Next Article in Journal
Shoreline Temporal Variability Inferred from Satellite Images at Mar del Plata, Argentina
Previous Article in Journal
Effects of Graphene on Soil Water-Retention Curve, van Genuchten Parameters, and Soil Pore Size Distribution—A Comparison with Traditional Soil Conditioners
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:

Impact of Climate Change on Waterborne Diseases: Directions towards Sustainability

Ministry of Health & Welfare Gongju National Hospital, Gongju 32601, Republic of Korea
Department of Geology, Kangwon National University, Chuncheon 24341, Republic of Korea
Department of Biochemistry, Kangwon National University, Chuncheon 24341, Republic of Korea
Authors to whom correspondence should be addressed.
Water 2023, 15(7), 1298;
Submission received: 15 March 2023 / Revised: 21 March 2023 / Accepted: 23 March 2023 / Published: 25 March 2023


Climate change has significantly influenced the spread of waterborne diseases (WBDs), which affect environmental quality and human life. The impact of climate change is greatest in developing countries, especially in the Association of Southeast Asian Nations (ASEAN) countries. Vibrio cholerae, a waterborne pathogen, is most susceptible to and most prevalent during severe climatic changes. The Philippines is regularly exposed to tropical cyclones, such as Bopha in 2012 and Haiyan in 2013, because of its geographical location, while Cyclone Nargis in 2008 caused over 95% of the damage and casualties seen in the preceding two decades in Myanmar. Therefore, implementing policies to adjust to these climate changes and to safeguard their citizens from the effects of WBDs is imperative for ASEAN countries. This study aimed to (1) investigate the effects of climate change on health and to understand the policy requirements to prevent or minimize its negative impact and (2) explore the link between the Sustainable Development Goals (SDGs) and the effects of climate change on WBDs to determine perspectives for global sustainability. The framework of the SDGs should be adapted to ASEAN countries to improve legislation, laws, and regulations on climate-related health issues. Efficient collaboration among scientists, researchers, health professionals, and policymakers will assist in addressing the problems associated with the impact of climate change on WBDs in ASEAN countries.

1. Introduction

Climate change has significantly and severely affected the environment and human life. Large numbers of casualties have been reported owing to extremely high temperatures and cold waves worldwide, including in Europe and Asia [1,2,3,4]. Moreover, the detrimental effects of climate change on sectors such as agriculture and tourism, and the service sector result in significant economic losses, in addition to the loss of life and property [5]. Climate change entails changes in the ecosystem, with a significant impact on the habitat and daily life activities of not only large animals but also small insects (e.g., mosquitoes and mites) and rodents (e.g., mice) [6]. Consequently, this association between climate change and small living organisms may greatly amplify health risks in many countries, as most infectious diseases are transmitted to humans through vector-borne pathogens, such as mosquitoes, mites, and mice [6]. These causative pathogens may alter the timing, intensity, and distribution of infectious diseases, according to the fluctuations in temperature, precipitation, and humidity [6].
Furthermore, the impacts of climate disasters, such as droughts and floods, on human health include not only direct injuries or fatalities but also indirect impacts on individual nutrition levels owing to food production losses [7]. Although these issues are highly evident in developing countries, economically developed countries may also encounter food security issues if climate change persists. Moreover, with increasing exposure to extreme climate events, the number of people experiencing mental health problems, such as melancholy, tension, pain, sense of deprivation, sadness, mental impairment, and suicide, is also gradually increasing [8].
Water-borne infectious diseases refer to diseases that develop mainly in the digestive system of the human body and are mediated by water or water-related foods (such as fish and shellfish), fruits, and vegetables. Climate change is changing precipitation patterns, causing rising sea levels, and altering seawater salinity, whilst also impacting several factors such as surface water temperature and the reproduction, survival, and sustenance of viruses and bacteria in waterbodies, which consequently affects human health [8,9]. Cholera and typhoid are representative bacterial foodborne or waterborne infectious diseases, which are clearly associated with temperature increases. The chance of developing Salmonella infections increases by 5–10% with every 1 °C increase in global temperature [9].
Enhancing the sustainability of the ecosystem by minimizing the negative impacts of ongoing climate change is a crucial part of the climate crisis response. As global warming continues to progress despite various efforts at both the international and national levels, adapting appropriately to the changing climate status is important. According to the previous literature, the effects of climate change on human health include heat- and cold-related diseases caused by extreme temperatures, heat waves, and cold waves; diseases caused by ecosystem changes; air quality-related diseases; and chronic diseases [10]. Naturally, risks, such as missing people, injuries, and fatalities from natural disasters (e.g., droughts, typhoons, and floods), are also consequences of climate change on humans. Furthermore, the risk of diarrhea, one of the most common waterborne diseases (WBDs), can potentially increase owing to heavy rainfall and high temperatures [10,11,12,13].
The available literature indicates that studies are shifting the focus from establishing correlations between climatic conditions and the outcomes of WBDs to merely projecting those correlations into the future while estimating and planning adjustment measures [13,14]. The concurrent influence of particular factors on the outcome, such as habitat loss, excessive travel and relocation of individuals, insecticide and drug resistance, industrialization, population explosion, and the unavailability of healthcare aid, makes it challenging to pinpoint the influence of climate change on the increasing occurrence of WBDs [14]. Additionally, one of the most important aspects of achieving sustainable development is having a clear understanding of how climate change will affect WBDs. Accordingly, this study aimed to (1) investigate the effects of climate change on human health from an adaptive perspective and understand the policies required to prevent or minimize the negative impacts and (2) explore the link between the Sustainable Development Goals (SDGs) and the effects of climate change on WBDs to determine current and future perspectives on global sustainability. The collaboration and interdisciplinary connection with political management and science can have a positive impact on the climate change problems affecting water-borne diseases. Alternative suggestions and communication were organized into three parts: the perspective view of the Southeast Asia countries’ situation, discussion about the sustainability directions, and the challenges and blueprint.
In the perspective view, we presented a mini overview of climate change’s impact on water-borne diseases mainly by pathogens and common status and the Global Climate Risk Index of Southeast Asian countries. As a second session, the discussion of the direction of sustainability is followed as the second part in order to give insights into the relationship between climate change’s impact on water-borne diseases and the Sustainable Development Goals. Lastly, the challenges and blueprint from the main interest of Southeast Asian countries have been drawn.

