Sustainable Development Goal target 6.1 calls for universal and equitable access to safe and affordable drinking water. The target is tracked with the indicator of “safely managed drinking water services” – drinking water from an improved water source that is located on premises, available when needed, and free from faecal and priority chemical contamination.
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In 2020, 5.8 billion people used safely managed drinking water services – that is, they used improved water sources located on premises, available when needed, and free from contamination. The remaining 2 billion people without safely managed services in 2020 included:
- 1.2 billion people with basic services, meaning an improved water source located within a round trip of 30 minutes;
- 282 million people with limited services, or an improved water source requiring more than 30 minutes to collect water;
- 368 million people taking water from unprotected wells and springs; and
- 122 million people collecting untreated surface water from lakes, ponds, rivers and streams.
Sharp geographic, sociocultural and economic inequalities persist, not only between rural and urban areas but also in towns and cities where people living in low-income, informal or illegal settlements usually have less access to improved sources of drinking water than other residents.
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Water and health
Contaminated water and poor sanitation are linked to transmission of diseases such as cholera, diarrhoea, dysentery, hepatitis A, typhoid and polio. Absent, inadequate, or inappropriately managed water and sanitation services expose individuals to preventable health risks. This is particularly the case in health care facilities where both patients and staff are placed at additional risk of infection and disease when water, sanitation and hygiene services are lacking. Globally, 15% of patients develop an infection during a hospital stay, with the proportion much greater in low-income countries.
Inadequate management of urban, industrial and agricultural wastewater means the drinking water of hundreds of millions of people is dangerously contaminated or chemically polluted. Natural presence of chemicals, particularly in groundwater, can also be of health significance, including arsenic and fluoride, while other chemicals, such as lead, may be elevated in drinking water as a result of leaching from water supply components in contact with drinking water.
Some 829 000 people are estimated to die each year from diarrhoea as a result of unsafe drinking-water, sanitation and hand hygiene. Yet diarrhoea is largely preventable, and the deaths of 297 000 children aged under 5 years could be avoided each year if these risk factors were addressed. Where water is not readily available, people may decide handwashing is not a priority, thereby adding to the likelihood of diarrhoea and other diseases.
Diarrhoea is the most widely known disease linked to contaminated food and water but there are other hazards. In 2017, over 220 million people required preventative treatment for schistosomiasis – an acute and chronic disease caused by parasitic worms contracted through exposure to infested water.
In many parts of the world, insects that live or breed in water carry and transmit diseases such as dengue fever. Some of these insects, known as vectors, breed in clean, rather than dirty water, and household drinking water containers can serve as breeding grounds. The simple intervention of covering water storage containers can reduce vector breeding and may also reduce faecal contamination of water at the household level.
Economic and social effects
When water comes from improved and more accessible sources, people spend less time and effort physically collecting it, meaning they can be productive in other ways. This can also result in greater personal safety and reducing musculoskeletal disorders by reducing the need to make long or risky journeys to collect and carry water. Better water sources also mean less expenditure on health, as people are less likely to fall ill and incur medical costs and are better able to remain economically productive.
With children particularly at risk from water-related diseases, access to improved sources of water can result in better health, and therefore better school attendance, with positive longer-term consequences for their lives.
Historical rates of progress would need to double for the world to achieve universal coverage with basic drinking water services by 2030. To achieve universal safely managed services, rates would need to quadruple. Climate change, increasing water scarcity, population growth, demographic changes and urbanization already pose challenges for water supply systems. Over 2 billion people live in water-stressed countries, which is expected to be exacerbated in some regions as result of climate change and population growth. Re-use of wastewater to recover water, nutrients or energy is becoming an important strategy. Increasingly countries are using wastewater for irrigation; in developing countries this represents 7% of irrigated land. While this practice if done inappropriately poses health risks, safe management of wastewater can yield multiple benefits, including increased food production.
Options for water sources used for drinking-water and irrigation will continue to evolve, with an increasing reliance on groundwater and alternative sources, including wastewater. Climate change will lead to greater fluctuations in harvested rainwater. Management of all water resources will need to be improved to ensure provision and quality.