Why have access to clean water and sanitation been major health challenges in Afghanistan?

Access to clean water and sanitation in Afghanistan has been a persistent health challenge due to a combination of infrastructure decay, political instability, and geographic limitations.

The lack of potable water across most of the country is a primary driver of widespread waterborne diseases. Historically, only a small fraction of the population—primarily in urban centers—has had access to safe water. This crisis is compounded by the following factors:1

• Infrastructure Damage: Decades of conflict have severely degraded urban and rural infrastructure. By the early 21st century, essential city services, including water and sewage disposal, were largely nonfunctional in many areas.2
• Political Instability: The absence of a robust, centralized government has hindered the development and maintenance of water systems. Furthermore, the exclusion of women from the workforce, including the medical sector, has further weakened the country's ability to address public health crises.1
• Geographic and Climatic Stress: Afghanistan’s semiarid climate and frequent droughts place immense pressure on water resources. While rivers like the Helmand are vital for irrigation and drinking water, their management is complicated by regional disputes and the country's reliance on inland drainage systems.345