From Indore to Delhi: How unsafe water is undermining public health

Repeated water contamination incidents across Indian cities reveal why safe drinking water remains neglected, despite its proven impact on public health and economic productivity

Indore has long enjoyed the reputation of being one of India’s cleanest cities. Yet earlier this year, that image cracked when contaminated tap water triggered a surge in diarrhoeal cases, hospitalising over a hundred people and exposing deep flaws in urban water management. The incident is a part of a wider, largely overlooked public health crisis unfolding across the country.

 

According to media reports, unsafe drinking water sickened more than 5,500 people and caused at least 34 deaths across India in the past year alone. Despite these numbers, safe drinking water continues to be treated as an infrastructure issue rather than a frontline public health intervention, a gap with serious human and economic consequences.

 

When 'clean' cities fall short

In January, Indore reported a sudden spike in diarrhoea cases after sewage-contaminated water entered the municipal supply. Investigations later revealed that leakages, ageing pipelines and poor monitoring had allowed untreated wastewater to mix with drinking water lines.

 

This was not the city’s first warning sign. A 2019 audit by the Comptroller and Auditor General of India (CAG), which reviewed urban water management between 2013–14 and 2017–18, highlighted alarmingly high levels of water that is produced but lost before it reaches consumers or generates revenue. The audit found that Indore was losing between 65 per cent and 70 per cent of its treated water, while Bhopal’s losses were estimated at 30 per cent to 49 per cent during the five year period, largely due to leakages, unauthorised connections and operational inefficiencies.  ALSO READ | Indore water contamination crisis: How to stay safe and avoid illness

Delhi NCR: A persistent and complex crisis

The Delhi NCR region presents a particularly complex challenge. Despite multiple water treatment plants, residents in parts of Delhi, Ghaziabad, Noida and Gurugram frequently report contaminated or irregular water supply. High ammonia levels in the Yamuna, illegal sewage connections and pipeline damage have repeatedly disrupted treated water flow. 

Elevated nitrate and fluoride levels have been detected in pockets of Delhi, Haryana and western Uttar Pradesh, posing long-term health risks. 

A recent Comptroller and Auditor General (CAG) audit has flagged serious drinking water risks in the National Capital Territory and NCR region, exposing systemic failures in water testing, treatment and monitoring.

• Nearly 55 per cent of groundwater samples tested were unsafe for human consumption, failing potable water standards.
• Delhi faced a roughly 25 per cent shortfall against its estimated water requirement, even before quality issues were factored in.
• Raw, untreated water from borewells was supplied directly into reservoirs and, in some cases, to consumers during the audit period.
• Crucial tests for toxic substances, heavy metals and biological contaminants were largely omitted.

A problem spanning states and cities

According to the Bihar Economic Survey (2024-25) report, over 26 per cent of all rural wards are reported to be exposed to unsafe drinking water, with widespread contamination of groundwater by arsenic, fluoride and iron. This has spurred state efforts to provide safer water sources and extend schemes such as Har Ghar Nal ka Jal to more communities. 

In Maharashtra, residents of parts of Mumbai and Nagpur have raised concerns over discoloured or foul-smelling tap water.

Gujarat’s Gandhinagar district reported a typhoid outbreak in 2025 linked to water pipeline contamination, underscoring persistent drinking water quality challenges in urban supply systems. 

The 2025 Central Ground Water Board report flagged widespread groundwater contamination in Andhra Pradesh, with elevated levels of nitrates, fluoride and other pollutants jeopardising drinking water safety across large areas.  

In Karnataka, Bengaluru’s dependence on alternative water sources has raised quality questions in peripheral areas, especially during dry months. 

In central Uttar Pradesh, including districts near Delhi, groundwater contamination with heavy metals further complicates drinking water safety. 

These recurring issues highlight that water quality problems extend far beyond single events and reflect systemic gaps in monitoring and infrastructure across states.

The hidden economic cost of unsafe drinking water

Beyond illness and death, unsafe water quietly drains household incomes and public resources. A peer-reviewed study published last year in the Journal of Water and Health, titled 'Health and economic consequences due to inadequate drinking water', highlights that contaminated water leads to:

• Increased healthcare spending on preventable diseases
• Loss of wages due to illness and caregiving
• Reduced school attendance among children
• Long-term productivity losses

 

Data from the Ministry of Water Supply and Sanitation shows that waterborne diseases affect around 37.7 million people each year, leading to the loss of nearly 73 million working days annually.

Why safe drinking water remains overlooked

A crisis is often not about water availability but what happens on the way to the tap. Frequent breaks in ageing pipelines, poor coordination between municipal departments and road authorities, and a lack of accurate underground utility maps lead to contamination long before water reaches households. These gaps are compounded by fragmented governance, where the same bodies responsible for supplying water also monitor its quality, creating conflicts of interest and weak accountability. 

Programmes aimed at expanding water infrastructure often emphasise new pipelines and coverage targets, without sufficiently investing in maintenance, safety protocols, continuous monitoring or independent regulation. As a result, contamination is often detected only after outbreaks occur, rather than through preventive surveillance.

Why clean water must come first

As India invests in urban development and healthcare expansion, safe drinking water must move from the margins to the centre of public health planning. Preventing future outbreaks will require a clear shift in approach:

• Routine, real-time water quality testing across sources and supply networks
• Repairing and upgrading ageing pipelines to prevent sewage intrusion
• Strengthening sewage and liquid waste treatment before expanding water supply
• Independent oversight and public disclosure of water quality data
• Closer coordination between water and health departments to detect risks early

For more health updates, follow #HealthwithBS

This report is for informational purposes only and is not a substitute for professional medical advice.