A new Productivity Commission report has urged Australian governments to commit to providing universal access to safe and reliable drinking water, warning that public health depends on it.

The report, National Water Reform 2024, is the result of an inquiry requested by the federal government. It found Australian governments must reform many of the ways water is managed to ensure the current and future wellbeing of our communities, environment and economy.

Australia has an existing strategy for national water reform, known as the National Water Initiative (NWI). It was agreed with the states and territories in 2004.

The Productivity Commission found the initiative has served Australia well throughout the past 20 years, but the challenges of water management are growing. Demand for water is increasing and changing. Climate change is making rainfall less reliable as a water source.

An updated National Water Initiative will help governments navigate these challenges.

The report urges a greater focus on water service provision that is “effective, equitable and efficient”. That requires good management. The report highlights the concept of a basic level of service, requiring all governments to commit to providing universal access to a safe and reliable supply of drinking water.

Why doesn’t everyone have a safe water supply?

Most Australians already enjoy very safe and reliable drinking water services. However, some communities don’t. Many small and remote communities, many of which have high Indigenous populations, have poor drinking water quality.

A December 2023 review looked at water quality trends in remote Australian communities. It highlighted contaminants in the water as a concern.

Very high levels of contaminants in source water are leading to levels that exceed thresholds set by the Australian Drinking Water Guidelines. Excessive hardness, turbidity, fluoride, iron and manganese levels are found in communities with limited treatment facilities.

Other communities have poorly maintained bores or groundwater. These are often vulnerable to runoff pollution from livestock. This exposes communities to risks of infection by bacteria and other pathogens, causing gastrointestinal diseases.

Inadequate water quality and quantity are harming the health of remote communities, particularly among Indigenous populations. Poor-tasting or visually unappealing drinking water may cause them to drink sugary beverages instead.

Water safety is still an issue for bigger communities

In contrast, water quality in Australia’s larger towns and cities is generally very high. But excellent levels of safety are not universal.

The safety of a water supply is not defined only by historical water quality. Safety also encompasses the likelihood and consequences of future incidents.

Some scenarios may be viewed as “an accident waiting to happen”. Even where water quality has historically been excellent, accidents do happen. The consequences can be significant if adequate measures are not in place to manage them. Important preventive measures include strict management of drinking water catchments, application of multiple independent water treatment processes, comprehensive monitoring of these processes, and effective incident response procedures.

In major cities of highly developed countries, water quality incidents tend to occur when something goes seriously wrong. There have been significant waterborne disease outbreaks in:

• New Zealand, caused by a bacterial infection, campylobacteriosis

• the United States, caused by the parasite Cryptosporidium

• Canada, caused by E. coli and Campylobacter jejuni bacteria

• the United Kingdom, caused by Cryptosporidium

• Norway, caused by Campylobacter bacteria.

What are the lessons for Australia?

Often, these incidents involve an element of human error. The risks are greater when skills and training have been neglected. Earlier this year, the Water Services Association of Australia highlighted inadequacies in skills and training for water supply operators.

Many of Australia’s drinking water supplies are also vulnerable to extreme weather conditions. Heatwaves, droughts, bushfires, cyclones and floods can all threaten drinking water supplies.

Climate change is projected to increase the frequency and severity of many types of extreme weather events. This means the risk of water quality incidents in our towns and cities is set to grow.

How do we pay for a safe supply?

Another important aspect of providing universal access is affordability. If improved services mean customers can no longer afford to pay their water bills, they will not be any better off.

This need for affordability is often what really limits our ability to improve water quality and safety. A technical solution to practically any water quality problem is available, but someone has to pay for it. The question of how we pay for water quality improvements needs to be considered further.

Our capital cities generally apply the concept of “postage stamp pricing”. All customers pay the same rates for their drinking water, even though some customers cost much more to service than others. But this cross-subsidisation between customers is limited in states where local councils, rather than larger state-wide entities, supply water for regional towns and remote communities.

All stages of the supply chain matter

The reforms needed to ensure universal access to safe and reliable drinking water also include institutional improvements. The Productivity Commission found there’s a need to ensure the separation of policy setting, service delivery and regulation, each with clearly defined roles.

Water service providers should have incentives to be efficient and innovative, and to deliver services in cost-effective ways that are in their customers’ interests.

