The document discusses two perspectives on water supply and sanitation in Africa: optimism and pessimism. It notes that while coverage is increasing, it is doing so incrementally and not through major leaps. A pessimistic view is suggested for sub-Saharan Africa where population growth is outpacing improvements and sustainability remains a challenge. However, some case studies from Ethiopia show positive economic and poverty impacts from improved access to water and sanitation, though benefits are complex and non-linear. The conclusion calls for a "pessoptimistic" view that acknowledges challenges but focuses on continued improvements to current situations through community-driven models and downward accountability.