Ananya Mukherjee, faculty at Azim Premji University
Khushi Thakur & Hiya Chakma, students, Azim Premji University
An emerging health threat could claim 40 million lives by 2050, mostly affecting South Asia, Africa, and the Caribbean, not from a new virus, but from common bacteria that no longer respond to medicine. This is Antimicrobial Resistance (AMR), often called the ‘silent pandemic’. New research shows that our urban lakes and waterbodies have become the primary breeding grounds for these deadly microorganisms.
As we crowd into urban areas, our relationship with water is reaching a breaking point. As per a Nature Conservancy study (2014), one in four major cities faces water stress, requiring 504 billion litres of water to be transported across 27,000 km annually. On the other hand, human-driven changes to water microbes are altering ecosystems and increasing risks to both environmental and human health. This means that urban growth is creating a dual crisis: a severe lack of water and a rise in deadly, drug-resistant bacteria in the water supply.
In countries like India, the problem is fuelled by, one, antibiotic overuse – India is one of the top five countries that uses antibiotics in livestock feed. Untreated effluents from healthcare facilities are also drained into water bodies. Combined with insufficient drainage systems, this often leaves many urban water bodies contaminated. Two, rapid urbanisation that introduces significant pollution, such as untreated sewage and microplastics. These human-introduced plastics act as ‘preferential habitats’ for microorganisms, enabling the formation of biofilms that allow them to thrive, spread, and persist in urban water bodies.
A global review of 1,561 studies found a worrying trend. Scientists are seeing a massive rise in ‘opportunistic’ bacteria, like E. coli, that have evolved to survive multiple drugs. A study found that the presence of resistant genes in water is directly linked to bacteria from the human gut. This is proof that leaking sewage systems are the main driver of antibiotic resistance in our cities.
While China has conducted the most research due to its own water shortages and high antibiotic use, there is a massive ‘data gap’ for the rest of Southeast Asia. We are in the dark about the very regions expected to be hit hardest by the AMR crisis in the coming decades.
Research findings underscore the importance of integrating freshwater microbiome monitoring into broader AMR mitigation strategies. Consistent monitoring of freshwater microbiomes can provide an important direction for addressing AMR. The results highlight the lack of studies of freshwater microbiomes, especially in large parts of Southeast Asia, where AMR has become a pressing concern. They also reinforce a ‘One Health’ perspective, which is that urban water management, microbial ecology and public health are inseparable components of the same system. Most of these studies were conducted on lakes and rivers. These waterbodies serve as both a direct daily water source for many communities and an indirect source via underground reservoirs accessed through tube wells or borewells.
The presence of resistant pathogens in community water sources provides insight into localised disease risk. Working exclusively on the water microbiome composition of community used water bodies can help us more effectively understand the risks faced by the people and inform targeted surveillance, water governance and public health interventions. The current geographic imbalance in urban freshwater microbiome research limits our ability to model and manage AMR in regions facing the highest anticipated risks by 2050.
Ananya Mukherjee is faculty at Azim Premji University; Khushi Thakur and Hiya Chakma are students at Azim Premji University.
The views and opinions expressed in this article are those of the authors and do not necessarily reflect the views or the positions of the organisation they represent.
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