Picture: A schoolgirl in rural Kenya using a piece of a water bottle for sunglasses
Photo taken by the author in 2011 in southern Kenya (close to the border with Tanzania) 

The article in Nature Sustainability is here: go.nature.com/2zR5vfH

The increasing use of bottled water in low- and middle-income countries (LMICs) first caught my attention in the context of 2013/14 collaborative research project focused on drinking water in rural China. The proportion of households who reported using bottled water (34%) was much higher than I expected, not least because this was a relatively poor area of rural China (with an average reported annual income of USD 900 at the time)¹.

Later, while preparing a conference presentation about this research, I came across an article in the Bottled Water Reporter magazine which summarized global consumption trends. I was struck by a few things: first, more than half of the top-ten bottled water consuming countries were LMICs; second, this appeared to be a relatively recent phenomenon; and third, a large-font, stand-alone sentence which proclaimed that bottled water is “...a partial solution to the problem of often-unsafe water...” in many LMICs (full quote and citation in our article).

I discussed this with Professor Isha Ray, my co-author on this article, and we reflected that we had both seen signs of increasing bottled water use in urban and rural areas of LMICs for many years (e.g., during field work Isha conducted in rural Mexico in 2006). Reflecting further, we were particularly struck by how little attention bottled water use was receiving in the water, sanitation, and hygiene literature.

To try and get a better understanding of these global trends, I searched for comprehensive data on bottled water use, only to find that such data exists chiefly in for-purchase market research reports. As such, I searched for every available issue of the Bottled Water Reporter which provided annual summary statistics, and then compiled and graphically summarized 10+ years of these data (see the Supplementary Dataset which accompanies our article).

With a clearer picture of the rapid rise of bottled water use in large LMICs, Isha and I felt an obligation to try and raise awareness of the ramifications we believe this shift will have for LMIC water utilities and, by extension, the global goal of achieving “safe water for all”. While our article is focused on LMICs, similar dynamics also exist in regions of some high-income countries. In parts of Appalachia in the USA, for example, tens of thousands of people live without safe piped water or indoor plumbing – for many, reliance on bottled water has become the norm^2,3.

We hope this article will help stimulate much-needed discussion on the policy actions needed to forestall the threats we believe this trend poses for the expansion of safe and affordable drinking water access, environmental health, and social equity more broadly.

1   Cohen, A. et al. Microbiological Evaluation of Household Drinking Water Treatment in Rural China Shows Benefits of Electric Kettles: A Cross-Sectional Study. PLoS ONE 10, e0138451, doi:10.1371/journal.pone.0138451 (2015).
2   Krometis, L.-A. et al. Environmental health disparities in the Central Appalachian region of the United States. Reviews on Environmental Health 32, 253, doi:10.1515/reveh-2017-0012 (2017).
3   McSpirit, S. & Reid, C. Residents' Perceptions of Tap Water and Decisions to Purchase Bottled Water: A Survey Analysis from the Appalachian, Big Sandy Coal Mining Region of West Virginia. Society & Natural Resources 24, 511-520, doi:10.1080/08941920903401432 (2011).