2. Materials and Methods

The search was carried out by conducting a search through “Google Scholar,” “Web of Science,” and “PubMed”. The primary search was carried out through the Web of Science database with additional searches through the Google Scholar and PubMed databases. The Web of Science database was used to search for articles, reviews, and reports with the keywords “water-borne diseases, climate change, climate impact factor, drinking water condition, sustainable future”. Because there were few papers before 2000, we narrowed down the time of publication, analyzing the impacts of climatic elements on water-borne diseases between the time periods from January 2000 to December 2022. Moreover, published reports from the WHO and UNICEF were also reviewed in order to comprehensively acquire all relevant studies in Southeast Asian countries. The search was carried out as a follow-up search in Google Scholar and PubMed by focusing on the keywords of “water-borne diseases,” and “climate change in each Southeast Asia country”. The internet databases’ article titles, key terms, and abstracts were searched.

3. Results and Discussion

3.1. Perspectives on the Impact of Climate Change on WBDs

WBDs have long been recognized as a significant public health issue worldwide, particularly in developing countries. In the context of climate change, vector-borne diseases, foodborne diseases, and WBDs are the major infectious diseases globally [15]. Humans can be exposed to WBDs by washing, bathing, and/or drinking water contaminated with pathogens. Pathogens modify their environmental habitats and survival behaviors according to changes in climate, which can lead to the transmission of pathogens [16,17]. Furthermore, even in developed nations, concerns about WBDs persist [18]. Generally, climate change and global warming events have increased the occurrence of WBDs [15,16,17,18]. As some developing nations lack an adequate and reliable health infrastructure that can monitor and retain records of past and present conditions of the WBDs, the influence of climate change on WBDs is incomprehensible in these nations [19]. Several WBDs exist, such as cholera, salmonellosis, typhoid, hepatitis A and E, diarrhea, leptospirosis, giardiasis, shigellosis, amoebiasis, dracunculiasis, cryptosporidiosis, Campylobacter enteritis, and poliomyelitis [20]. The issue of WBDs is becoming increasingly serious because of insufficient clean drinking water [21]. Children are more vulnerable to WBDs than adults because children have an impaired immune defense system and self-control [22]. The fecal–oral pathway, in which human feces are ingested through contaminated food or water and which mostly arises from inadequate sewage management and unsanitary conditions, is a frequent passage for the transmission of WBDs. Moreover, when the distance between the toilets outside households and wells is not sufficiently large (more than 50 m), there is a higher chance of fecal–oral pathogens entering wells, which could be the main water source for villagers [23] (Figure 1).
The influence of climate change on the environment is one of the main threats to human health at present, and many studies have indicated that the incidence of WBDs will increase [24,25,26,27]. Extreme weather-related WBDs will disproportionately affect particular populations and probably exacerbate pre-existing health inequities. For example, Vibrio cholerae is the most common pathogen linked to extreme climate change processes [28]. Furthermore, climate change may increase the risk of WBDs because of changes in the quality of water sources and the frequency of natural disasters that might consequently contaminate water supplies. Eventually, infectious diseases, such as cholera, dysentery, and typhoid, may become more common. According to the World Health Organization, 1.1 billion individuals consume water that is moderately polluted by feces, and 1.8 billion people die per year from diarrhea, a WBD [29,30]. The association between climatic factors and WBDs can vary significantly between countries and geographic areas [23,25,31]. Typhoid and cholera are the two main illnesses that pose a serious threat to and have a significant impact on human health. Developing nations, particularly the Association of Southeast Asian Nations (ASEAN) countries, will inevitably suffer disproportionately from WBD epidemics and climate change disasters, such as heavy rains, flooding, increasing temperatures, and droughts. This, coupled with large populations, high poverty rates, low development levels, and limited adaptive capacity, makes ASEAN countries vulnerable to health issues associated with climate change [31].
WBDs in ASEAN countries are underestimated because such cases have not been reported and explored in specific regions. The understanding of scientific approaches and public policy (government, policymakers, and researchers) should be balanced to minimize the impact of climate change on WBDs in ASEAN countries. Among the 11 ASEAN countries, 4 (Myanmar, the Philippines, Thailand, and Vietnam) have been included in the top 10 ranks of the Global Climate Risk Index (GCRI) (Table 1). The GCRI is determined by combining quantitative and qualitative data, such as information on extreme weather occurrences, socioeconomic indices, and professional opinions. The GCRI was initially released in 2005, and it has gained widespread recognition as a tool for evaluating the risk of climate change and increasing awareness of the need for adaptation and mitigation actions. The GCRI has grown in importance as a tool for assessing climate change risk and informing policy decisions at national and international levels since governments, NGOs, and academic researchers have used the GCRI to identify the nations and regions that are most vulnerable to climate change. The GCRI was selected because it is a crucial resource for comprehending and mitigating the efforts of climate change, as well as for advancing sustainable development and climate resilience. Based on variables such as social and economic development, infrastructure, and governance, the GCRI assigns countries a ranking based on their exposure and sensitivity to climate-related risks such as floods, droughts, heat waves, and storms. In particular, floods, droughts, sea-level rises, and tropical events (cyclones and typhoons) are the prevailing major climate occurrences in ASEAN countries, whilst the most common WBDs are diarrhea, cholera, and typhoid (). The severity of natural disasters and diseases could be because of the lack of coping mechanisms to manage instant water overflows, such as deluge sanitation and water drainage systems, to manage instant water flow [32,33] The GCRI of the Philippines and Myanmar was higher than that of other countries, indicating that these two countries are the most likely to suffer the consequences of climate change on WBDs. Usually, countries that lack strong infrastructure and local authorities (government), such as Myanmar, and countries that have small separate islands, such as the Philippines, are more vulnerable to climate change than other countries. Mitigation and remediation issues for emergencies, susceptibility to WBDs, and resilience to disasters are primary issues in such countries [34,35]. Consuming a large amount of low-quality water in the summer can increase the potential risk of ingesting waterborne pathogens, which can lead to serious diarrhea and cholera. [11]. In ASEAN countries, children defecating in public rural open areas near streams or lakes can increase the risk of typhoid, paratyphoid, and cholera infections during the monsoon season, heavy rainfall events, and floods. These climate events increase the transmission of Vibrio cholerae and other bacteria that are transmitted from feces to drinking water or food systems [36,37,38]. Poor sanitation and low drinking water quality are responsible for approximately 80% of infections in developing nations [39]. However, participating in global climate change mitigation efforts, such as carbon reduction targets under the Paris Agreement, is important for ASEAN countries.

