The hidden costs of water on public health
This article is authored by Dr Balram Bhargava, president, National Academy of Sciences, India.
We have spent years focusing on health and disease prevention. Over time, we have realised that health is influenced by much more than just medical care – is deeply shaped by the environment.
According to the World Health Organization, in 2022, at least 1.7 billion people globally (one fifth of the world population) relies on drinking water sources contaminated with faeces. This contamination, coupled with poor sanitation, contributes to the spread of diseases such as cholera, diarrhoea, hepatitis A, and typhoid. While waterborne diseases are the most visible consequences, there are numerous other hidden risks linked to consuming contaminated water.
We have seen patients with non-communicable diseases where health is worsened by poor access to clean water, sanitation, and basic hygiene. These environmental factors lead to chronic infections, malnutrition, and weakened immune systems, which, in turn, exacerbate non-communicable diseases.
Research now confirms that unclean water and poor sanitation are directly linked to poor health. Improving health outcomes require addressing the fundamental factors like water, sanitation, hygiene, and nutrition.
India has made significant strides in addressing contaminated and insufficient drinking water through the ministry of Jal Shakti’s flagship program, the Jal Jeevan Mission (JJM). This programme has contributed to a more than threefold reduction in the number of cases of waterborne diseases between 2019 and 2022.
As of date the mission, since inception, has provided piped water supply to approximately a million schools and over a million aanganwadi centres, reducing vulnerability among children during their formative years.
However, the success of JJM is not just about installing infrastructure; it is about ensuring that the communities themselves take ownership of these water systems. The real challenge lies in transferring the responsibility of managing and maintaining water sources to the very people who use them, thereby transforming JJM into a true people's movement—or Jal Andolan.
India is blessed with a variety of water bodies— rivers, lakes, and groundwater; however, with rising demand and the climate crisis, water scarcity is becoming a real issue, especially in rural areas. As our population grows, it is time we all step up and take responsibility for conserving this essential resource.
Water may seem plentiful, but it is not unlimited. To ensure everyone has access to clean water, we need to embrace sustainable practices and reduce waste. This is not just about the future — it is about improving our quality of life today and encouraging everyone to play their part in protecting this vital resource.
Access to safe drinking water is about more than health — it is about boosting productivity and creating economic opportunities. In rural areas, when clean water is readily available, people, especially women, spend less time collecting it, freeing them for education or work and improving household income. Families are less likely to face catastrophic health costs, and individuals can maintain their economic productivity without being held back by preventable illnesses.
Reliable water access enhances personal safety, reducing the need for long, risky journeys that often expose women and children to danger. Additionally, easy access to clean water can lower the risk of musculoskeletal disorders caused by carrying heavy loads of water over long distances.
The next step for ensuring safe, reliable drinking water is clear: it must become a community priority. When people take ownership of their water sources, they are more likely to protect and sustain them. This shift in mindset requires active engagement, education, and recognizing that clean water is not just a right but a shared responsibility.
Every household, every community leader, and every individual must step up—whether by conserving water or protecting local sources from pollution. Clean water has a direct impact on our health, reducing the spread of waterborne diseases and improving overall well-being. By taking action now, we can safeguard our health, boost productivity, and secure a better future. The time to act is now—because the cost of inaction is far too great. Water remains the most essential building block of life.
This article is authored by Dr Balram Bhargava, president, National Academy of Sciences, India.