Clean water, good sanitation and hygiene are still elusive for people living with HIV in 2016

30 Nov 2016

This World AIDS Day, WaterAid is urging governments to prioritise access to clean water and basic toilets for people living with HIV. 

These necessities are an essential but neglected part of managing living with HIV, WaterAid said.

As part of the drive to improve life for people living with HIV/AIDS, WaterAid is threading the crucial role of access to safe water, effective sanitation and good hygiene for those with HIV/AIDS in Southern Africa throughout its projects and advocacy.

Earlier this year, WaterAid and Southern Africa agency SAfAIDS launched a toolkit as part of their mission to persuade governments to combine programmes more effectively to deliver water, sanitation and hygiene with those for people living with HIV/AIDS.

Some 70% of all people living with HIV in the world are in Sub-Saharan Africa, or about 25 million people. Clean water is critical to keeping them healthy, for taking antiretroviral drugs and for the good hygiene required to minimise infections.

Yet 32% of people in Sub-Saharan Africa are without access to clean water and 70% are without basic sanitation, leaving many people living with HIV suffering from chronic diarrhoea and unable to care for themselves or their families. 

Diarrhoea compromises the effectiveness of ARV drugs by reducing the body’s ability to absorb nutrients from food and medicine.

Some 90% of people living with HIV in Southern Africa suffer from diarrhoea, and an overwhelming majority of these cases, 88%, are linked to unsafe drinking water, inadequate sanitation and poor hygiene. Nine of Southern Africa’s ten countries have the highest HIV prevalence rates worldwide. 

WaterAid Regional Director for Southern Africa, Robert Kampala, said:

“There has been so much progress on education and in delivering anti-retroviral drugs to improve the lives of those living with HIV, yet there has not been a focus on making sure they have the most basic of life essentials: clean water, basic toilets and the means to keep themselves and their surroundings clean. 

“These basic tools for preventing infection can mean more parents being well enough to work or to care for children, and healthier, more productive communities, even where HIV infection rates are high.”

The toolkit follows a 2014 assessment of people living with HIV in Lesotho, Mozambique, Swaziland and Zambia. Swaziland has an HIV prevalence rate of 27.4%, one of the highest in the world; Lesotho’s HIV prevalence rate remains at 22.9%, while Zambia’s is 12.7% and Mozambique 11.1%.

Though rates of access to water and sanitation vary among these countries, research revealed many households with more than a kilometre to walk for water, and households without toilets where people including those who are sick or older have no choice but to defecate in the bush.

Taking ARV drugs requires 1.5 litres of safe, clean water each day. A person living with HIV may require up to 100 litres a day to stay clean and healthy – for drinking, food preparation, laundry and washing, formula feeding babies born to mothers with HIV, watering gardens to improve nutrition, and for the extra cleaning required during bouts of diarrhoea common in people living with HIV.

In many parts of Sub-Saharan Africa, this is simply not possible.

WaterAid offers guidance to health practitioners on how to include issues around water, sanitation and hygiene into HIV services to recognise that without them, people living with HIV will be more ill more often, and less able to live healthy and productive lives.

Chilufya Chileshe, Regional Advocacy Manager for Southern Africa
, said:

“Ultimately, the integration of WASH and HIV programmes is about meeting the needs of people living with HIV. If they are unable to participate in planning, decision making and implementation, consideration of their specific water and sanitation needs will be limited, and we will have missed the point.

The UN Global Goals on Sustainable Development call for universal access to clean water and sanitation by 2030, which will play a critical role in supporting healthcare targets and improving the length and quality of life of those living with HIV.



For more information or to arrange interviews, please contact:
Lisa Martin, Senior Media Officer, on +44 (0)207 793 4524 or [email protected] or Carolynne Wheeler, News Manager, on +44 (0)207 793 4485 or [email protected]

Notes to Editors

About WaterAid:

WaterAid’s vision is of a world where everyone has access to safe water and sanitation.  The international organisation works in 37 countries across Africa, Asia, Latin America and the Pacific Region to transform lives by improving access to safe water, hygiene and sanitation in some of the world’s poorest communities.  Since 1981, WaterAid has reached 23 million people with safe water and, since 2004, 21 million people with sanitation.  For more information, visit, follow @WaterAidPress or @WaterAid on Twitter, or visit us on Facebook at

  • Around 315,000 children die each year from diarrhoeal diseases caused by dirty water and poor sanitation. That’s almost 900 children each day, or one child every two minutes.
  • Some 663 million people (around one in ten) are without safe water
  • Nearly 2.4 billion people (around one in three) live without improved sanitation
  • For every £1 invested in water and sanitation, an average of £4 is returned in increased productivity.
  • Just £15 can help provide one person with access to safe water.
  • For details on how individual countries are keeping their promises on water and sanitation, please see our online database,