10 countries with high water stress and scarcity levels

Despite considerable resources, including access to two of Africa’s most important water basins (the Chari and Ubangi Rivers), only 30.2% of Central Africans have access to basic drinking water. Just 6.2% have access to safely-managed drinking water.

There are overlapping forces at play: the Central African Republic’s population has nearly quadrupled since 1960, rising from 1.5 million then to just over 5.3 million in 2024. The water infrastructure is outdated, both in terms of technology and capacity, and conditions became worse starting in 2012 with conflict that at times specifically targeted water access points and wells. CAR also lacks a national sanitation and water treatment system.

» Learn more about how Concern is improving water access in the Central African Republic

Water scarcity in Chad is especially dire in both the dried-out Lake Chad Basin and, since 2023, the refugee camps hosting hundreds of thousands of Sudanese refugees. Just 46% of Chadians have access to basic water services, and only 6.34% have access to safely-managed water.  

A lack of infrastructure has also left most of the country without access to basic or safely-managed sanitation services. This is especially critical for young Chadians, who are at higher risk for malnutrition, even if they’re eating enough food, due to waterborne diseases like diarrhoea leading to malabsorption of nutrients. 

Water is a key aspect of Concern’s work in Chad, and currently we’re part of two emergency interventions in the country focused specifically on water, sanitation, and hygiene (WASH). Our emergency WASH response reached over 60,000 people last year. 

The coastal nation of Sierra Leone faces high levels of water stress, with many families relying on polluted sources for everyday use. Only 10.9% of the country has access to safely-managed water, and just 57% of Sierra Leoneans have access to basic services. 

Improving access to safe, clean drinking water is a core component of many of Concern’s projects in Sierra Leone. Last year, our WASH initiatives reached over 17,000 people, with both our flagship programme Yoti Yoti and our Livelihoods Inclusion, Food, and Energy (LIFE) project both helping to build more water points and rehabilitate hand-dug wells in vulnerable regions. We also work with healthcare facilities to ensure that they have the adequate WASH infrastructure to best serve their patients. 

Decades of crisis in the Democratic Republic of the Congo have left nearly 89% of the country’s population without access to safely-managed drinking water. More than 97% of the population are also without basic sanitation services. Like the Central African Republic, the DRC has a wealth of freshwater resources, including 62% of the Congo River basin. However, underdevelopment over the last 65 years – combined with both national and localised conflicts – mean under-serviced sanitation needs that lead in turn to contaminated drinking water. The UN’s Environment Programme also warns that the situation may become worse if the climate crisis continues at pace. 

With an increase in violence in eastern DRC beginning in late 2023 and continuing in 2025, Concern has been responding by providing over 1.5 million litres of drinking water each day to civilians affected by the conflict. Overall in 2025, we reached nearly 362,000 Congolese with a variety of WASH programmes.  

» Learn more about our recent work in the DRC WASH Consortium

Ethiopia has faced increased water shortages as a result of ongoing droughts and other climate shocks. This leaves just 13.55% of the country with access to safely-managed drinking water. Conflicts over the last five years have also left fetching water a matter of life and death for millions — especially women and girls, who traditionally are the ones to collect water. Poor sanitation has also led to major cholera outbreaks in recent years. 

Concern has worked to improve water and sanitation in Ethiopia in both the short and long term. Our new flagship programme that covers a region where Ethiopia, Kenya, and Somalia intersect (known as the Mandera Triangle), Hanaano, has been constructing water points and implementing other solutions to the wider issue of child malnutrition, with priorities determined by participating communities. Last year in Ethiopia alone, the project reached over 47,800 participants with critical support during a prolonged drought season.

» Learn more about how drought has affected Ethiopia 

On average, Malawi has a slightly higher rate of water access, with nearly 55% of families having at least basic coverage. However, there are wider disparities in access among districts and between villages and cities. Only 18% of the country has access to safely-managed drinking water, and families who rely on agriculture for their livelihoods are at especially high risk for water scarcity. Poor sanitation and hygiene services are also a major threat to public health – particularly for children. In recent years, floods have also increased in terms of frequency and intensity, leaving millions of people at risk for waterborne illnesses. 

