Water and… health

Keith Hayward

The vital nature of water is evident in the frequency with which we deploy the word ‘and’ when talking about it. This is the ‘and’ that connects the substance with the use or role or dependency – the need that water fulfils for humans and the natural world. The connection is perhaps never stronger than when we speak of water and health.

This connection has always been at the heart of our organisation. The article on page 22 shares details of work to chart IWA’s 75-year heritage. This heritage starts with the founding of the International Water Supply Association (IWSA). Focused on the delivery of safe drinking water, IWSA’s activities included providing input to the World Health Organization’s drinking water guidelines. The health connection was also evident in IWA’s other ancestral line, which ran from the International Association on Water Pollution Research through to the International Association on Water Quality, not least in the conferences and Specialist Group focused on health-related water microbiology.

This health focus has developed since, from the launch of the Journal of Water and Health in 2003, in the early years of IWA, through to current activities such as our programmatic push on inclusive sanitation.

The then Specialist Group chair, Professor Joan Jofre, marked the launch of the journal by noting that “water has an important role in transmission of infectious diseases. The aim of health-related water microbiology is to minimise the role of water in such transmission and the pending challenges for those working in the field are enormous”.

Twenty years on, this issue’s cover story (page 36) looks at prospects for emerging viruses and the potential of wastewater-based epidemiology (WBE). There has been a revolution in monitoring techniques and in technologies allowing sharing of information, with the COVID-19 pandemic propelling WBE into wider practical use. The article makes the case that WBE can help strengthen global health systems, including supporting equitable distribution of vaccines, and calls for a monitoring-focused community of practice.

This is just a part of what lies ahead for water and health. UN Water’s latest GLAAS report spells out the huge gaps worldwide on water supply, sanitation and hygiene. It notes: “While a majority of countries have measures in WASH policies and plans to reach vulnerable populations and settings, these measures are not supported with monitoring or financial resources.” Regulation and surveillance are vital dimensions for progress. Key indicators here include that the percentage of countries with regulatory authorities publishing publicly accessible reports range from 42% for urban drinking water quality down to 13% for rural wastewater and faecal sludge treatment. Figures for implementing risk management approaches at a significant scale are 31% of countries for urban drinking water and 16% for sanitation.

Such figures signal what are, in effect, global shortcomings around the water and health connection. They are a clear sign that the need for a focus on water and health is as vital as it was 75 years ago.