South Africa has made tremendous progress in the areas of health and human rights following the end of the apartheid era in 1994. The country has garnered global respect for their comprehension of human rights and sophisticated constitution which ensures a range of free services such as maternal healthcare, no-fee school systems, and child support grants to all 1. However, Cape Town, a capital city in South Africa, is currently on the brink of one of the world’s most grim urban crises to date; the loss of one of its most valuable commodities, water. Indeed, the magnitude of the water crisis transcends all economic strata and political allegiances and is a common threat faced by over four million citizens, many of whom fear anarchy in the advent of “Day Zero” 2. Perhaps, most tragic is that whispers of an impending water crisis have circulated across the country for decades and, yet, preventative measures have only really emerged as a national priority in the eleventh hour when there is little that can be done to stay the rate at which the city hurtles towards disaster 2.
In light of the impending water crisis, it is critical that South Africa consider both the immediate and long-term health implications of one of its major metropolitan hubs running dry. Ironically, water is one of the major drivers of public health outcomes and social welfare and yet its importance is only noticed in a state of absence or excess rather than sufficient abundance. Quite simply, even a reduced frequency in handwashing could catalyze an epidemiological shift towards the resurgence of disease profiles in regions where they have largely been eradicated 3,4. As such, it is critical that disease outbreak surveillance be enhanced in order to capture these outbreaks in their infancy. Further, emphasis needs to be placed on ensuring that these services are inclusive of individuals who are hard to reach and, resultantly, typically excluded from traditional health care services. This is particularly relevant in the Cape Town context where the concept of ‘five kilometers too far’ has emerged as a key factor rendering those most vulnerable invisible to vital health and social services; that is, individuals who are too close to major service distribution points to be included in the outreach agenda, but are too far to be able to access them in a state of poor health 1.
Beyond the public health concerns, the ramifications of the water crisis in Cape Town are likely to ripple to the broader global health scientific research community. Regional universities, as well as other tertiary education institutions, are major players in the fields of HIV, tuberculosis and other infectious disease research and their capacity to continue to perform vital research could be severely stalled without the ability to operate laboratories at their full potential 5. This includes a reduced capacity to care for laboratory animals, operate chemical safety equipment, and even perform clinical trials for life-saving novel therapies 5. Further, with an estimated 5000 individuals expected to congregate at any respective army-monitored water distribution point, the workforce capacity will be significantly reduced and scientific productivity could decelerate 4,5. Combined with the potential for interrupted education and training through school and university closures, this crisis will likely not be restricted to a generation but will resonate into the future through diminished training opportunities unless preventative action is taken. Thus, we, as a scientific community, need to acknowledge and respond to the Cape Town crisis as a crisis of the global research community rather than a crisis of South Africa’s alone. It is absolutely critical that African-led research continues to grow and thrive both for the benefit of researchers globally and for the construction of solutions to complex health and development challenges faced locally. It is now more important than ever that the global research community embrace collaborations with African institutions, in particular those where the terms of collaboration are structured by the African institution, in order to ensure the continued growth of equitable exchange of knowledge at a global scale.
With approximately two-thirds of the world’s population projected to live in a state of water stress by the year 2025, the Cape Town water crisis does not mark the failure of a country, a government, a city or that of its citizens 6. Rather, it should serve as a global call to action for improved water management and a reminder that we cannot continue to operate with a static understanding of water use and supply in light of ever-advancing development, population dynamics, and climate change. Against a backdrop of climate change, national borders are rendered abstract and, unless global action is taken, the harsh reality that Capetonians are currently experiencing will quite certainly become a reality faced by the rest of the world.
- Skead, K., Marchese, A., Lim, S., Rau, A., Houshmand, K., Wong, J. (2016) Reaching the Hard to Reach: A case study of birth registration in South Africa. Accessed at: https://munkschool.utoronto.ca/wp-content/uploads/2016/11/South-Africa-Reach-Report-compress.pdf
- Welch, C. (2018) Why Cape Town Is Running Out of Water, and Who’s Next. National Geographic. Accessed at: https://news.nationalgeographic.com/2018/02/cape-town-running-out-of-water-drought-taps-shutoff-other-cities/
- Browdie, B. (2018) Cape Town’s water crisis is already posing a risk to public health. Quartz Africa. Accessed at: https://qz.com/1200949/cape-town-water-crisis-poses-risk-to-public-health/
- Kukaswadia, A. (2018) Day Zero: The impact of Cape Town’s water shortage on public health. PLOS Blogs Public Health Perspectives. Accessed at: http://blogs.plos.org/publichealth/2018/02/05/day-zero-the-impact-of-cape-towns-water-shortage-on-public-health/
- Maxmen, A. (2018). As Cape Town water crisis deepens, scientists prepare for ‘Day Zero’. Nature, 554(7690), 13. Accessed at: https://www.nature.com/articles/d41586-018-01134-x
- Brueck, H. (2018) A major South African city is about to run out of water, and officials say it will be the worst disaster since 9/11. Business Insider. Accessed at: http://www.businessinsider.com/officials-in-cape-town-warn-day-zero-will-be-worst-disaster-since-sept-11-water-shortage-2018-1
Kimberly Skead graduated from Trinity College, University of Toronto with a Hon. BSc in Global Health and Genome Biology and will be starting her Ph.D. in the Department of Molecular Genetics at the University of Toronto in the fall of 2018. Her main interests in global health include the development of accessible diagnostic tools and the parallel analysis of how existing health-related behavioral patterns, policies and interventions can be leveraged to ensure their compatibility and effective implementation.