Ghana must act now to end open defecation.

President John Dramani Mahama recently addressed this issue during the launch of Ghana's 2025 Voluntary National Review for the Sustainable Development Goals, calling the practice "unacceptable" and urging immediate action.

Stronger enforcement and smarter investment needed

President Mahama emphasised the need to end the long-standing practice of issuing building permits without toilet facilities. He stressed that Ghana's sanitation crisis stems not only from underinvestment but also from poor enforcement of regulations and limited community involvement.

This call is echoed by civil society groups and organisations such as WaterAid Ghana and the Media Coalition Against Open Defecation, who have long demanded that every new building be required to include a toilet. According to Ewurabena Yanyi Akofur, Country Director of WaterAid Ghana, local governments must start enforcing sanitation laws more effectively if real change is to be achieved.

A crisis with far-reaching consequences

While Ghana has made progress in expanding access to clean water, sanitation improvements remain slow. WaterAid has warned that at the current pace, universal access to decent toilets may not be achieved until 2103, nearly 80 years too late.

The consequences of this neglect are severe. Frequent cholera outbreaks serve as a stark reminder of the dangers of inadequate toilet access. Vulnerable communities continue to suffer poor health outcomes, which in turn reinforce cycles of poverty.

The 2023 SDG Technical Report makes clear that achieving universal access to water and sanitation is critical to over 70% of all other targets.

Sanitation impacts everything from health and gender equality to economic growth and climate resilience.

Innovative solutions for rural communities

The sanitation challenge goes beyond permits and enforcement. It reflects systemic weaknesses such as weak regulation, poor coordination, and under-resourced local authorities. Experts stress that to make progress, Ghana must engage the private sector more effectively, particularly in rural areas where innovative toilet construction and maintenance models could transform access.

WaterAid advocates for a "sanitation for all" model that prioritises strong institutional frameworks and public-private partnerships. Instead of simply counting toilets, the focus should shift towards ensuring their consistent use and measuring the health outcomes they deliver.

Government commitment to sanitation

President Mahama announced plans to allocate 80% of the District Assemblies Common Fund directly to districts for water and sanitation projects. However, without capacity-building and adequate resources at the local level, this funding may not be used effectively.

The path forward requires bold leadership, better coordination, and genuine collaboration between government, civil society, and the private sector. Ghana cannot afford to delay. Ending open defecation is essential to protecting public health, achieving the SDGs, and building a cleaner, more resilient future for all.