West Africa has the lowest coverage of drinking water and sanitation in the world, and the numbers are rising not falling, according to the United Nations children’s agency (UNICEF).

As populations have boomed throughout the region, the absolute number of people without drinking water increased from 124 million in 1990 to 157 million in 2004, and the number without sanitation from 173 million to 225 million, according to a UNICEF report released on Friday.

West and Central Africa have the highest under-five mortality rate of all developing regions. Out of every 1,000 children born, 191 will die before their fifth birthday.

“It is a tragedy,” Esther Guluma, UNICEF’s regional director for West and Central Africa, told reporters. “Worldwide, 1.5 million children every year will not live to see their fifth birthday - they will die of a preventable diseases, including diarrhoea. Many millions more will suffer to survive through persistent water- and sanitation-related diseases.”

There are still five countries in the region where less than half of the population has access to improved drinking water sources: Chad, Equatorial Guinea, the Democratic Republic of the Congo, Niger and Nigeria.

Only four of the region’s 24 countries have provided sanitation facilities, such as latrines and washrooms, to more than half of their population. They are: Senegal, Equatorial Guinea, Gambia and Cameroon.

Improved sanitation facilities could reduce diarrhoea-related diseases in young children by more than one-third, according to UNICEF, or by two-thirds if combined with better hygiene practices.

Only Senegal is expected to achieve its Millennium Development Goal sanitation target among countries in the region.

The UNICEF report says that the benefits of improved drinking water and sanitation could be extended to many more of the world’s people if sufficient resources and resolve were dedicated.

The UN’s humanitarian coordination office (OCHA) has determined that emergencies in the West and Central African countries of Cote d’Ivoire, the Democratic Republic of Congo, the Republic of the Congo, Liberia and the Central African Republic are “chronically under-funded”, with water and sanitation projects among the least funded sectors.

“I think that at the moment it is quite true and has been true for the past 10 years that more emphasis has been placed on providing food than infrastructure,” UNICEF's Guluma said.

“I think many times it is also due to the fact that in situations of emergency, the provision of wells and hand pumps is considered a more permanent development, so it is not provided,” she said. “But at the same time more people die from the lack of availability of safe water to drink than the lack of food because of diarrhoea, so it is very true that the balance needs to change.”