By Cate Namyalo
What if Uganda was losing billions of shillings every year, not because of a global economic crisis or declining exports, but because millions of people still lack access to safe water, adequate sanitation and proper hygiene?
The evidence is now impossible to ignore. Poor water, sanitation, and hygiene (WASH) services cost Uganda UGX 648.7 billion each year1—enough to build 25 large water and sanitation projects annually. If current investment trends continue, the country could lose UGX 98.96 trillion by 2035. The same analysis projects cumulative losses of UGX 98.96 trillion by 2035 if current investment trends continue. These figures represent different dimensions of the economic burden: the UGX
648.7 billion is an estimated annual cost associated with inadequate WASH, while the UGX 98.96 trillion is the projected longer-term loss.
WASH remains underfunded and under-prioritized because its benefits are less tangible and less immediately visible than investments in roads, buildings or other infrastructure. The diseases prevented, school days preserved and productivity gained rarely make headlines, even though their impact is profound. Behind these figures are children dying from preventable diseases, students missing school, workers losing productive time and communities trapped in cycles of poverty. The real question is no longer whether Uganda can afford to invest more in WASH; it is whether Uganda can afford not to.
The health burden is particularly stark. Poor sanitation and hygiene accounts for nearly 75% of Uganda’s preventable disease burden2. Every year, more than 4,500 children under five die from WASH-related illnesses—the equivalent of the number of children in five primary schools in a rural Ugandan setting. Mothers, newborns and vulnerable communities face additional health risks. Uganda also spends more than UGX 1.5 trillion annually treating preventable water-borne diseases. This is a health expenditure burden that better WASH services can help reduce.3 The broader economic burden is also substantial.
But the cost of poor WASH goes far beyond health. It undermines education, household welfare and national productivity. Consider 13-year-old Amina from Alwa Sub-county in Kaberamaido District, who walks long distances to fetch water before school. By the time she returns, valuable learning hours have been lost. At school, inadequate sanitation facilities can force her to miss classes, especially during menstruation. Her experience reflects the reality of millions of Ugandan children whose education, health and dignity are compromised by inadequate WASH services.
Uganda loses nearly UGX 9.71 trillion annually through illness, premature deaths, lost productivity, time spent collecting water and seeking healthcare. This figure should not be confused with the UGX 648.7 billion annual WASH cost or the more than UGX 1.5 trillion in
1 1 World Bank (2013) Economic Impacts of Poor Sanitation in Africa: Uganda
2 https://health.go.ug/wp-content/uploads/2024/04/3RD-Quarter-Newsletter1.pdf
3 https://eprcug.org/press-releases/inadequate-investment-in-water-sanitation-and-hygiene-wash-services-cost-uganda-nearly-three-percent-of-gdp
treatment costs: the figures capture different components of the wider burden, from the direct cost of inadequate services and healthcare expenditure to broader productivity and welfare losses.
This is why investing in WASH is an investment in human capital and economic growth. With improved services, children like Amina can stay in school, families can spend less time and money coping with preventable illness, and workers can remain productive. Better WASH also creates economic opportunities through local sanitation enterprises, water service providers, faecal sludge management, construction and maintenance services, hygiene-product markets and other parts of the growing sanitation economy.
The cost of action is far lower than the cost of inaction. Greater investment in WASH can prevent disease, reduce avoidable healthcare costs and protect productivity. Over the next decade, a substantial increase in investment could avoid major economic losses while creating jobs and strengthening local businesses. Uganda’s sanitation economy also has significant potential to expand by the end of 20304, creating opportunities for enterprises that provide sanitation products and services while improving public health.
But financing alone is not enough. Uganda needs financing that is protected, targeted and accountable. WASH resources should be clearly identifiable in national and local budgets, with ring-fenced allocations where appropriate; district-level performance targets should be established; annual progress and expenditure should be transparently reported; and investment should prioritize schools, health facilities and underserved communities. This would shift WASH from fragmented spending to measurable service delivery. The solutions exist, what is needed is sustained financing, accountability, and collective action.
4 Investment case: Catalyzing the Sanitation Economy and the Menstrual Hygiene Marketplace in Uganda, May 2023
The Ministry of Finance, Planning and Economic Development (MoFPED) should reframe WASH in budget programming as a high-yield, productive investment rather than a recurring social cost. It should commit at least 1.5% of the national budget to WASH in the FY 2027/28 Budget Framework Paper, anchored in revised allocation guidelines and endorsed by Cabinet by October 2026. The 1.5% target would provide a clear, measurable minimum financing floor and make WASH a visible budget priority rather than an unfunded aspiration.
Parliament, through the Parliamentary Forum on WASH, should champion a WASH financing bill in the 12th Parliament to address persistent funding gaps and strengthen accountability. MoFPED and line ministries should also establish a mechanism for tracking WASH allocations and expenditure across sectors, while local governments should translate national commitments into funded district targets and report annually on results.
Additionally, having the President’s pronouncement will provide high-level policy direction for all Ministries, Departments and Agencies (MDAs), Local Governments, the private sector, and communities to prioritize sanitation, and invest in sustainable WASH interventions as a shared national responsibility.
Uganda’s path to middle-income status depends not only on infrastructure and industry, but also on universal access to safe water, sanitation and hygiene. For Amina and millions of other Ugandans, WASH investment is not an abstract budget line; it determines whether a child reaches school on time, whether a mother can access a dignified sanitation facility and whether a family can avoid preventable illness. The choice is clear: invest now, or pay far more later.
Written by Cate Namyalo – Senior Environmental Health Officer with 16 years’ experience in the WASH sector serving at the Ministry of Health-Uganda
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