This overview paper tests current publicspending patterns against the economic rationale for suchspending, including reducing disparities in service deliveryand overcoming market failures. Reducing the disparities inaccess to basic water supply and sanitation (WSS) is aresponsibility of government. Individuals have littleincentive to build and maintain extensive WSSinfrastructure, but communities and societies do. Targetedpublic spending benefitting households that otherwise wouldbe unable to afford those services can be a component of abroader social policy agenda to redistribute resources tothe poor. Several market features call for governmentintervention in the WSS sector. This review mines the richdata of 15 Public Expenditure Reviews (PERs) conducted inSub-Saharan Africa and funded by the World Bank over thepast years. From 2003 the World Bank has funded more than 40PERs that contain an analysis of the water supply andsanitation (WSS) sector. In most of these, the WSS sector isdiscussed alongside other sectors. A set of stand-alone PERsspecifically addressing the WSS sector have also beencarried out in African countries. The scope of the presentreview includes expenditures by public institutions (at thecentral and local government levels) on domestic resourcesand grants or loans provided by external funding agencies.The review does not include off-budget spending by waterutilities. In other words, while the numbers in this reviewinclude public subsidies to utilities, they do not includeexpenditure by utilities, thus disregarding expenditurespaid for by consumer cost-recovery. The public expenditureanalyses in all reviews focus on WSS services, although somereports also discuss water resources management. Almost allof the PERs, however, are limited to WSS, thus excludingwater resources management and irrigation issues from theanalyses. The reviewed PERs did not use standarddefinitions, which has led to some data limitationsdescribed later. This review is a data mining exercise ofcountry PERs that were written to serve in the politicaldialogue on the challenges in achieving the MillenniumDevelopment Goals (MDGs) by 2015 and on bottlenecks inenhancing public finance management performance.