Watershed management and water conservation are key to many of Concern’s current programmes in Malawi. One recent success we’ve seen is in solar-powered irrigation systems: In 2025, as part of the programme Food Systems for Food Security, we installed 18 solar pumps – a low-cost solution that harnessed renewable energy and helped to sustain crops during the severe 2024-25 El Niño drought. Despite the unpredictable climate, farmers were able to enjoy two annual harvests without incurring prohibitive operational costs. 

Landlocked and dominated by the Sahara Desert, only one-eighth of the land in Niger is considered arable — an especially large challenge to the workforce, 80% of which relies on agriculture and livestock. Threatened with drought and desertification, the country has also faced recent bouts of violence and political instability, leaving just 28.9% of the country with access to safely-managed drinking water. The knock-on effects of these shortages cut across sectors, including economies and livelihoods, health and nutrition, and hunger. 

Last year, Concern helped to restore more than 150 hectares of land through agricultural half-moons, a low-tech, literally earth-based structure designed to reclaim arid land and capture rainwater. We have also found soilless farming techniques to help families living without access to fertile land and limited water resources. Sack gardens installed across five villages in 2025 helped more than 600 families enjoy a variety of vegetables throughout the year.  

Water is becoming harder to access in Afghanistan. Just over 30% of the country has access to safely-managed drinking water, and that access drops significantly in rural and hard-to-reach provinces. Even cities are at risk, however: One 2025 report warns that Kabul may become the first modern city to run out of water, possibly as soon as 2030.

Concern has been responding to a prolonged drought in the northeastern province of Kunduz. One programme, funded by the Afghanistan Humanitarian Fund, increased access to safe water, adequate sanitation, and good hygiene in the Ali Abad and Chardara districts. Between 2024 and 2025, we rehabilitated 128 groundwater wells, which restored access to safe drinking water for more than 12,000 people. We also built 60 latrines and rehabilitated another 60, which now serve more than 1,000 people. 

Pakistan is among the most water-stressed and scarce countries in the world, according to multiple rankings. Both the UN Development Programme and Pakistan Council of Research in Water Resources have also warned that the country could face absolute water scarcity as soon as this year. 

While access to water is comparatively higher than other countries on this list, it’s still low, with just over 48% of the country having access to safe drinking water. Heat traps caused by deforestation, combined with underinvestment in public works, have left 16 million people in Karachi alone without water access. Concern is very active with WASH support in Pakistan. Our humanitarian WASH responses alone reached over 295,000 people last year. 

» Check out our photo essay on delivering water during a prolonged drought in Pakistan’s Thar Desert

Access to water in the Occupied Palestinian Territories has historically been difficult, with UNICEF and the WHO estimating pre-2023 access to basic drinking water at just 18.11%, and basic sanitation at 29.33%. The onset of the crisis in Gaza that year dramatically reduced what access there was in the area. Over 90% of Gaza’s water supply is unfit for human consumption due to contamination and damage, and only 40% of the population currently has access to safe drinking water. The collapse of sanitation services has also led to rising cases of waterborne diseases, including cholera and Hepatitis A. Last year, scientists also confirmed traces of polio in water samples. 

Concern has been supporting Alliance2015 partner CESVI in its emergency response in Gaza.  Our work in 2025 supplied 5,000 litres of drinking water every two days to camps in Deir al-Balah and Khan Younis (a total of 75,000 litres each month). We also installed a water filtration machine in Al-Rantisi Hospital, which has helped the 350-bed children’s hospital continue daily care – including essential dialysis services for children with kidney issues. 

Ensuring access to clean water and sanitation and providing hygiene information and training are key aspects of Concern’s work, with active water, sanitation, and hygiene (WASH) programmes in the majority of countries where we work. 

Over the last six decades, we have dug, drilled, and bored thousands of wells in remote and vulnerable communities across dozens of countries, and built countless latrines in their schools and health centres. The hours saved and the illnesses prevented make it one of the most effective things we do. 

When drought or displacement prevent access to clean water supplies, we do what it takes to connect communities, including trucking water to temporary tanks and installing pumps in camps. We work hand-in-hand with communities to help them assess the longstanding challenges they face, change behaviours, and ensure water and sanitation infrastructure will be maintained for the long term. And we foster a sense of ownership, build sustainable maintenance practices, and create transparent financial management systems that benefit the community.