Macapá, the capital of Amapá, has been highlighted as one of the cities with the worst sanitation rankings in Brazil, according to the 'Ranking do Saneamento 2026' published by the Trata Brasil Institute. The report indicates that only 14.94% of Macapá's population has access to sewage collection services, a stark contrast compared to other state capitals such as Goiânia, São Paulo, and Curitiba, where more than 90% of residents are served. This indicates a significant disparity in access to basic sanitation, which is a critical public health issue.

Moreover, the report emphasizes that Macapá does not meet the national standards for sewage treatment, failing to be among the seven capitals that manage to treat at least 80% of the sewage collected. This shortfall is part of a worrying trend seen in other North and Northeast Brazilian cities like Porto Velho and São Luís, where the treatment rates are even lower, with some cities treating less than 20% of collected sewage. The findings illustrate the pressing need for improvements in sanitation infrastructure in these regions.

In addition to sewage management, the study points to significant water loss during distribution as another pressing issue in Brazilian capitals. While cities like Goiânia, Teresina, and São Paulo have managed to keep water loss under control, many others, including Macapá, continue to face challenges in providing reliable and clean water, further complicating the public health landscape and highlighting areas for urgent intervention.