Abstract
Humans were once nomadic, constantly moving in search of resources. However, the Industrial Revolution marked a significant turning point. We chose to abandon our wandering ways and establish permanent settlements, creating communities designed to meet our diverse needs. Water, an elemental necessity for life, continued to be a crucial resource. Yet we failed to foresee how fluctuations in water availability would profoundly affect the ecology of environmentally sensitive pathogens, thereby impacting human health in unforeseen ways. This oversight has led to complex challenges in managing water resources and safeguarding public health functions. With more than 3.5 million deaths each year attributable to waterborne pathogens, it is a critical time to question our ability to understand the relationships between water and public health, particularly to the etiological pathways in which environmentally sensitive pathogens interact with human populations and have resulted in major pandemics of our times. We also need to provide introspection on the very basic tenet of life: is safe water a right or a privilege? This report seeks scientific scholarship and evidence to answer this question, with particular emphasis on waterborne pathogens as the key indicators of safe water available for humans. This report is based on the deliberations of experts who participated in a colloquium on December 5 and 6, 2024, organized by the American Academy of Microbiology, the honorific leadership group and think tank within the American Society for Microbiology (ASM), and the American Geophysical Union (AGU). These experts, from various fields and sectors, focused on how changes in water and the environment affect the spread of infectious diseases. They reviewed current knowledge and identified key gaps in understanding the relationship between water and disease-causing microorganisms in today's world. They identified several key issues to enhance public health.• Expand collaboration and engagement. Experts in earth sciences, microbiology, hydrology and public health along with community leaders need to collaborate.• Strengthen water systems. Modern and resilient water infrastructure allows for improved water safety, reduced disease risk and sustainable economic benefits.• Improve knowledge sharing. Integrate data systems that link Earth observationsand weather parameters with public health information for proactive public healthsupport.