Reduced water availability will have adverse health effects The water supply situation in Africa is already precarious. The water stress will be exacerbated with climate change. Less water will result in increasing gastrointestinal problems. As water resource stresses become acute in future water-deficit areas of Africa as a result of a combination of climate impacts and escalating human demand, the conflict between human and environmental demands on water resources will intensify. Because maintenance of healthy ecosystems is an underpinning to economic sustainability, there is need in each water basin management unit to identify and factor into development projects the need for environmental flows.
The main challenges that the African populations are likely to face will emanate from the effects of extreme events such as tropical storms, floods, landslides, wind, cold waves, droughts, and abnormal sea-level rises that are expected as a result of climate change. These events are likely to exacerbate management problems relating to pollution, sanitation, waste disposal, water supply, public health, infrastructure, and technologies of production (IPCC, 1996). Possible health implications of climate change and climate variability will be through vector – and water-borne pathogens. In many African urban settlements, urban drift has outpaced the capacity of municipal authorities to provide civic works for sanitation and other health delivery services.
The outbreak of cholera during recent floods in East Africa and Mozambique underscores the need for adequate sanitation. It should be noted that although the outbreaks were spread from as far north as Mombassa and Nairobi in the north to Beira in the south, incidences remained localized to the outbreak centers because of the isolated nature of the affected urban areas. If settlement conglomerations such as those envisaged for West Africa and the eastern seaboard of South Africa developas discussed by Nicholls et al. (1999) – vulnerable population and areas will tend to be regional, rather than local.
Review of sanitary facilities now rather than later will not only be beneficial to communities now but in the long run will be cost saving for long-term health delivery services. Water issues in urban and rural areas are likely to become more critical, given increasing and competing demands, as well as rapid population growth. Infrastructure to store and serve water in major urban areas is mostly overstretched in capacity, and extreme events such as floods that cause physical damage add to the problem. Monitoring of water levels and water use is very poor and limits analysis of vulnerability