Facing two water crises: Having enough water and ensuring it's safe to drink

A market vendor in Bamako, Mali buys Aquatabs water purification tablets for her shop from a Palladium sales promoter. The tablets are one of several solutions for ensuring safe water at point of use. Photo: David J. Olson

This was originally published on Global Health TV on March 29, 2018.

We talk about a world water crisis like there’s only one but there are really two. The first crisis we see playing out in Cape Town – the growing number of places that do not have enough water of any kind. The second crisis is ensuring that the water people do have is safe to drink.

The city of Cape Town has just dodged a bullet – at least for 2018. Day Zero -- the day when dams levels reach 13.5% of capacity and the taps are turned off – was originally expected to take place in April, then pushed back to July. Now it has been postponed to 2019. This video shows how Capetonians are dealing with the crisis.

The three-year long drought hasn’t ended but severe water rationing has helped postpone disaster. The combined levels of dams supplying Cape Town is down to 22.7%, according to the city’s water dashboard. Capetonians have been asked to limit their water use to 50 liters (13 gallons) per person per day, and many have risen to the occasion (as a point of comparison, the average U.S. resident uses 367 liters per day, or 100 gallons).

Unfortunately, Cape Town is not an anomaly: Fourteen of the world’s megacities now experience water scarcity or drought conditions, according to Ecolab’s Water Risk Monetizer. 

Initiatives to expand access to medicine on the rise, but need better evaluation

In Nairobi, Kenya, parents receive prescription medicines for their children as part of a free medical camp operated by Slums Information Development & Resources Centers. Photo: George Onyango, Courtesy of Photoshare

This was originally published on Global Health TV on August 31, 2018.

In the 1990s and 2000s, AIDS activists and other global health advocates started pressuring pharmaceutical companies to share their largesse with low- and middle-income countries (LMICs) by supplying critical medicines for free or at subsidized prices, especially for HIV/AIDS. The pressure was successful, and led to a series of access-to-medicine (AtM) initiatives.

The international community increasingly recognizes that the pharmaceutical industry must play a leading role in improving access to medicines. And apparently pharma companies themselves also acknowledge this responsibility, according to a study published in Health Affairs by a team of researchers at Boston University Department of Global Health. That study found that the number of these initiatives grew from 17 in 2000 to 102 in 2015. The researchers called this “clear evidence” that pharmaceutical companies had responded to calls to increase their commitment to improving access to medicines.

How does global health fare in the Sustainability Development Goals?

This originally appeared on Global Health TV on Sept. 28, 2015.

Last weekend in New York City, world leaders formally approved the Sustainability Development Goals (SDGs), which will guide development efforts over the next 15 years. They replace the Millennium Development Goals (MDGs) that were signed in 2000 and expire on Dec. 31, 2015.

The MDGs were terrific for global health, both in raising money, and raising its profile on the global agenda.

Eight goals made up the MDGs, and three of them were entirely focused on health. In addition, two other goals included health-related targets. Eight (38%) of the 21 total MDG targets were health-related, and seven of those targets were numerical (i.e. reduce maternal mortality by three quarters).

Between 2000 and 2014, $228 billion was allocated to address the three health-related MDGs, according to the Institute for Health Metrics and Evaluation (IHME) 

More importantly than how much was raised, serious progress was made on many of these health fronts. For example, two weeks ago, the World Health Organization announced that malaria death rates have plunged by 60% since 2000 and that the malaria target to have halted and begun to reverse the incidence of malaria by 2015 has been met “convincingly.” Most people think the Target 1A to halve the proportion of people living on less than $1.25 has been met.

But where is health in the SDGs? The answer to that question contains both good and bad news for global health advocates.