Water-Health Nexus

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  • The Water-Health Nexus Programme of the UNU Institute for Water, Environment and Health (UNU-INWEH) aims to encompass three broad areas of interest in all of its activities. Firstly, the programme seeks to incorporate ecosystems into the health equation — examining human well-being in the context of relationships within the biophysical environment and resolving or preventing degradation by fostering sustainable, healthy ecosystems. In addition, the work of this programme seeks to add the hydro-social system into the health equation — examining human health within the context of the social, cultural and political systems that determine the flow of water through society. Finally, the programme also aims at developing approaches and technologies for providing access to safe drinking water in small, remote communities, including activities that promote local engagement and empowerment.

    The Water-Health Nexus programme further comprises the Water Without Borders Programme which is a collaborative postgraduate programme in water, environment, and health between UNU-INWEH and McMaster University in Canada. It is characterized by a commitment to excellence in the science, whether that be health, natural or human science; to transdisciplinary research; knowledge transfer; and capacity building.

    The primary goal of the programme is to develop highly qualified personnel in the area of water-health, broadly defined, to fill a growing global societal need for science and service, policy and practice, around the fundamental human issue of safe water provisioning. Issues of provision, access, quality, equity, conflict, distribution, change, and governance are all of paramount importance to studying and responding to the water problematique.


    Negotiations continue on the establishment of a ‘twin’ with Alexandria University in Egypt. Recent political changes in that country have delayed the process substantially but indications are that the university remains an interested party. A key indicator is the signing of a Memorandum of Understanding in October 2011that establishes the basis for joint research activities and for development of collaborative academic programmes.

    Focal Point

    The programme is led by Prof. Chris Metcalfe who has extensive experience in a range of water quality-related areas, including community-based wastewater treatment and integrated watershed management. As a world-class research leader working at the interface between water and the environment, he has access to a broad network of experts working in this cross-disciplinary field.


    Over 2.4 million people, mostly children, die each year from water-related health problems, while billions are made ill. It is now widely accepted that no other single intervention is likely to reduce global poverty more than the provision of safe water and sanitation. At the core of the programme is the focus on meeting the safe water crisis by developing capacity within communities, institutions, governments and the private sector, and by improving technologies and infrastructure to achieve timely action. The overall aim is that people should be able to access sources of water that are adequate in quality and quantity for environmental services, day-to-day living and health. A special focus is on rural, remote communities that are often not a priority for development.


    As a newly developed programme, it is able to draw upon the significant networks, platforms and expertise that have been developed within UNU-INWEH, enabling it to position itself at the nexus of the ecosystem approach to health and the hydro-social cycle in order to examine community-based approaches and interventions. A long-term goal is to build, in a staged manner, a global ‘Learning Network’ for the provisioning of safe water services. This network would include scientific organizations, governments and civil society groups as well as practitioners dedicated to improving management and delivery of safe water knowledge to rural and remote areas.


    In this programme there is a strong focus on reduction in gender inequalities in access to and management of safe water. This is important because women are the primary water managers in most developing countries. There is particular attention being paid to developing leadership amongst women in the research community operating on the water-health nexus.

    Target Audience

    The main audiences are research and academic institutions, including universities; the international development community; community groups; and policymakers at the national and international level; and the private sector. The programme activities and outputs are targeted to these distinct groups.

    Intended Impact

    Impact: Influencing policymaking in the United Nations System
    Target: This programme aims to highlight the linkages between provision of safe water and actions taken by the UN system to meet the Millennium Development Goals (MDGs).
    How: The programme leads a dialogue process across the UN system, including interfacing with various task forces set up within UN-Water — a coordination mechanism for 26 UN agencies working on water issues.

    Impact: Influencing policymaking at the international level
    Target: The programme aims to bring the safe water debate squarely in the middle of the international development agenda.
    How: We create a number of publications that delineate the linkages of safe water and adequate sanitation to all the MDGs and identify policy options to address these challenges. Wide dissemination of these publications is also linked to an international dialogue process that is implemented through a series of targeted workshops

    Impact: Capacity development in developed/developing countries
    Target: There is a particular focus on building the capacity of remote and rural communities to address their water and sanitation challenges.
    How: We work closely with communities in a number of African countries, conducting research on their challenges, interfacing with community leaders to provide them with resources, and work with international partners to develop their capacity in terms of human, technological, managerial and financial resources.

    Research Findings

    Regarding the KAPE project, data are being collected in Kenya to indicate that there is a positive impact from improvements in safe water provisioning on indicators of community health, including reductions in the incidence of water-related disease, increased school attendance by children, and an increase in household income.

    For the vulnerability mapping project, data are being collected in Malaysia that indicate that there are environmental and social factors that influence the incidence of Dengue, DHF and Chikungunya and these factors are being incorporated into a GIS-based system for mapping vulnerability to these diseases.

    Policy Bridging

    The ongoing work in the programme, particularly the focus on global vulnerability mapping exercise, is designed to lead to the development of policies that will increase community resilience in response to disease outbreaks. Developing policy-relevant recommendations in this respect is a key mechanism for bridging between existing scientific knowledge and policy responses to the global water-health crisis.

    Value Added

    The programme brings attention to a global mapping of the vulnerability of communities and countries to water-related health problems and day-to-day challenges. A number of international partners have been brought together to undertake a worldwide analysis that leads to actionable information.


    The programme has strived to create policy-relevant publications and their wide dissemination through international, multi-partner workshops.

    Timeline/Programme Cycle

    This is an ongoing programme, with multi-year projects with distinct start and end dates. Projects are funded through external donors, notably the World Bank and the Global Environment Facility. It is anticipated that the programme activities will continue in the scope of the current UNU strategic plan (2009-2012). As new projects evolve, it will likely be continued beyond that period as well.


    UNU-INWEH employs a well-defined results-based management approach, which includes gathering of indicators at the programme- and project-level. This is done on an annual basis and the indicators provide trends in improvement, leading to appropriate management responses.


    This programme was established relatively recently. Creating long-term partnerships and extensive research networks in developing countries is a major challenge. Extensive water networks already present in other UNU-INWEH programmes are of great value in addressing this challenge.

    Expected Duration

    The programme is expected to run for a duration of 180 months, from 1 January 2006 through 31 December 2020.

  • Activities within the programme will involve cooperation between the UNU Institute for Water, Environment and Health and six partners:

    • UNU Institute for Environment and Human Security
    • UNU International Institute for Global Health
    • UNU Vice Rectorate in Europe
    • United Nations Economic Commission for Europe
    • United Nations Children’s Fund
    • World Health Organization
  • Title: Assessing the Need: Knowledge, Cohesion and Safe Water Provisioning (part 1 of 3)
    Publication/Output Type: Policy Brief
    Publisher: UNU-INWEH
    Date Published: 2012

    Title: Protecting Water Quality for Health: The Key to Global Environmental Change
    Publication/Output Type: Policy Brief
    Publisher: UNU-INWEH
    Date Published: 2012

    Title: Sustainable Livelihoods for Safe Water Provisioning in East Africa (part 2 of 3)
    Publication/Output Type: Policy Brief
    Publisher: UNU-INWEH
    Date Published: 2013

  • Dr. Adeel Zafar, Director
    United Nations University
    Institute for Water, Environment and Health
    175 Longwood Road South
    Suite 204
    Hamilton, Ontario
    Canada L8P OA1

    T: +1 905 667-5511
    F: +1 905 667-5510