**2.4 Water shortages a threat to water quality and cause of waterborne diseases in Africa**

Apart from its negative socio-economic impacts, inadequate access to safe water remains a high risk for communicable diseases that in return reduce vitality and economic productivity. The serious water shortages in SSA has forced communities to rely on unsafe water sources. Unfortunately, the water of these sources is often used without any form of treatment [31]. Almost half of the people drinking water from unprotected sources live in SSA [32]. This explains why more than 70−80% of diseases on the African continent are related to poor water quality [32].

Even in the presence of water availability, water management practices at the level of households have also a great responsibility in spreading water-borne diseases [33]. For instance, lack of awareness, knowledge, and hygiene practices could therefore be barriers to safe water use. Poorly managed sanitation facilities expose water resources to contamination [4]. For example in Cameroon, recurrent ruptures of septic tanks dumping their content on the main roads connecting working-class neighborhoods in cities like Yaoundé are recorded daily [34]. Such human wastes are carried by rainfall and sometimes end their course in a river or any other water source thereby exposing the community to serious waterborne diseases. Other wastes that contribute to polluting water sources in our major cities in SSA include plastic bags and plastic bottles. As they accumulate in the rivers, they can divert the direction of the water flow into the community. This may explain why the quality of the water sources often correlates well with the prevalence of water-related diseases in the community [35]. Additionally, lack of waste treatments in urban areas, insufficient water treatment facilities, as well as mismanagement of the existing water facilities are among the factors that contribute to the deterioration of Africa's water quality [34, 36, 37]. In addition, the use of chemical contaminants in the cultivable areas of our cities represents a source of risk of contamination of water from wells, boreholes, etc. The presence of these products might result to heavy metals in various water sources across SSA and poses as much a public health problem as microorganisms [31, 38, 39]. In addition to the questionable quality of water due to water shortages, urbanization and population growth also contribute to the disposal of more wastes into water bodies in many countries in SSA [38].

Worldwide, the annual loss of human life associated with the consumption of unsafe water is estimated at 30 million people. It thus appears that, for lack of proper access to the resource, water has become directly or indirectly the first cause of death in Africa [8]. Water-related diseases constitute a significant proportion of the burden of disease in SSA.
