Completed Public Health & Healthcare

Health and economic benefits of water-sensitive revitalisation in informal urban settlements

In plain English

AI plain-English summary

A quarter of the world’s urban population lives in informal settlements where conventional piped water and sewerage networks rarely reach. The standard “big pipes” solution—centralised, underground infrastructure—has barely changed since the Victorian era, costs billions, and routinely bypasses these communities. This project will test whether a radically different approach, called water-sensitive design, can work in the developing world. Instead of burying pipes, this method uses decentralised, climate-adapted systems that manage the entire water cycle on site—capturing rainwater, treating wastewater locally, and integrating green spaces to reduce flooding and improve sanitation. The researchers will roll out these systems across 24 settlements in Makassar, Indonesia, and Suva, Fiji, collecting the first hard public health and environmental data on their effects. If the approach proves effective, it could reshape how international development banks and governments invest in urban water infrastructure across Asia-Pacific and beyond. The findings would shift policy away from expensive, centralised networks toward flexible, incremental upgrades that can adapt to future technologies and climate pressures—quietly changing the systems that keep rapidly growing cities running.

View original technical description
Urbanisation is a major demographic trend globally. Informal settlements account for much urban growth, exacerbating the inextricably linked challenges of sanitation, water provision, and public health. The conventional ‘big pipes’ solution to these challenges has changed little in 150 years, comes at major financial, environmental, and social costs, and frequently overlooks informal settlements. We have pioneered an alternative, water-sensitive approach that integrates sustainable design with the management of the water-cycle, benefiting human health and urban ecosystems. This decentralised, climate-change sensitive approach provides financial flexibility for multistage developments and adaptability to future technologies. It promises a solution to the water services challenges of informal settlements, yet has only been demonstrated in developed world settings. We will examine whether the water-sensitive approach can be applied to revitalise developing-world informal settlements to improve environmental and public health outcomes. Our evidence-based assessment of its efficacy across 24 settlements, poorly served by water infrastructure in Makassar and Suva, will deliver the first public health and environmental data on the benefits and risks of water-sensitive approaches. Our scientific, economic and implementation findings will provide the basis for profound changes to infrastructure policies, investments, loan strategies, and their sustainability across the Asia-Pacific and the developing world.

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Researchers

Ana Deletic (EPMC Awardee)Andrew Forbes (EPMC Awardee)Bruce Cahan (EPMC Awardee)Daniel Reidpath (EPMC Awardee)David Johnston (EPMC Awardee)David McCarthy (EPMC Awardee)Diego Ramirez-Lovering (EPMC Awardee)Julie Simpson (EPMC Awardee)Karin Leder (EPMC Awardee)Mohamed El-Sioufi (EPMC Awardee)Pascale Allotey (EPMC Awardee)Rebekah Brown (EPMC Awardee)Stephen Luby (EPMC Awardee)Steven Chown (EPMC Awardee)Thomas Clasen (EPMC Awardee)Tony Wong (EPMC Awardee)

Related Research

Grants with similar aims, by meaning.

Health and economic benefits of environmentally sensitive water-cycle management in informal urban settlements
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Sustaining groundwater safety in peri-urban areas
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Improving hygiene and safety in informal vegetable value chains in Low- and Middle- Income Communities (LMICs).

Original classification

Our Planet, Our Health Programme Grant

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