Water is fundamental to our existence. Yet mismanagement and complacency over water resources have led to a perilous situation, with access to clean water and sanitation services elusive to many people. The world is hugely off track from achieving Sustainable Development Goal (SDG) 6 by 2030: ensuring availability and sustainable management of water and sanitation for all. In 2015, 70% of people had access to safely managed drinking water; by 2020 this had only progressed to 74%. Over the same period, people accessing safely managed sanitation only increased from 47% to 54%. The UN states that efforts on the provision of water, sanitation, and hygiene (WASH) would need to increase four-fold to meet 2030 targets, a prospect that will probably become increasingly difficult amid climate change. This World Water Day, March 22, marks the first UN conference on freshwater in nearly 50 years, and will serve as a midterm review of the Water Action Decade, which runs from 2018 to 2028 and aims for the sustainable development of water resources. Failure to secure water for all would cause widespread harms across the SDGs, and for human health in general. The stakes could not be higher.
Access to water is already an emergency in many areas. A quarter of the world’s population faces extremely high levels of water stress, where industry and agriculture use more than 80% of the available supply per year. Water scarcity is an equity issue. It impacts those on the lowest incomes, not only in low-income countries, but also those with the lowest incomes in high-income countries. A Comment in The Lancet highlights that access to safe water is gendered, with the burden of sourcing and supporting safe water falling mainly on women. The WASH-related burden of disease is substantial and hampers economic development. Progress on nutrition, poverty, education, and conflict is impossible without proper water management. The hygiene necessary for good infection control, including good pandemic prevention, relies on clean water and access to sanitation. A recent report from WHO highlights how a billion people without access to proper sanitation are at risk from a surge in cholera cases as a result of climate change.
The planetary dimension to water and sanitation access has been underappreciated by the global health community. The water we rely on for drinking, washing, and cleaning is part of the interconnected and interdependent global water cycle. Human activities are harming and stressing this whole system. Anthropogenic planetary warming alters evaporation and precipitation. Humans are driving ocean acidification, rising sea levels, the devastation of marine biodiversity, and extreme weather events, such as flooding and drought. Safeguarding water for health requires attention across these areas, but the global governance of water is uncoordinated and often ineffectual, ignoring conservation standards and prizing trade policy outcomes over addressing water scarcity. The recently signed High Seas Treaty, which establishes a framework that could see 30% of international waters protected for conservation, is a hugely positive step.
A transformation in the governance of water is the central call in a vital new report from The Global Commission on the Economics of Water. Called Turning the Tide, the report calls for the recognition of water as a global collective good, and demands that it be protected as such, with stabilisation of the water cycle, investment in water access in low-income and middle-income countries, and an end to the underpricing of water. It also highlights how US$700 billion of subsidies to industry are actively harming progress towards WASH provision and proposes that these subsidies be used instead to promote water conservation and universal access to clean water. The Lancet‘s upcoming WASH Commission aims to provide a shift in WASH interventions, to emphasise state responsibility over the individual, and address an international architecture of WASH policies shaped by colonial legacies.
The UN recognises access to water and sanitation as a human right, describing it as fundamental to everyone’s health, dignity, and prosperity, but the world’s mismanagement of water endangers the planet and, as a result, all of us. This World Water Day needs to mark a turning point. It needs to spark action on protection of the water cycle, on better focused and smarter funding targeted at the provision of WASH, and on filling the gaps and inefficiencies in clean water governance. Most importantly, it must prompt a wider realisation that achieving sustainable access for all cannot succeed without confronting the deeply intertwined nature of the health, economic, environmental, and ecological aspects of water.
Published: March 22, 2023
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- Women, work, and water
March 22 is World Water Day, reminding us that safe and affordable drinking water for all is essential for human health and is a human right.1 Safe drinking water access prevents numerous infectious diseases and exposure to harmful chemicals, whereas ineffective access can compromise public health efforts, including the quality of health-care services.2 In most countries, managing and safeguarding domestic water relies on women’s unpaid work. This is also true of many proposed solutions, allowing them to appear falsely low-cost, cementing existing inequalities, and blunting the potential for water research, policy, and practice to support both gender equality and safe drinking water for all.