3.2. Directions towards Sustainability: SDGs and Climate Change-Related WBDs

Interdisciplinary and transdisciplinary studies are required to advance the direction of sustainability related to the impacts of climate change on WBDs. Human activities have been responsible for initiating climate change even before the Industrial Revolution, and climate change has been accelerating since the mid-19th century [63,64]. Consequently, the impacts of climate change on WBDs are major challenges in developing countries, particularly in Southeast Asia. The SDGs have been implemented to identify the common goals and missions for preventing and controlling WBDs arising owing to climate change [65].
To ensure world peace and welfare, alleviate poverty, and protect natural resources for future generations, the United Nations announced 17 SDGs in 2015. Integrated intervention with the SDGs should be focused on to design a prevention-strategy-based blueprint, which will help to reduce the impact of damage caused by WBDs in each ASEAN country.
Several SDGs, particularly, SDGs 3, 6, 11, 13, and 17, are directly related to WBDs and climate change worldwide. ASEAN countries should attempt to achieve these specific goals to achieve a more sustainable future (Table 2).
Among the SDGs, SDG number 3 (Good Health and Well-Being) and 13 (Climate Action) are the most relevant to the impacts of climate change on WBDs. Moreover, both SDG 3 and 13 aim to reduce illness and increase human well-being worldwide, and both include reducing the occurrence of WBDs and implementing immediate measures to fight climate change and its consequences, especially on WBDs. Furthermore, SDGs 6 (Clean Water and Sanitation), 11 (Sustainable Cities and Communities), and 17 (Partnerships for the Goals) are also important in terms of the impact of climate change. SDG 6, which aims to guarantee that everyone has access to affordable and clean drinking water, is important considering that climate change may significantly affect the accessibility and sustainability of water sanitation. Furthermore, creating comprehensive, sustainable, durable, and safe communities in cities is an objective of SDG 11, which also strives to augment the public approach to secure drinking water and reduce damages arising from WBDs. SDG 17 aims to improve the implementation processes and stimulate international collaboration for sustainable development, which is a key point for ASEAN countries because they require a strong partnership with a focus on achieving the SDGs in the future.

