Water, climate change, and COVID-19: prioritising those in water-stressed settings
Authors: Richard Armitage, Laura B Nellums
Journal: The Lancet Planetary Health (2020)

Regular handwashing is strongly recommended to combat coronavirus disease 2019 (COVID-19), which necessitates access to sufficient, safe, and affordable water in addition to that required for cooking, hydration, and general sanitation. Universal and equitable access to water, sanitation, and hygiene is a critical public health issue and the focus of Sustainable Development Goal 6. However, over 50% of the global population lacks access to adequate sanitation, and 75% of households in low-income and middle-income countries are unable to wash with soap and water.1UNESCO World Water Assessment ProgrammeThe United Nations world water development report 2019: leaving no one behind. UN Educational, Scientific and Cultural Organization, 2019https://unesdoc.unesco.org/ark:/48223/pf0000367306Date accessed: March 24, 2020Google Scholar Despite its importance, water infrastructure is substantially underfunded, particularly in informal settings such as slums, rural areas, and refugee camps, where access to adequate water is deteriorating due to accelerating climate change. Without access to safe water, COVID-19 could to disproportionately affect individuals living in these settings Humanitarian activists have called for provision of water that is free of cost to comply with hygiene recommendations and mitigation strategies throughout the COVID-19 pandemic.2UN NewsWater access critical to beating back COVID-19 spread in slum areas. UN News, March 23, 2020https://news.un.org/en/story/2020/03/1060042Date accessed: March 24, 2020Google Scholar However, this campaigning coincides with increasingly unreliable water supplies in many parts of the world. Climate change contributed to multiple unprecedented severe weather events in 2019, placing substantial so-called water stress on affected regions, including widespread flooding in southeast Asia, the driest year on record in Australia, and Cyclone Idai on Africa's east coast, in addition to extended periods of significantly reduced rainfall in sub-Saharan Africa and central America.3World Meteorological OrganizationWMO statement on the state of the global climate in 2019. World Meteorological Organization, March 10, 2020https://library.wmo.int/index.php?lvl=notice_display&id=21700#.XmgP4S2caqSDate accessed: March 24, 2020Google Scholar 800 million people must travel over 30 min to access safe water,4Wheeler C Callister F Gosling L et al.The water gap: the state of the world's water 2018. WaterAid, 2018https://washmatters.wateraid.org/sites/g/files/jkxoof256/files/The%20Water%20Gap%20State%20of%20Water%20report%20lr%20pages.pdfDate accessed: March 24, 2020Google Scholar many of whom reside in informal settings, and have additional risk from COVID-19 due to overcrowded living conditions that promote disease transmission. An urgent need exists for improved water forecasting and monitoring and management of supplies to guide the planning of water projects in response to accelerating climate change. Such planning is of particular importance for COVID-19, because allocation of water resources must prioritise those at greatest risk, such as communities in informal settings. Efforts to improve access to water must also be accompanied by water conservation measures and climate action. Industry and policy maker engagement is urgently needed to ensure the efficient and equitable allocation of this resource, both in response to COVID-19 and going forwards to sustainably manage water use and ensure access for those who need it most. Water and climate are central to achieving "global goals on sustainable development, climate change and disaster risk reduction."5UN News'Count every drop, every drop counts': UN weather agency calls for better water data on World Meteorological Day. UN News, March 23, 2020https://news.un.org/en/story/2020/03/1059922Date accessed: March 24, 2020Google Scholar To strengthen global health systems and protect the health of communities urgent action is needed that recognises the critical link between environment and COVID-19. We declare no competing interests.