Protecting Health in Dry Cities: Considerations for Policy Makers

Citation

Frumkin, H., Das, M. B., Negev, M., Rogers, B. C., Bertollini, R., Dora, C., & Desai, S. (2020). Protecting health in dry cities: considerations for policy makers. BMJ, 371.

Link to file

Water has always been essential for cities to survive and thrive. The earliest cities, dating back to 4000 BCE, were built near water sources. On the flip side, water scarcity may contributed to the demise of ancient cities like Tikal (in present-day Guatemala) and Angkor (in present-day Cambodia). Water was even used as a weapon in ancient times — when Sennacherib of Assyria ransacked Babylon in 689 BCE, he destroyed the city’s water supply.

Today, dry cities face complex challenges in a rapidly changing world. In many cities, the demand for water is outpacing supply and that gap is expected to grow. The health consequences could be severe. And in a world marked by deep inequalities, water scarcity will hit the most vulnerable people the hardest. These problems are even worse in places with limited resources, weak governments, and unstable societies.

To make progress, the connection between human health and the environment needs to be at the center of how cities plan and manage both water systems and health systems. Promoting health and well-being in dry cities is essential to meeting global sustainable development goals. Innovation will be key, and that requires foresight, strong institutions, and action from many people working together.

Abstract

Water has always been essential for cities to survive and thrive. The earliest cities, from 4000 BC, were founded near water sources. Conversely, water scarcity might have contributed to the demise of ancient cities such as Tikal in present day Guatemala and Angkor in present day Cambodia. Water deprivation was also used as a weapon in ancient times; when Sennacherib of Assyria ransacked Babylon in 689 BC, he destroyed the city’s water supply.

Dry cities present complex challenges in a dynamic world. The supply of water in many cities will increasingly fall short of demand, with diverse and potentially severe effects on health. In a world of pervasive inequalities, water scarcity is likely to hit the most vulnerable hardest. The challenge of achieving health in dry cities is intensified in the setting of resource scarcity, state and societal fragility, and weak institutions.

The inter-relation between human health and the environment needs to be central to planning and management of both water and health systems. Promoting health and wellbeing in dry cities is essential to achieving the sustainable development goals. Innovation will be key to progress; it requires foresight, strong institutions, and action from many people.