3.3. Challenges and Blueprint

Worldwide, policymakers and decision-makers encounter the difficulty of applying the SDGs concurrently with the expectation of achieving overall environmental progress [64]. Several developmental directions have been presented at stages where full-scale investigations and assessments have not yet been conducted [6,29,38]. First, revising laws and regulations that are not appropriate for the legal system is necessary to ensure swift operation and to maintain internal stability. In Southeast Asian countries, there are different laws and organizations which are influenced by WBDs; however, it is necessary to determine their actual impact on the waterborne disease rates in each of these countries through statistical analysis. From a long-term perspective, considering the enactment of separate laws is also vital for maintaining climate quality. Second, the investigation and reporting systems for infectious diseases have been established successfully, but the surveillance and reporting systems for other climate factors (such as the impact of temperature changes, precipitation, and drought on WBDs) are insufficiently developed; therefore, surveillance (monitoring) and reporting systems in ASEAN countries must be established for assessment. Third, in many instances, the causal relationship and correlation between climate change and the mechanism of occurrence of each WBD have not been clearly revealed. Accordingly, long-term investment in research and development is needed to identify the medical connections between climate change and various illnesses. Fourth, the health authority (for example: the Disease Control and Prevention Agency; the department name can differ depending on each ASEAN country), which currently lacks functions and roles in relation to climate health, should be reinforced by adding more experts related to the climate health domain and expanding their organizations. In ASEAN countries, there are laws and organizations that address WBDs and encourage access to clean water, including The Clean Water Act in the Philippines, the Water Resources Management Law in Vietnam, the National Environmental Agency and Environmental Protection and Management Act in Singapore, the Water Pollution Control Act in Thailand, and the Environmental Quality Act in Malaysia. Nonetheless, there is still room for improvement in the assessment of the effect of climate change on WBDs, and more statistical research would be necessary to ascertain the precise impact on and any correlation with WBDs in those countries. The above four policy blueprints could play a vital role mostly in Southeast Asian nations and it will be helpful to build adaptation or mitigation strategies for the impact of climate change on WBDs.

4. Conclusions

In conclusion, climate change events influence WBDs, which pose a serious public health concern, particularly in ASEAN countries. Cholera and typhoid are the most common WBDs. Identifying the effects of climate change on WBDs (not only cholera and typhoid) is the first stage of assessing climate change impacts on human health. Thus, WBDs should be controlled and prevented strategically. The SDGs offer a suitable framework for addressing the effects of climate change on WBDs. Therefore, observing the relationship between the SDG targets and the impact of climate change on WBDs may provide new perspectives and new policy options. By making progress and achieving specific SDGs, we can lower the prevalence of WBDs and build a more adaptable and sustainable future.

Author Contributions

Conceptualization, Y.-J.J. and H.K.; methodology: Y.-J.J. and H.K.; investigation, Y.-J.J. and N.A.K.; resources, Y.-J.J.; data curation, Y.-J.J. and N.A.K.; writing—original draft preparation, Y.-J.J., H.K. and N.A.K.; writing—review and editing, Y.-J.J., S.N. and H.K.; supervision, Y.-J.J., S.N. and H.K.; project administration, S.N. and H.K.; funding acquisition, H.K. All authors have read and agreed to the published version of the manuscript.


This work was supported by the Korean Ministry of Environment as The SS (surface soil conservation and management) projects (grant number: 2019002820004) and the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Education (grant numbers: 2019R1I1A2A01057002 and 2019R1A6A1A03033167) and “Regional Innovation Strategy (RIS)” through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (MOE)(2022RIS-005).

Data Availability Statement

The data supporting the reported results can be found in the cited bibliography.

Conflicts of Interest

The authors declare no conflict of interest.


