Notwithstanding its large internal diversity, of all continents Africa si undoubtedly the one whose future is the most affected by water issues, from a social and political standpoint as well as in terms of environmental and economic development. This paper underlines the importance of institutional capacity for integrated management of river basins. Strategic development issues such as food, agriculture, and public health are addressed through the challenges of providing access to clean drinking water and sanitation. Enormous resources and efforts at better governance are required. They demand a very urgent collective mobilization.