Partly because of low sanitation coverage about 17,000 children die each year because of diarrhoea. Another challenge is low cost recovery due to water tariffs that are among the lowest in the world. This in turn requires government subsidies even for operating costs, a situation that has been aggravated by salary increases without tariff increases after the Arab Spring. Poor operation of facilities, such as water and wastewater treatment plants, as well as limited government accountability and transparency, are also issues.