  1. Goggins, W.B.; Chan, E.Y.; Yang, C.; Chong, M. Associations between mortality and meteorological and pollutant variables during the cool season in two Asian cities with sub-tropical climates: Hong Kong and Taipei. Environ. Health 2013, 12, 59. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  2. Mishra, V.; Ganguly, A.R.; Nijssen, B.; Lettenmaier, D.P. Changes in observed climate extremes in global urban areas. Environ. Res. Lett. 2015, 10, 024005. [Google Scholar] [CrossRef]
  3. Parliari, D.; Giannaros, C.; Keppas, S. Assessment of heat and cold waves phenomena and impacts on environment. In Extremes in Atmospheric Processes and Phenomenon: Assessment, Impacts and Mitigation; Springer Nature: Singapore, 2022; pp. 141–167. [Google Scholar]
  4. Revich, B.; Shaposhnikov, D. The influence of heat and cold waves on mortality in Russian subarctic cities with varying climates. Int. J. Biometeorol. 2022, 66, 2501–2515. [Google Scholar] [CrossRef]
  5. International Strategy for Disaster Reduction (ISDR). Economic Losses, Poverty, and Disasters 1998–2017; ISDR: Geneva, Switzerland, 2018; pp. 1–33. [Google Scholar]
  6. Braks, M.; Giglio, G.; Tomassone, L.; Sprong, H.; Leslie, T. Making vector-borne disease surveillance work: New opportunities from the SDG perspectives. Front. Vet. Sci. 2019, 6, 232. [Google Scholar] [CrossRef]
  7. Lee, J.; Perera, D.; Glickman, T.; Taing, L. Water-related disasters and their health impacts: A global review. Prog. Disaster Sci. 2020, 8, 100–123. [Google Scholar] [CrossRef]
  8. Berry, H.L.; Waite, T.D.; Dear, K.B.G.; Capon, A.G.; Murray, V. The case for systems thinking about climate change and mental health. Nat. Clim. Change 2018, 8, 282–290. [Google Scholar] [CrossRef]
  9. Kendrovski, V.; Gjorgjev, D. Climate change: Implication for foodborne diseases (Salmonella and food poisoning among humans in R. Macedonia). In Structure and Function of Food Engineering; IntechOpen: Rijeka, Croatia, 2012; pp. 151–170. [Google Scholar]
  10. Guzman Herrador, B.R.G.; de Blasio, B.F.; MacDonald, E.; Nichols, G.; Sudre, B.; Vold, L.; Semenza, J.C.; Nygård, K. Analytical studies assessing the association between extreme precipitation or temperature and drinking water-related waterborne infections: A review. Environ. Health 2015, 14, 29. [Google Scholar] [CrossRef] [Green Version]
  11. Levy, K.; Woster, A.P.; Goldstein, R.S.; Carlton, E.J. Untangling the impacts of climate change on waterborne diseases: A systematic review of relationships between diarrheal diseases and temperature, rainfall, flooding, and drought. Environ. Sci. Technol. 2016, 50, 4905–4922. [Google Scholar] [CrossRef] [Green Version]
  12. Lo Iacono, G.; Armstrong, B.; Fleming, L.E.; Elson, R.; Kovats, S.; Vardoulakis, S.; Nichols, G.L. Challenges in developing methods for quantifying the effects of weather and climate on water-associated diseases: A systematic review. PLoS Negl. Trop. Dis. 2017, 11, e0005659. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  13. Semenza, J.C.; Herbst, S.; Rechenburg, A.; Suk, J.E.; Höser, C.; Schreiber, C.; Kistemann, T. Climate change impact assessment of food- and waterborne diseases. Crit. Rev. Environ. Sci. Technol. 2012, 42, 857–890. [Google Scholar] [CrossRef] [Green Version]
  14. Funari, E.; Manganelli, M.; Sinisi, L. Impact of climate change on waterborne diseases. Ann. Ist. Super. Sanità 2012, 48, 473–487. [Google Scholar] [CrossRef] [PubMed]
  15. Cissé, G.; Menezes, J.A.; Confalonieri, U. Climate-sensitive infectious diseases. In The Adaptation Gap Report; United Nations Environment Programme (UN Environmental Program): Nairobi, Kenya, 2018; pp. 49–59. [Google Scholar]
  16. Khan, M.D.; Thi Vu, H.H.; Lai, Q.T.; Ahn, J.W. Aggravation of human diseases and climate change nexus. Int. J. Environ. Res. Public Health. 2019, 16, 2799. [Google Scholar] [CrossRef] [Green Version]
  17. Wu, X.; Lu, Y.; Zhou, S.; Chen, L.; Xu, B. Impact of climate change on human infectious diseases: Empirical evidence and human adaptation. Environ. Int. 2016, 86, 14–23. [Google Scholar] [CrossRef] [Green Version]
  18. Murphy, H.M.; Pintar, K.D.M.; McBean, E.A.; Thomas, M.K. A systematic review of waterborne disease burden methodologies from developed countries. J. Water Health 2014, 12, 634–655. [Google Scholar] [CrossRef] [Green Version]
  19. UNFCC. Climate Change: Impacts, Vulnerabilities and Adaptation in Developing Countries Framework for Climate Convention; United Nations: Bonn, Germany, 2007; Volume 1, Available online: (accessed on 1 February 2023).
  20. Cheesbrough, M. District Laboratory Practice in Tropical Countries, Part 2; Cambridge University Press: Cambridge, UK, 2005. [Google Scholar]
  21. Bidhuri, S.; Taqi, M.; Khan, M.M.A. Water-borne disease: Link between human health and water use in the Mithepur and Jaitpur area of the NCT of Delhi. J. Public Health 2018, 26, 119–126. [Google Scholar] [CrossRef]
