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Story 16 Apr, 2020

Blog 'Water, Health and Ecosystems: inextricably linked for a sustainable future'

Billions of people around the world still liveÌýin conditions that deprive them ofÌýsafe drinking water andÌýadequate sanitation facilities.ÌýThe absence of both translatesÌýinto the prevalence of disease.ÌýIn addition, one in four health facilities lack basic water services, critical to people's recovery and a functionalÌýhealth system.Ìý

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Photo: ©Shutterstock/Paramarta Bari

In January 2020, the World Health Organisation (WHO) released aÌý‘’Ìýfor the decade ahead. Dr Tedros Adhanom Ghebreyesus,ÌýWHO Director-General, wrote:Ìý"We need to realize that health is an investment in the future. Countries invest heavily in protecting their people from terrorist attacks, but not against the attack of a virus, which could be far more deadly and far more damaging economically and socially. A pandemic could bring economies and nations to their knees."

These words sounded ominous in January, yet they were the planet’s reality just a few weeks later with the spread of the COVID-19 virus. We were warned this could happen. Scientists, historians, security advisors, epidemiologists and many others have raised the alarm bell of a global pandemic for decades ().ÌýIn 2015, Bill Gates foretold an outbreak of theÌýcoronavirusÌýas we are living it today: ‘’.

There are many similarities with the warning signals raised on theÌýimpacts of climate change. A global body of scientists and intellectuals warning of a severe threat, yetÌýanswered by a slow response and general sense of apathy, inaction or worse, denial. The major differenceÌýis that the impacts of climate change are nuanced whereas the impact of a pandemic is instant. Whilst it may be too late to reverse the spread of COVID-19, it is not too late to reverse the trajectory of the climate crisis. The next ten years are crucial and actions now will define our common future.

COVID-19 is primarily a health crisisÌýand there are manyÌýlessons to draw as to how we respond to these rapid onset crises.ÌýClimate change will impact the spread of diseases that peak in the warmer months. In the heat wave of summer 2003 in Europe for example, more than 70Ìý000Ìýexcess deaths were recorded.ÌýA number of diseases well known to be climate-sensitive, such as malaria, dengue fever, West Nile virus, cholera and Lyme disease, are expected to worsen as climate change results in higher temperatures and more extreme weather events (). In addition, we do not know yet what the melting of permafrost and other impacts of temperature rise and changes in rainfall will have on the release and spread of pathogens.Ìý

Water is an economic and social good everyone needs for survival - fundamental to human health and well-being.Ìý Without good quality water, our health systems fail. Without reliableÌýwater availability our food security fades,Ìýand our energy and industrial production struggles.Ìý An estimated 896 million people globally still have no water services and 1.5 billion no sanitation services ().

Could a broader perspective help to better understand how delivery of sustainable waterÌýand sanitation help to protect the ecosystems that provide the water, absorb pollution, and future-proof the health of our societies?

Going back to the WHO , water features amongst the most urgent challenges, along with harnessing new technologies and investing in medical staff. Similarly, water is repeatedly ranked as one of the biggest risks to business and economic development according to the .Ìý A significant amount of diseases could be prevented through access to safe water supply, adequate sanitation services and better hygiene practices.ÌýThe WHO report ‘’ estimates that in developing countries an investment of US$1 in improvedÌýwater supply, quality and access to sanitation leadsÌýto a return of US$5–6. That is a five to six-fold return on investment[1].

As often when we seek understanding, we look back at history. A quick such review (IWA ‘) will teach us that for early civilisations to thrive, access to healthy river basins and consequently, investment in good water and sanitation facilities, were key for survival and prosperity. In New York, investment upstream in the has saved more than $10 billionÌýdollars through investing in water source protection, and not in wastewater treatment, recycling and additional infrastructureÌýcosts that would ultimately have been passed on to the consumer.ÌýThis has also improved the overall state of the watershed, including water and soil quality.Ìý

A vital link between a healthy supply of safe drinking water accessible to people is the broader river basin system. For all the investments in water supply, sanitation and hygiene services, if maintenance and environmental sustainability aren’t factored in, then you get failing systems.

According to data, four countries in sub-Saharan African have an average sustainability rate for water points of only 6% after ten years ().ÌýThis means that for any new water points developed in these countriesÌýthis year, on averageÌýonly 6% will be working by 2030, the year the world assesses the success of the .ÌýClearly funding andÌýcampaignsÌýare important, but more so is the connecting of interventions,Ìýsocially, economically, and environmentally, with sustainability as the primary goal.ÌýAs international agencies, governments, and donors look to supplement interventions with investment from private finance, sustainability has to be a primary focus if investors and companies are going to be convinced to support Ìýand seeÌýcorporate water stewardship improved.Ìý

The current COVID-19 pandemic is exposing challenges which go well beyond the health care system, including food supply chains and international cooperation. It starkly brings to mind that if we do not look at the broader picture of any system, we will be unlikely to deliver on a post-2020 policy agenda and fine-tune our actions to truly achieve the targets set under the SDGs.

WASH - the collective term for Water, Sanitation and Hygiene - is regularly distanced from water resource management, water source protection, and pollution control.ÌýYet a strong, resilient WASH system needs to include not just the policies, processes, infrastructure, resourcing, behaviour and leadership, it needs to better integrate with water management agencies – those who protect and manage the sources they need, including groundwater.ÌýEqually, pollution downstream of sanitation interventions needs to be factored in all WASH interventions.Ìý

The context of water resources needs to be better understood, as well as the very practical elements such as can soap be consistently provided, do local health centres have adequate facilities – and soap?ÌýAs the COVID-19 pandemic is causing grief, loss and hardship at levels not seen in recent decades, some solace can be found in theÌýsocial resilience and innovation that isÌýtaking place.

Looking ahead, let us consider the fragile state of water, sanitation and hygiene delivery globally, and the number of people consistently ill and losing their livesÌýto waterborne diseases due to polluted water, daily. How countries respond and improve WASH for marginalised people in rural areas,Ìýslums and peri-urban environments, unable to self-isolate or receive support during economic downturns, will be an indicator as to how lessons were learnedÌýand how committed we really areÌýto all the indicators under SDG6.

Now is the time to lean-in on sustainable water management, for people, and for nature.ÌýCompanies able to weather the financial storm during the lockdown period are those able to adapt, diversify, innovate, and reflect.Ìý A large part of that is culture – institutionally ensuring resilience is a part of the ‘thinking’ internally, developing new foundations for working and delivering differently.Ìý Economic stimulus packages that can drive resilience, and focus on low carbon approaches as we better understand that climate change is not just a physical risk, but a human health and economic risk of a scale we do not fully graspÌýyet.

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Blog by the Ïã¸ÛÁùºÏ²Ê¿ª½±½á¹ûÏÖ³¡Ö±²¥ Water Programme team in HQ.

For the Ïã¸ÛÁùºÏ²Ê¿ª½±½á¹ûÏÖ³¡Ö±²¥Ìýstatement on the COVID-19 pandemic, please click here


[1] The cost-effectiveness of each intervention was assessed in terms of US dollars per disability adjusted life year (DALY) averted. TheÌýdisability-adjusted life yearÌý(DALY) is a measure of overallÌý, expressed as the number of years lost due to ill-health, disability or early death. It was developed in the 1990s as a way of comparing the overall health and life expectancy of different countries.

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