Turning on the taps

A ready supply of clean water is critical for producing the food, energy, and products that modern society needs in order to survive and thrive, in addition to being key for safe guarding human health and the natural environment. The United Nations recognized this by making clean water and sanitation a Sustainable Development Goal. While water covers about twothirds of the planet, ~97% of this is saline water in oceans, seas, and bays, and thus cannot be used in its natural form, while less than 0.8% is fresh and accessible for use. Global fresh water withdrawls have been estimated at about 4000 km per year, which is about 7% of the global renewable fresh water supply. This means that if our fresh water withdrawls were only used once and then disposed of, our fresh water supplies would last only 14 years. This dilemma defines the “clean water gap”, which underscores the importance of maintaining natural water supplies so that they can be used, and in efficient processing of wastewater. About 70% of wastewater is treated globally, but only 4% is reused and most is ocean discharged and not immediately reusable. However, were advanced treatments applied to enable reuse of the 70%, assuming adequate water quality could be achieved, it would increase the lifetime of our fresh water reserves to almost 50 years. Desalination is an obvious option and has been employed in Middle East, North African, and Mediterranean countries for over half a century. So, water reuse and desalination are viable, but at relatively high cost, energy demand and carbon footprint, due to predominant energy supplies still deriving from combustion of fossil fuels. The “clean water gap” remains, and the most likely solutions are advanced water treatment processes and effective water resource management. The good news is that nature provides world’s first and longest operating renewable-powered desalination and water reuse plant: solar evaporation of ocean water, transported by wind over the land and falling by gravity back to the Earth as fresh water. Indeed, we can learn much from nature, and there has been significant emphasis on mimicking both natural and biological processes to address the “clean water gap”. For example, the Water Abundance X-Prize challenges teams to develop renewable-powered technologies that harvest fresh water from air. It turns out numerous technologies can meet water production and energy demand targets, but to do so affordably is challenging. Could human-engineered renewable energy-powered water reuse and desalination provide the answer? Partly, perhaps, in certain locations. But this does not address the need to clean up vast existing fresh water sources that are contaminated, for example, with nitrates and pesticides from agricultural runoff, with arsenic from natural origins, or heavy metals and organic solvents from industrial activities. Also, ignoring the high cost of implementation, for many developing countries there is abundant fresh water, but the challenge is to reliably disinfect it to prevent waterborne diseases that can devastate populations: diarrheal disease, hepatitis A, cholera, botulism, typhoid, etc.—diseases that are caused by protozoa, viruses, bacteria, and intestinal parasites. Much attention is rightly placed on access to clean water in the developing world, while in California (the World’s sixth largest economy) there is concern regarding a lack of clean drinking water in some rural communities. As a result, California is the only U.S. state to legally recognize a human right to water. Clean water supply is not an issue limited to third world and developing countries only; understanding the problems, and solutions to these problems, are needed the world over. The last half century has seen the emergence and growth of numerous trends in water use, policy, research, and investment, including (1) water as a human right; (2) “virtual water” and estimates of the water footprint of everything and anyone; (3) mainstream application of water desalination and reuse; (4) first came “energy for water and water for energy”, then the “energywater nexus”, and now the “food-energy-water nexus”; (5) the “one water” movement; (6) decentralized water and wastewater treatment; (7) wastewater as a resource; and (8) water-focused investment funds and venture capital funds. In addition, water as a topic is highly newsworthy, and there is wide and deep interest in all aspects of the subject, spanning the natural and social sciences. It is hard to understate the importance of a clean water supply. Research into treatment processes and how to effectively manage and distribute water is a dynamic landscape and there are various scientific journals that cater specifically for water-related research. So, why do we need npj Clean Water? As identified in the previous discussion, the importance of a clean water supply is clear, as is the criticality of research; the number of papers in this field increases year-on-year (which will continue), and npj Clean Water aims to report some of the best of these to the scientific community. Specifically, the journal is looking for important advances for the clean water research communities, which significantly extend understanding or capability. This includes original research papers that report new treatment processes, or noteworthy refinement and improvement of existing ones, via physical, chemical, and biological processes, as well as thoughtprovoking and critical reviews of the literature. Moreover, the journal will publish research and perspective pieces on water management policy; as discussed above, the natural sciences alone will not solve the clean water problem, and effective water management is crucial. Presenting these two aspects side-by-side in a single journal is therefore not only appropriate, but vital for a complete treatment of clean water-related research. In addition, by providing considered editorial selection of papers published, and a comprehensive peer review process, we aim to present high-quality works to the community. npj Clean Water will publish all papers under an Open Access license type. Clean water supply is a global issue and we passionately believe that research on this topic should be widely and freely available to the research community, as well as to the policy makers whose decisions are informed by scientific output, and to the global population who ultimately stand to benefit from the studies reported. We are truly excited to present to the research community npj Clean Water, and are delighted to be “turning on the taps” to a new forum for the dissemination of important works that address the societal issue of a clean water supply.