  22. Sinclair, R.G.; Jones, E.L.; Gerba, C.P. Viruses in recreational water-borne disease outbreaks: A review. J. Appl. Microbiol. 2009, 107, 1769–1780. [Google Scholar] [CrossRef]
  23. Bekturganov, Z.; Tussupova, K.; Berndtsson, R.; Sharapatova, N.; Aryngazin, K.; Zhanasova, M. Water related health problems in Central Asia—A review. Water 2016, 8, 219. [Google Scholar] [CrossRef]
  24. DeJarnett, N.; Robb, K.; Castellanos, I.; Dettman, L.; Patel, S.S. The American Public Health Association’s 2017 year of climate change and health: Time for action. Am. J. Public Health 2018, 108 (Suppl. 2), S76–S77. [Google Scholar] [CrossRef] [PubMed]
  25. Lake, I.R.; Barker, G.C. Climate change, foodborne pathogens, and illness in higher-income countries. Curr. Environ. Health Rep. 2018, 5, 187–196. [Google Scholar] [CrossRef] [Green Version]
  26. Levy, K.; Smith, S.M.; Carlton, E.J. Climate change impacts on waterborne diseases: Moving toward designing interventions. Curr. Environ. Health Rep. 2018, 5, 272–282. [Google Scholar] [CrossRef]
  27. Schijven, J.; Bouwknegt, M.; de Roda Husman, A.M.; Rutjes, S.; Sudre, B.; Suk, J.E.; Semenza, J.C. A decision support tool to compare waterborne and foodborne infection and/or illness risks associated with climate change. Risk Anal. 2013, 33, 2154–2167. [Google Scholar] [CrossRef] [PubMed]
  28. Cann, K.F.; Thomas, D.R.; Salmon, R.L.; Wyn-Jones, A.P.; Kay, D. Extreme water-related weather events and waterborne disease. Epidemiol. Infect. 2013, 141, 671–686. [Google Scholar] [CrossRef]
  29. Bain, R.; Cronk, R.; Hossain, R.; Bonjour, S.; Onda, K.; Wright, J.; Yang, H.; Slaymaker, T.; Hunter, P.; Prüss-Ustün, A.; et al. Global assessment of exposure to faecal contamination through drinking water based on a systematic review. Trop. Med. Int. Health 2014, 19, 917–927. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  30. World Health Organization. Guidelines for Laboratory and Field Testing of Mosquito Larvicides; (No. WHO/CDS/WHOPES/GCDPP/2005.13); World Health Organization: Geneva, Switzerland, 2005. [Google Scholar]
  31. McMichael, A.J.; Campbell-Lendrum, D.H.; Corvalán, C.F.; Ebi, K.L.; Githeko, A.; Scheraga, J.D.; Woodward, A. Climate Change and Human Health: Risks and Responses; World Health Organization: Geneva, Switzerland, 2003. [Google Scholar]
  32. Parker, D.J. Floods in cities: Increasing exposure and rising impact potential. Built Environ. 1995, 21, 114–125. [Google Scholar]
  33. Rashid, S.F. The urban poor in Dhaka City: Their struggles and coping strategies during the floods of 1998. Disasters 2000, 24, 240–253. [Google Scholar] [CrossRef]
  34. Hernández-Delgado, E.A. The emerging threats of climate change on tropical coastal ecosystem services, public health, local economies and livelihood sustainability of small islands: Cumulative impacts and synergies. Mar. Pollut. Bull. 2015, 101, 5–28. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  35. Keim, M.E. Building human resilience: The role of public health preparedness and response as an adaptation to climate change. Am. J. Prev. Med. 2008, 35, 508–516. [Google Scholar] [CrossRef]
  36. Harris, A.M.; Chowdhury, F.; Begum, Y.A.; Khan, A.I.; Faruque, A.S.; Svennerholm, A.M.; Harris, J.B.; Ryan, E.T.; Cravioto, A.; Calderwood, S.B.; et al. Shifting prevalence of major diarrheal pathogens in patients seeking hospital care during floods in 1998, 2004, and 2007 in Dhaka, Bangladesh. Am. J. Trop. Med. Hyg. 2008, 79, 708–714. [Google Scholar] [CrossRef]
  37. Schwartz, B.S.; Harris, J.B.; Khan, A.I.; Larocque, R.C.; Sack, D.A.; Malek, M.A.; Faruque, A.S.; Qadri, F.; Calderwood, S.B.; Luby, S.P.; et al. Diarrheal epidemics in Dhaka, Bangladesh, during three consecutive floods: 1988, 1998, and 2004. Am. J. Trop. Med. Hyg. 2006, 74, 1067–1073. [Google Scholar] [CrossRef] [Green Version]
  38. World Health Organization. Drinking Water Quality in the South-East Asia Region (No. SEA-EH-567); WHO Regional Office for South-East Asia: New Delhi, India, 2010; Available online: (accessed on 2 February 2023).
  39. Halvorson, S.J.; Williams, A.L.; Ba, S.; Dunkel, F.V. Water quality and waterborne disease in the Niger River Inland Delta, Mali: A study of local knowledge and response. Health Place 2011, 17, 449–457. [Google Scholar] [CrossRef]
  40. Beirne, J.; Renzhi, N.; Volz, U. Bracing for the typhoon: Climate change and sovereign risk in Southeast Asia. Sustain. Dev. 2021, 29, 537–551. [Google Scholar] [CrossRef]
  41. Gödeke, S.H.; Malik, O.A.; Lai, D.T.C.; Bretzler, A.; Schirmer, M.; Mansor, N.H. Water quality investigation in Brunei Darussalam: Investigation of the influence of climate change. Environ. Earth Sci. 2020, 79, 419. [Google Scholar] [CrossRef]
  42. Seah, S.; Martinus, M.; Jiahui, Q. The Southeast Asia Climate Outlook: 2021 Survey Report. Available online: (accessed on 5 February 2023).
  43. World Health Organization. Joint External Evaluation of IHR Core Capacities of Brunei Darussalam: Mission Report, 28 October–1 November 2019. 2020. Available online: (accessed on 5 February 2023).
