Worldwide, over one billion people lack access to an adequate water supply; more than twice as many lack basic sanitation. Areas without adequate supplies of freshwater and basic sanitation carry the highest burdens of disease which disproportionately impact children under the age of five. The lack of access to and availability of clean water and sanitation has had devastating effects on many aspects of daily life. While poverty has been a major barrier to gaining access to clean drinking water and sanitation in many parts of the developing world, access to and the availability of clean water is a prerequisite to the sustainable growth and development of communities around the world.

Recognizing water availability, water quality, and sanitation as fundamental issues underlying infectious disease emergence, the Institute of Medicine’s Forum on Microbial Threats held a two-day public workshop in Washington, DC on September 23 and 24, 2008. Through invited presentations and discussions, participants explored global and local connections between water, sanitation, and health; the spectrum of water-related disease transmission processes as they inform intervention design; lessons learned from water-related disease outbreaks; vulnerabilities in water and sanitation infrastructure in both industrialized and developing countries; and opportunities to improve water and sanitation infrastructure so as to reduce the risk of water-related infectious disease.