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This article is a part of the essay series: World Water Week 2025
Over the past century, global water consumption has surged sixfold, and the trend continues upward. This dramatic increase highlights the indispensable role of clean water in sustaining ecosystems, supporting economic progress, promoting public health, and ensuring food security, as stated by the World Health Organization (WHO). Access to a dependable and clean water supply is fundamental—not only for individual well-being, but also for the broader pursuit of environmental sustainability. Improved water access typically leads to better health outcomes and reinforces the social and economic development of communities. Despite ongoing advancements, poor water quality continues to pose a significant global challenge. Both industrialised and developing regions still confront outbreaks of waterborne diseases tied to unsafe sources. In many low-income areas, millions rely on water that is unreliable, contaminated, expensive, and located far from their residences. This reality places a disproportionate burden on households—particularly women and children—who often spend hours each day collecting water.
Water provision is not simply about keeping the taps running; it requires comprehensive oversight by relevant authorities who manage distribution, pricing, and accessibility to water resources. While ensuring consistent and equitable supply is foundational, it’s equally critical that water quality adheres to established health and safety standards. After all, the availability of water is insufficient if it fails to meet the necessary criteria for safe consumption. Water quality is shaped by a complex interplay of factors—climate conditions, biological activity, landforms, and the chemical composition of surrounding soils and rocks. Human actions, such as agriculture, industrial processes, and unregulated waste disposal, further complicate the situation. In underserved or informal settlements across many developing countries, these issues are often compounded due to inadequate infrastructure and ineffective water resource management, leading to even greater challenges in maintaining safe and reliable water supplies.
Access to clean water is not just a basic necessity — it’s fundamental to public health and sustainable development. Without access to safe water, communities face the triple threat of waterborne disease, stunted childhood development, and long-term cognitive impairments. Simply installing new infrastructure isn’t enough; a comprehensive approach is needed. This implies improving existing systems, judiciously managing water resources, and fostering community awareness about the significance of safe water. Only by addressing all these aspects can reliable and safe water become a reality for everyone.
“Unsafe water isn’t just an inconvenience — it’s a driver of disease, stunting, and lost potential for millions in underserved communities.”
The Public Health Toll of Contaminated Water
Contaminated drinking water is a major driver of gastrointestinal illnesses such as cholera, typhoid, dysentery, and intestinal worms. These diseases are particularly prevalent in low-income communities where sanitation infrastructure is weak and hygiene practices are inadequate. Recent studies in low- and middle-income countries reveal high levels of faecal contamination not only at water sources but also in household-stored water — often due to unsafe handling and poor awareness. (Figure 1)
Figure 1: Collection of drinking water in unsanitary environments and its improper/unsafe storage (Image source: by author)
Urban Water Supply Challenges: The Case of Hyderabad
Urban water systems face complex challenges in ensuring a safe and continuous supply. For instance, in Hyderabad, while 90 percent of the city is covered by a water network, only 70 percent of residents receive piped water. In peripheral municipalities, coverage drops to 65 percent, serving just 40 percent of the population. This intermittent supply — often limited to a few hours every other day—forces households to store water, creating a critical point of vulnerability.
In Hyderabad, while 90 percent of the city is covered by a water network, only 70 percent of residents receive piped water.
A study in Hyderabad’s low-income neighbourhoods revealed that while supplied tap water met safety standards, stored water at the household level was frequently contaminated. Key behavioural factors contributing to this included:
- Unsafe Handling: 73 percent of households used bare hands to fetch water from containers, often without washing, introducing pathogens such as coli. (Figure 2)
- Intermittent Supply: Irregular access compels residents to store water for extended periods. (Figure 3)
Figure 2: Handling water with bare hands increases the risk of contamination (Image source: by author)
- Limited Awareness: Several people assessed the quality of water just by its appearance- odour, taste, and colour, resulting in 67 percent skipping treatment if the water ‘looked clean’. It was only when households encountered a waterborne disease or had infants at home that they ensured the quality of drinking water was safe for consumption. They preferred to buy bottled drinking water in such cases.
- Cross-Contamination: Practices such as using long pipes to draw water and manually transferring it between containers increased contamination risks.
Figure 3: Collection of stored household water to assess the impact of intermittent supply
Microbial analysis revealed that while tap water had minimal bacterial load, stored water samples from these low-income settlements contained faecal coliforms and opportunistic pathogens, such as Pseudomonas aeruginosa and Staphylococcus aureus. This household-level recontamination is a serious public health concern.