  44. Eckstein, D.; Künzel, V.; Schäfer, L.; Winges, M. Global Climate Risk Index 2020; Germanwatch: Bonn, Germany, 2019; Available online: (accessed on 5 February 2023).
  45. Tofiloski, S. Geospatial Analysis of Water-Associated Infectious Diseases: Case of Myanmar. 2018. Available online: (accessed on 5 February 2023).
  46. Davies, G.I.; McIver, L.; Kim, Y.; Hashizume, M.; Iddings, S.; Chan, V. Water-borne diseases and extreme weather events in Cambodia: Review of impacts and implications of climate change. Int. J. Environ. Res. Public Health 2014, 12, 191–213. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  47. Irvine, K.; Murphy, T.P.; Sampson, M.; Dany, V.; Vermette, S.; Tang, T. An overview of water quality issues in Cambodia. J. Water Manag. Model 2020, 6, 14, 17–52. [Google Scholar] [CrossRef] [Green Version]
  48. Molyneux, N.; Da Cruz, G.R.; Williams, R.L.; Andersen, R.; Turner, N.C. Climate change and population growth in Timor Leste: Implications for food security. Ambio 2012, 41, 823–840. [Google Scholar] [CrossRef] [Green Version]
  49. Pinto, A.M. Traditional Knowledge and Water Quality in Timor-Leste: Climate Change Adaptation Strategies Used by Local Communities in Laco-Mesac and Ulmera Villages. Doctoral Dissertation, Ohio University, Ironton, OH, USA, 2014. [Google Scholar]
  50. Wirawan, I.M. Public health responses to climate change health impacts in Indonesia. Asia Pac. J. Public Health 2010, 22, 25–31. [Google Scholar] [CrossRef]
  51. Willetts, J.; Priadi, C.; Ombasta, O.; Wulandari, D.; Imtiyaz, I.; Sudhiastiningsih, N.N.S.N.; Kohlitz, J.; Mills, F.; Listyasari, M. Co-developing evidence-informed adaptation actions for resilient citywide sanitation: Local government response to climate change in Indonesia. Environ. Plan. B Urban Anal. City Sci. 2022, 49, 2129–2150. [Google Scholar] [CrossRef]
  52. Pink, R.M. Laos: The poorest country in Asia. In Water Rights in Southeast Asia and India; Palgrave MacMillan: New York, NY, USA, 2016; pp. 119–138. [Google Scholar]
  53. Alhoot, M.A.; Tong, W.T.; Low, W.Y.; Sekaran, S.D. Climate change and health: The Malaysia scenario. In Climate Change and Human Health Scenario in South and Southeast Asia; Akhtar, R., Ed.; Springer: Cham, Switzerland, 2016; pp. 243–268. [Google Scholar]
  54. Annua, Z.F.; Azmi, W.N.F.W.; Ahmad, N.I.; Sham, N.M.; Mahiyuddin, W.R.W.; Veloo, Y.; Abdullah, N.A. Drinking water quality in Malaysia: A review on its current status. Int. J. Environ. Nat. Res. 2020, 24, 556132. [Google Scholar] [CrossRef]
  55. Asia, G.S. The state of water resources in the Philippines. Clean Water Proj. East Kamias. 2007, pp. 82–91. Available online: (accessed on 10 March 2023).
  56. Chua, P.L.; Dorotan, M.M.; Sigua, J.A.; Estanislao, R.D.; Hashizume, M.; Salazar, M.A. Scoping review of climate change and health research in the Philippines: A complementary tool in research Agenda-Setting. Int. J. Environ. Res. Public Health 2019, 16, 2624. [Google Scholar] [CrossRef] [Green Version]
  57. Dennis, S.; Fisher, D. Climate change and infectious diseases: The next 50 years. Ann. Acad. Med. Singap. 2018, 47, 401–404. [Google Scholar] [CrossRef]
  58. Ivanov, V. Bacteriological monitoring of ships ballast water in Singapore and its potential importance for the management of coastal ecosystems. Environ. Toxicol. 2006, 1, 59–63. [Google Scholar] [CrossRef] [Green Version]
  59. Kruawal, K.; Sacher, F.; Werner, A.; Müller, J.; Knepper, T.P. Chemical water quality in Thailand and its impacts on the drinking water production in Thailand. Sci. Total Environ. 2005, 340, 57–70. [Google Scholar] [CrossRef] [PubMed]
  60. Marks, D. Climate change and Thailand: Impact and response. Contemp. Southeast Asia 2011, 33, 229–258. [Google Scholar] [CrossRef]
  61. Mai Kien, T.; Thi Tuyet Hanh, T.; Duc Cuong, H.; Shaw, R. Identifying linkages between rates and distributions of malaria, water-borne diseases and influenza with climate variability and climate change in Vietnam. In Climate Change Adaptation and Disaster Risk Reduction: An Asian Perspective; Shaw, R., Pulhin, J.M., Pereira, J.J., Eds.; Emerald Group Publishing Limited: Bingley, UK, 2010; Volume 5. [Google Scholar]
  62. Phung, D.; Huang, C.; Rutherford, S.; Chu, C.; Wang, X.; Nguyen, M. Climate change, water quality, and water-related diseases in the Mekong Delta Basin: A systematic review. Asia Pac. J. Public Health 2015, 27, 265–276. [Google Scholar] [CrossRef]
  63. Nichols, G.; Lake, I.; Heaviside, C. Climate change and water-related infectious diseases. Atmosphere 2018, 9, 385. [Google Scholar] [CrossRef] [Green Version]
  64. Simane, B.; Beyene, H.; Deressa, W.; Kumie, A.; Berhane, K.; Samet, J. Review of climate change and health in Ethiopia: Status and gap analysis. Ethiop. J. Health Dev. 2016, 30, 28–41. [Google Scholar] [PubMed]
