The Water-Food-Health Nexus; Exploring the Water Foundations of Family to Community to Global Health.

Many people in low-income countries and fragile states struggle to access the foundations of family and community health which we see as a three-way nexus of; access to safe water and sanitation, a sufficient and balanced diet and effective health services. These factors interact with each other to affect personal and community health in different ways mediated by environmental and social factors specific to local and national contexts. Our paper conceptually explores the hydrological foundations of safe water, food and health interactions that underpin individual, community and global health. In doing so we recognise the recursive dynamics of water and sanitation and health (WASH), food and diet systems, climate change, emergent diseases, conflict and freshwater ecosystems degradation, loss of biodiversity and migration.  Outbreaks of Ebola and the COVID-19 pandemic have demonstrated that localised community health problems, and the local freshwater needed to combat them, can emerge and quickly escalate to have global health, economic, social, and political consequences. Therefore, a focus on improving the foundations of health (improved water access, food and nutrition security and health services) in low-income communities (LIC) and fragile or conflict affected states (FCS) not only targets populations in greatest need and most likely to benefit but creates opportunities to strengthen and protect global health.