Turning on the taps?

Introduction
Access to water is essential to human life and health.Everyone must have water, or they can not survive.And yet, experiences can vary widely.Piped supplies into the household can be taken for granted, though frustrations occur when the supply is dirty, intermittent or costly.But when the only water supply available is a dirty well or river located far from the household, accessing water becomes a serious and constant challenge.This brief presents data on Ugandan citizens' experiences and opinions on water, sanitation and hygiene (WASH).How serious of a challenge is access to water for different groups in society?Where do they access their water, and how long does it take?Do they treat the water before drinking, and if so how?And what types of toilet and handwashing facilities do they use?Data for the brief come from Twaweza's Sauti za Wananchi, a nationally-representative, high-frequency mobile phone panel survey.Information on the overall methodology is available at www.twaweza.org/sauti,and more detail on panel members can be found in the brief introducing the second panel1 .For this brief, data were collected from 2,809 respondents in the mid-term survey of the second Sauti za Wananchi panel, conducted by physically visiting panel members' in their households between 15 August and 13 September 2023.
The key findings are: • Most citizens say access to clean drinking water is a serious problem • Citizens point to limited number of

Ugandans' experiences and opinions on water, sanitation and hygiene
water points as the main challenge they face in accessing clean drinking water • 2 out of 10 households access drinking water from an unsafe source • Some progress can be seen in access to safe drinking water between 2018 and 2023 • In the dry season, three out of ten households are able to collect drinking water in under 30 minutes • 6 out of 10 households treat their water in some way before drinking it • 4 out of 10 households use an "improved" toilet facility • 1 out of 4 households has some form of handwashing facility near the toilet / latrine that they use

Eight insights on water, sanitation and hygiene
Insight 1: Most citizens say access to clean drinking water is a serious problem Most citizens (63%) access to clean drinking water is a serious problem in their community, including four out of ten (39%) who say it is the most serious problem that their community faces.
It is more common in rural areas than urban for citizens to say access to clean drinking water is a serious problem, and more common outside Greater Kampala.It is also more common among poorer citizens and those with lower levels of education.Citizens point mainly to two closely related matters when asked about the main challenges they face in accessing clean drinking water: distance to water points (44%) and the limited number of water points (43%).Together, these account for the vast majority of challenges mentioned by citizens, as has been the case consistently over recent years.This is particularly the case in rural areas, while in urban areas the cost of water is cited as the biggest challenge, slightly ahead of distance to water points and the number of water points.
One out of eight citizens report that there are no challenges in their communities when it comes to accessing clean drinking water.