  65. Griggs, D.J.; Nilsson, M.; Stevance, A.; McCollum, D. A Guide to SDG Interactions: From Science to Implementation; International Council for Science: Paris, France, 2017; Available online: (accessed on 7 February 2023).
Figure 1. Graphical illustration of the impacts of climate change on the occurrence of water-borne diseases caused mainly by pathogens.
Figure 1. Graphical illustration of the impacts of climate change on the occurrence of water-borne diseases caused mainly by pathogens.
Water 15 01298 g001
Table 1. Typical extreme climate events and common water-borne diseases (WBDs) with the Global Climate Risk Index (GCRI, 1999–2018) in the Southeast Asian countries.
Table 1. Typical extreme climate events and common water-borne diseases (WBDs) with the Global Climate Risk Index (GCRI, 1999–2018) in the Southeast Asian countries.
CountryExtreme Climate EventsCommon WBDsGCRISource of Drinking WaterReferences
Brunei DarussalamFloods, sea-level rise, and heat wavesDiarrhea175Surface water (rivers) and tap water[40,41,42,43]
Burma (Myanmar)Floods, cyclones, and droughtsAcute diarrhea, cholera, dysentery, and typhoid2Surface water (rivers and lakes), and groundwater (tube and dug wells)[40,44,45]
CambodiaFloods, droughts, and typhoonsDiarrhea and typhoid12Surface water (rivers), and groundwater (hand-dug wells)[40,46,47]
Timor-LesteFloods and droughtsDiarrhea, cholera, and typhoidndSurface water, spring water, and groundwater[48,49]
IndonesiaTropical cyclones, floods, droughts, and tsunamisDiarrhea, cholera, typhoid, and leptospirosis77Surface water (rivers) and groundwater[40,50,51]
LaosFloods and droughtsDiarrhea and cholera76Surface water (rivers; the Mekong) and groundwater[40,52]
MalaysiaFloods, rainfall-induced landslides, and droughtsCholera and typhoid114Surface water (rivers), tap water, spring water, and groundwater[40,53,54]
The PhilippinesTyphoons, ambient temperatures, heat waves, and floodsCholera, acute bloody diarrhea, and typhoid4Surface water (rivers, lakes, and river basins) and groundwater reservoir[40,44,55,56]
SingaporeSea-level rise, heat waves, and floodsCholera and typhoid (only in rare cases)180Imported water, local catchment area, reclaimed water, and desalinated (purified) water[40,57,58]
ThailandSea-level rise, floods, and droughtsCholera, typhoid, and paratyphoid8Groundwater and surface water (river basins)[40,44,59,60]
VietnamSea-level rise, floods, and droughtsCholera, dysentery, typhoid, and diarrhea6Surface water (rivers; the Red and Mekong rivers) and groundwater[40,44,61,62]
Note(s): nd, not described.
Table 2. Overview of Sustainable Development Goals (SDGs) 3, 6, 11, 13, and 17 and targets related to preventing water-borne diseases (WBDs) impacted by climate change.
Table 2. Overview of Sustainable Development Goals (SDGs) 3, 6, 11, 13, and 17 and targets related to preventing water-borne diseases (WBDs) impacted by climate change.
SDGsThe Interrelationship between the Impacts of Climate Change on WBDs and SDGsSpecific Targets of the SDGs
Water 15 01298 i001Attempt to eradicate WBDs by the end of 2030 and enhance global cooperation to recognize, control, and mitigate local and foreign health risks3.3 and 3.d
Water 15 01298 i002Aim to ensure widespread access to affordable and sanitary drinking water, increase funding for water- and sanitation-related initiatives, such as desalination technology and wastewater treatment methods, and boost engagement of local people by the end of 20306.1, 6.a, and 6.b
Water 15 01298 i003Try to reduce the proportion of fatalities and financial losses caused by water-related diseases, with an emphasis on developing countries, and promote financial and technical help to construct sustainable and sound structures using local materials by the end of 203011.5 and 11.c
Water 15 01298 i004Aim to increase global preparedness for climate-related risks and natural catastrophes and the effectiveness of climate change strategy planning, mitigation, and adaptation (including early warning signs)13.1, 13.2, and 13.3
Water 15 01298 i005Aim to strengthen the global partnership for the SDGs and share information, technology, and financial resources with developing countries and respect each country’s policies and strategies for implementing efforts to eradicate poverty and achieve the SDGs17.15 and 17.16
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.

Share and Cite

MDPI and ACS Style

Jung, Y.-J.; Khant, N.A.; Kim, H.; Namkoong, S. Impact of Climate Change on Waterborne Diseases: Directions towards Sustainability. Water 2023, 15, 1298.

AMA Style

Jung Y-J, Khant NA, Kim H, Namkoong S. Impact of Climate Change on Waterborne Diseases: Directions towards Sustainability. Water. 2023; 15(7):1298.

Chicago/Turabian Style

Jung, Yong-Ju, Naing Aung Khant, Heejung Kim, and Sim Namkoong. 2023. "Impact of Climate Change on Waterborne Diseases: Directions towards Sustainability" Water 15, no. 7: 1298.

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

Article Metrics

Back to TopTop