Although, water fever is high in the country these days due to sustained interest being taken by the Apex Court but there are other avenues than just the ‘dam’ where focus must be diverted as well.First, the tap water, which was abundant and safe to drink a few decades ago, has become unfit for drinking and is likely to become unavailable in the next few years. How the luxury of bottled water has been made a necessity, pivoting on ‘poor water quality’ or unavailability in a generation’s lifetime has been a marvel to watch in the land of the pure. The political economy of water explainsa great deal of the government inertia to conserve surface and sub-surface water resources. Imposition of taxes and stricter laws on water launderers such as bottled water companies, industrialists and municipal authorities may better serve the purpose of future proofing our water resources than anything else.Second, Pakistan has one of the most elaborate water management regimes in the world, only to achieve diminishing supply of water for irrigation and deteriorating water quality for potable use. This is because, not only the abstraction of groundwater resources for agricultural use and human consumption is going on unrestricted but the untreated municipal, agricultural and industrial wastewater is being discharged in the rivers and water bodies at the same time. For instance, the River Ravi receives 55-60 percent of its pollution load from Lahore, which dumps its untreated wastewater into it through nine major drains. As the river meanders to escape the cityscape, it becomes biologically dead and a travesty of what it used to be a few decades ago. The good news is that this is not a unique situation. Rivers like Thames, Seine, Rhine and Danube faced a similar situation in 18th and 19th Centuries whereas, Yamuna and Bagmati Rivers are currently doing the same. The bad news is that we don’t have enough popular support or political capital in Pakistan to push the concerned agencies into action.Rivers have nourished and flourished big cities and great civilizations across history and geography. Unfortunately, cities send them huge quantities of wastewater in turn, without treatment or even proper monitoring. According to the UN, somewhere around 1,000 km3 of municipal and industrial wastewater per year is being put in oceans, rivers and other water bodies around the world, 80 percent of which is released without treatment. In Pakistan, only 1 percent of the wastewater is treated before draining in rivers. According to the World Bank, the poor sanitation and wastewater management in Pakistan cost 3.9 percent of GDP in 2006, of which about 90.0 percent was health related. Punjab Growth Strategy claimed that as of 2015, more than 50 percent of all reported diseases in Punjab were waterborne.Engineering solutions to wastewater treatment are generally capital intensive both in terms of installation and operation & maintenance. Moreover, they require advanced skills for their smooth and continuous running. That’s why, Water and Sanitation Agencies and industry owners in Pakistan have always shied away from installing conventional wastewater treatment plants. To address these cost and capacity issues, some cities of the world are looking for alternative or mixed approaches for treating their wastewater. For instance, the city of Binan in Philippines uses a nature-based technology for wastewater treatment, comprising of plants, microorganisms, biofilms, and engineered media, which substantially reduces energy demand for its operations and produces less sludge compared to conventional technologies. In India, the City of Kolkata has long been using constructed wetlands to treat virtually all of its wastewater and produce livelihood for fish farmers without any additional cost. These wetlands help recharge groundwater as well and are managed by the fish farmers themselves.“Innovative solutions for wastewater treatment such as cleaner production, distributed wastewater treatment, and nature based treatment technologies will certainly help improve water quality, recharge groundwater and reduce the health and economic costs of the communities”, says Dr Asif Riaz who is a Wastewater Management Specialist and has worked on design and engineering of nature-based treatment plants of various capacities in Pakistan. It is time to use an integrated approach by combining water and health economics and take bold decisions that go beyond the parochialism of a typical five-year political stint in officeFinally, the water systems improvement makes a strong economic sense and leads to massive reduction in household and government expenditures on community health as well. According to UN, every dollar invested in this sector generates up to eight dollars in benefits.The incumbent government in Pakistan led by PTI has been promising to invest in health and education sectors but as per initial plans exhibited by the top leadership, most of the expenditures, if accrued, would be on the clinical side including establishment of hospitals and provision of medicines than on preventive side of healthcare system that includes water quality improvement, water infrastructure development and wastewater treatment.It is time to use an integrated approach by combining water and health economics and take bold decisions that go beyond the parochialism of a typical five-year political stint in office.The writer works as a Communication Specialist in River Ravi Revitalization Project and can be reached at firstname.lastname@example.orgPublished in Daily Times, November 9th 2018.