Insight 3: 2 out of 10 households access drinking water from an unsafe source
Two out of ten households (20%) collect drinking water from an unsafe source, either a surface source such as a river or dam (7%) or another type of unimproved source such as an unprotected spring or well (13%).It is more common among poorer households and those in central or western parts of the country to be dependent on unsafe sources.It is considerably less common in urban areas, Greater Kampala in particular, and eastern and northern regions.
Two out of ten households across Uganda (19%) access their drinking water from a piped source, which includes both piped connections to the household and public standpipes.A further six out of ten (61%) access drinking water from another type of "improved" source, including protected springs, protected wells and boreholes.
Disparities in access are extreme.Households in Greater Kampala are at least ten times more likely than households in northern Uganda to access their drinking water from a piped source.In rural areas, the single most common type of source for drinking water is a tube well or borehole with a pump, accounting for half of all households (52%).In urban areas, a wider range of sources are widely used, including tube wells and boreholes (21%), protected springs (11%) and protected wells (12%) and public standpipes (10%).One out of twenty households in urban areas (5%) has piped water into their home, and a further two out of ten have piped water to their yard (18%), while a considerable number access water from a neighbour (13%).Insight 4: Some progress can be seen in access to safe drinking water Over the last five-six years, some progress has been made at improving access to safe drinking water.Nationwide, the proportion of households that access drinking water from a piped or other improved source has risen from 74% in 2018 to 80% in 2023.Most of this improvement has been seen in rural areas (69% to 77% over the same period), while in urban areas -where access is higher -the change has been smaller (86% to 90%). 2 However, there are also signs of stagnation in access to piped supplies in the last five years.
Figure Insight 5: In the dry season, three out of ten households are able to collect drinking water in under 30 minutes In the dry season, three out of ten households (30%) are able to collect their drinking water in under 30 minutes.This figure is considerably higher in urban areas, particularly Greater Kampala, and among wealthier households.Unsurprisingly, it is closely linked to the type of source on 2 It is unclear why there was a small but significant increase in use of piped water supplies in 2020, and why this increase was only temporary.It is likely that this was related in some way to the Covid-19 pandemic, perhaps with some households opting to switch from their usual source of water to a better source -a piped supply -in order to raise their hygiene standards at a time when increased attention was focused on hygiene which a household depends, with piped supplies much more likely to be accessible within 30 minutes.
Figure Insight 6: 6 out of 10 households treat their water in some way before drinking Six out of ten households (61%) treat their water in some way before drinking it.This rises to eight out of ten households (79%) in urban areas, and almost all households (99%) in Kampala.
Poorer households and those in northern and eastern parts of the country are less likely to treat their drinking water.
Treatment of drinking water has declined by 9 percentage points in the last 5 years.Base: all respondents; n=2,809 The most common form of water treatment is boiling (54%), followed by allowing it to stand and settle (11%), straining it (9%) and using chemical disinfectants such as WaterGuard (7%).
The most common reasons given for not treating water before drinking are a belief that the water is already safe for drinking (22%) or a lack of resources for treating the water (14%).Half of all households (51%) use a pit latrine without a slab as their toilet facility, and a further 5% do not have access to any facility.A small number have a flush toilet (2%), dominated by households in Greater Kampala (15%), use a pit latrine with a ventilation pipe (5%), or a pit latrine with a slab 3 .
Lower quality toilet facilities are much more common in rural areas, among poorer households, and in eastern, northern and western parts of the country.
3 Facilities were physically observed by surveys teams.

Conclusions
Access to clean drinking water (and other aspects of water, sanitation and hygiene) are highly dependent on where in Uganda you live and how wealthy you are.If you are relatively wealthy -and remember less than one quarter of citizens earns more than UGX 300,000 (USD $80) per month -then your experience of accessing drinking water is very different from that of most Ugandans.
For the relatively wealthy, drinking water is most likely to be accessed via a piped supply: either directly into their household or yard or from a neighbour.For the poor, it is most likely to be accessed from a less convenient type of source: most likely a tube well or borehole.For the relatively wealthy, it is unlikely that it will take much time to collect that water, for the poor it can take hours each day leading to lost time.The wealthy are much more likely to treat their water before drinking it, and are much more likely to also have access to a higher standard of toilet and handwashing facility.It is not surprising, therefore, that fewer than half of wealthier households, and even fewer in the Greater Kampala area, consider access to drinking water to be a serious problem in their communities, while three out of four poorer households feel this way.Perhaps more than any other aspect of public services, your experience of water supplies is very different depending on where your household fits in the country's socio-economic structure.
The challenge this raises is that those responsible for decisions about what types of public investment should be prioritised may be having an easier experience of accessing water than the majority of their fellow Ugandans.This means first that decision makers may prioritise issues that they and their immediate communities experience as more pressing.And second, it means that their priorities when it comes to improving water supply services may also focus more on expanding piped supplies into more yards and more households rather than addressing the more fundamental challenge -a shortage of water points -experienced by the majority of citizens.In the context of limited resources, this is necessarily a trade-off: to prioritise public investment on improving services for the poorest and least-well-served -which often represent greater value for money in terms of quantity -or to focus on expanding the more expensive water pipe networks to reach more middle-class households.This survey of Ugandans suggests that on the grounds of equity and value for money, investing in water points may be the more prudent action to take.

Figure 4 :
Figure 4: What is the main source of drinking water for your household?

Figure 8 :
Figure 8: What do you do to the water to make it safer to drink?/ Why don't you treat your water to make it safer to drink?(multiple responses permitted)

Figure 2: What are the two main challenges your community is facing in accessing clean drinking water?
Source: Sauti za Wananchi mid-term survey (Aug-Sep 2023);Base: all respondents; n=2,809

Figure 3: What is the main source of drinking water for your household?
Source: Sauti za Wananchi mid-term survey (Aug-Sep 2023);Base: all respondents; n=2,809

Insight 8: 1 out of 4 households has some form of handwashing facility near the toilet / latrine that they use
Figure 10

: Is there a functional hand washing facility with soap and water near the toilet/latrine?
Source: Sauti za Wananchi mid-term survey (Aug-Sep 2023);Base: all respondents; n=2,809