added. 

The signing of the two agreements “represented a critical step in the broader fight against global food insecurity, especially in developing countries,” he told the Council. 

“Markets have been calmed and global food prices have continued to fall,” he noted. 

Stepping up engagement 

Mr. Griffiths said the UN is doing everything possible to make sure that the Black Sea Grain Initiative can continue, and is engaging with all the parties. 

Additionally, Secretary-General António Guterres and the head of the UN trade agency, UNCTAD, Rebeca Grynspan, “are sparing no effort” to facilitate the full implementation of the Memorandum of Understanding with Russia. 

“We have made meaningful progress. Impediments remain, however, notably with regard to payment systems. There is more to do and our efforts to overcome these remaining impediments will continue unabated,” he said. 

Staggering humanitarian needs 

The UN relief chief also warned of the threat to sustainable development in the face of an unstable global economy and growing poverty, and with humanitarian needs outpacing resources.  

This year, humanitarians will require an unprecedented $54 billion to support nearly 347 million people in 69 countries. Last year, donors gave a historic $38.7 billion for their operations. 

He said it was uncertain that this level of financing can be achieved so that humanitarians can deliver for the world’s most vulnerable people. 

End the war 

Mr. Griffiths also highlighted the need for closer collaboration between the humanitarian and development communities, and financial institutions, to seek sustainable solutions in the face of spiralling global needs, and new crises on the horizon. 

“More than ever, in this context do we need a political solution to the war in Ukraine,” he said.  “The people of Ukraine deserve peace, first and foremost. They deserve to turn the page on this terrible war, as do we all.”  

At the outset of the meeting, Council members declined Russia’s proposal to allow Daria Morosova, reportedly an ombudsperson of the Donetsk People’s Republic, to brief as a civil society representative. 

The Council is comprised of 15 members. Four countries voted in favour, eight against, and three abstained. 

The World Food Programme (WFP) appealed for urgent funding for its operations in the country, where families are battling crisis after crisis, including growing hunger, since the Taliban takeover of 2021.

Catastrophic hunger could become widespread across Afghanistan, and unless humanitarian support is sustained, hundreds of thousands more people will need assistance to survive, the agency said in an alert.

‘Half of what they need’

Due to funding constraints, at least four million people will receive just half of what they need to get by in March. Ss food stocks have run out before the next harvest is due in May, this is traditionally the most difficult time of the year for rural families, WFP said.

The cuts come at a time when already vulnerable Afghans are just emerging from yet another freezing winter. Sub-zero temperatures combined with economic distress has pushed millions into despair, the agency added.

WFP urgently needs $ 93 million to assist 13 million people in April and $800 million for the next six months. Although donors gave record amounts in 2022, since November last year WFP had been warning that funds would run out just as the lean season is reaching its peak in March and April.

‘Last lifeline’

The country is at the highest risk of famine in a quarter of a century, with half of all families living in crisis-coping mode to survive. For millions in Afghanistan, WFP’s food assistance is now the “last lifeline”.

Since August 2022, nine out of 10 Afghan families cannot afford enough food – the highest in the world. Nearly 20 million Afghans do not know where their next meal will come from, and six million of them are one step away from famine.

Levels of moderate acute malnutrition are the highest ever recorded in the country. Two thirds of the population – more than 28 million people – need humanitarian assistance in 2023, almost triple than in 2021.

In response, WFP massively scaled up its assistance across Afghanistan in 2022, thanks to generous funding. The agency supported 23 million people, distributing more than 1 million metric tons of food and $326 million in cash or vouchers to help families survive.

“Brutal” armed conflict has left 10 million children in Burkina Faso, Mali and Niger in need of humanitarian assistance – more than double the number in 2020, UNICEF warned in a new report.

And hostilities spilling over into neighbouring countries, are putting an extra four million children at risk.

“The conflict may not have clear boundaries, there may not be headline-grabbing battles, but slowly and surely things have been getting worse for children, and millions of them are now caught up in the centre of this crisis,” said UNICEF spokesperson John James.

Children living on the frontlines of hostilities between armed groups and national security forces are increasingly in the line of fire, too.

In Burkina Faso, for instance, the number of children killed during the first nine months of 2022 tripled compared to the same period in 2021. Children are also being recruited by armed groups and forced to fight or support militants in backup role, UNICEF said.

School attacks

In addition, armed groups in Burkina Faso, Mali and Niger have been directly targeting schools, in an “accelerating attack on education”. According to the UNICEF report, more than a fifth of schools in Burkina Faso have closed as a result of attacks.

“More than 8,300 schools in those three countries – Mali, Burkina Faso and Niger – are now closed due to violence and insecurity”, said Mr. James. That’s teachers who fled the schools, children who are too scared to go to the schools, families who are displaced – that’s buildings that have been attacked and caught up in the violence”, UNICEF’s Mr. James told journalists in Geneva.

Spillover effect

Hostilities have already spilled over from the central Sahel into the northern border regions of Benin, Cote d’Ivoire, Ghana and Togo where, UNICEF notes, “children have extremely limited access to essential services and protection”.

At least 172 violent incidents, including attacks by armed groups, were reported in the northern border areas of the four countries in 2022.

Climate crisis and food insecurity

UNICEF explained that the central Sahel suffers from severe food and water scarcity, and that armed groups make survival for civilians even harder by blockading towns and villages and contaminating water points.

Fifty-eight water points were attacked in Burkina Faso alone in 2022, close to a threefold increase from the previous year.

Overall, more than 20,000 people in the border area between Burkina Faso, Mali and Niger face ‘catastrophe-level’ food insecurity by June 2023, according to humanitarian assessments.

Climate change shocks

Climate shocks are a key factor affecting crops, with temperatures in the Sahel rising “1.5 times faster than the global average”, and “erratic” rainfall which leads to flooding, UNICEF said.

The impacts of extreme weather events are an important driver of displacement, with over 2.7 million displaced across the three countries.

The crisis in the Sahel is increasingly mirrored globally: in 2022, over 8,000 children worldwide were killed and maimed by armed forces and groups, more than 7,000 children recruited and over 4,000 abducted, the Special Representative of the Secretary-General for Children and Armed Conflict, Virginia Gamba, told the Human Rights Council on Thursday.

A displaced young woman holds her newborn baby in the north-central region of Burkina Faso.

Chronic underfunding

The UN Children’s Fund underscored that the crisis in the central Sahel remains “chronically and critically underfunded”, with only one third of the required funding received by UNICEF in 2022.

This year, the UN agency has appealed for $473.8 million to support its humanitarian response in the central Sahel and in neighbouring coastal countries.

UNICEF has also called for “long-term flexible investment” in essential social services, and stressed the need to work with communities and young people in the region to ensure a better future for them.