Microbial analysis revealed that while tap water had minimal bacterial load, stored water samples from these low-income settlements contained faecal coliforms and opportunistic pathogens, such as Pseudomonas aeruginosa and Staphylococcus aureus.
Figure 4: Laboratory analysis revealing residual chlorine decay with time and microbial presence in collected drinking water
Test tube 1 (from left) contains stored water, which was colourless after testing for residual chlorine, and indicated negligible levels of the same. Test tube 2 contained tap water, lending a light yellowish appearance to the water with a chlorine level of 1-2mg/L. The third test tube gave a bright orange colour as it contained water from the water treatment plant just after chlorination (2-3 mg/L). This series of images showcases how residual chlorine levels decrease over time from the source to the final household collection. In the other picture, colourful plates with different microbial species are shown. Microbes observed in stored water were Pseudomonas aeruginosa (colourless), Enterococcus faecalis (blue-green) and Staphylococcus aureus (cream to golden). (Figure 4)
Towards Safer Water: A Risk-Based Approach
Improving water safety demands more than endpoint testing — it requires a comprehensive, risk-based strategy. The WHO’s Water Safety Plans (WSPs), introduced in 2004, offer a robust framework for managing risks across the entire water supply chain — from source to tap. WSPs are especially effective in low-resource settings and include:
- Risk Assessment: Identifying chemical, physical, microbiological, and radiological threats.
- Mitigation Measures: Implementing strategies to reduce risks to acceptable levels.
- Continuous Monitoring: Establishing control systems to ensure ongoing water safety.
Successful WSP implementation enhances water quality, builds technical capacity, and fosters collaboration among stakeholders. However, technical solutions alone are not enough — behavioural change at the community level is equally vital.
Community Engagement and Hygiene Practices
The Hyderabad study underscores the need for targeted interventions to address behavioural gaps. Promoting awareness about contamination risks and encouraging hygienic practices—such as proper handwashing techniques and using clean containers — can significantly reduce household-level contamination.
Awareness capacity-building campaigns should focus on:
- Safe Water Handling: Training communities to avoid direct hand contact and use clean utensils.
- Water Treatment Awareness: Encouraging simple household-level treatment methods such as boiling or chlorination. (Figure 5)
- Behavioural Nudges: Using visual cues and community champions to reinforce safe practices.
Figure 5: Raising community awareness on how to check water quality at home using chlorine tablets
A Climate-Resilient Water Strategy
In a climate-stressed world, where water scarcity and contamination risks are intensifying, a multi-pronged strategy is essential. These include:
- Technical Measures: Strengthening infrastructure, improving supply continuity, and enforcing water quality standards.
- Legal and Policy Frameworks: Ensuring accountability and universal access through inclusive governance.
- Community-Based Solutions: Empowering residents with knowledge and tools to safeguard their water.
“Supplying water is not enough — safeguarding it is what saves lives.”
Ultimately, ensuring safe water access in low-income communities requires a holistic approach—one that integrates source protection, robust treatment, and hygienic handling at the point of consumption. By combining technical rigour with community engagement, we can move closer to achieving universal access to safe drinking water and the broader goals of public health and sustainable development.
Acknowledgements: This work was carried out at the Environment Surveillance Laboratory, Administrative Staff College of India (ASCI). We would like to express our gratitude to Prof. V Srinivas Chary for his support, facilitation and guidance throughout the course of this work. The work was funded by a Canadian not-for-profit organisation, Centre for Affordable Water and Sanitation Technology (CAWST), and we remain indebted to their support. We also thank Ms. Chirantana Kar for advisory inputs on behaviour analysis and recommendations.
Priya Sharma is working as Lead for Research and Capacity Building at Consortium for DEWATS Dissemination (CDD) India, Bengaluru, India.
P Sumasree Shivanvitha is a biochemist serving as a Technical Expert at the Environmental Surveillance Laboratory, Administrative Staff College of India, Hyderabad, Telangana, India.
Anumeha Vats is working as a Senior Scientist at the Administrative Staff College of India, Hyderabad, Telangana, India.
Rajarshi Banerjee is serving as Director of the Environment Monitoring Laboratory, AAETI (unit of CSE), Neemli, Rajasthan, India.
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