For long-term success, Australian governments must establish and maintain processes that ensure water infrastructure developments and refurbishments are ecologically sustainable, economically viable and culturally responsive. If these wider impacts are overlooked, improvements in drinking water quality and safety will be short-lived and come at a high price.

Stuart Khan, Professor and Head of School of Civil Engineering, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

The genetic risk of developing Alzheimer’s disease is more strongly influenced by the mother’s side than the father’s side, a recent study has discovered.

Alzheimer’s disease steals memories, independence and the capacity to connect with loved ones. In 2020, over 55 million people worldwide were living with dementia. Alzheimer’s disease is the most common form of dementia, accounting for 60-70% of all dementias.

It’s expected the number of people affected by dementia will nearly double every 20 years. Finding ways to better diagnose, treat and even prevent dementia is more important than ever. This latest study could provide a useful target for researchers hoping to develop new therapies.

The study, published in JAMA Neurology, showed that people whose mother had a history of memory loss had a greater risk of developing Alzheimer’s disease at any age when compared to people with only a paternal history of memory loss (or no family history of memory loss whatsoever). However, if a person’s father had early-onset memory loss (occurring before the age of 65), they also had a greater risk of Alzheimer’s disease.

The study analysed data from 4,413 people aged 65 to 85 who had no issues with cognitive function or memory problems. The study’s large sample size is a key strength, making for a more accurate interpretation of the findings compared to previous research. But it’s important to note it’s not a complete representation of the population, as most participants were white – so results may differ in other ethnicities.

The participants were part of the Anti-Amyloid Treatment in Asymptomatic Alzheimer study, which is a phase 3 clinical trial investigating a drug researchers hope will slow the progression of memory problems. The participants’ cognitive function was measured using questions from the widely used mini-mental state examination.

Positron emission tomography (PET) imaging was also used to scan their brains for markers of Alzheimer’s disease and determine their risk of developing it.

The researchers were mainly looking for the presence of amyloid plaques, which are one of two hallmarks of Alzheimer’s disease. These toxic amyloid plaques form when protein pieces, called beta-amyloid, clump together.

The hypothesis is that these clumped amyloid plaques are the prime suspects in damaging and killing brain cells (neurons), resulting in Alzheimer’s disease. The second hallmark of Alzheimer’s is the protein tau, which wasn’t assessed in this study.

The accumulation of beta-amyloid is thought to be a prominent precursor of Alzheimer’s disease, as people can have raised amyloid levels years before memory problems start.

The results of the PET scans showed that participants whose mother had a history of memory impairment (regardless of the age her memory problems started) had higher beta-amyloid levels. The amyloid levels were significantly higher on average in those with maternal history than paternal history of memory impairment.

Participants whose fathers had early-onset memory loss (occurring before 65) also had higher beta-amyloid levels. In comparison, participants who only had a paternal history of late-onset memory impairment (happening after 65 years of age), and those who had no family history of memory loss, had normal beta-amyloid levels.

The reason for this link is not completely understood.

One suggestion from the researchers is mitochondria dysfunction. Mitochondria are energy-providing structures inside our cells. These are only inherited from the mother’s side. Mitochondria possess their own DNA, which may include mutations that cause them to malfunction. Previous research has already demonstrated mitochondria dysfunction is associated with Alzheimer’s disease.

The brain is an energy-hungry organ, taking up about 20% of the body’s energy. So it’s unsurprising that dysfunction in mitochondria could lead to cognitive impairment – and potentially Alzheimer’s disease.

Developing treatments

This study builds on previous, smaller studies which have investigated the role genetics play in Alzheimer’s disease. Since these studies only had small sample sizes, they lacked the statistical power to draw strong conclusions. This study’s much larger sample size allowed for stronger conclusions and reaffirmations on the importance of maternal genetics to be made.

The key message from the study is that a person’s risk for Alzheimer’s disease could depend on whether they inherit it from their mother or father, as well as their parent’s age when memory loss began. As such, considering gender-specific parental history could be fundamental in identifying those at greatest risk of Alzheimer’s.

In light of these findings, next steps could be to determine whether the DNA from the mother – specifically the X chromosome itself – influences the disease’s development. If it does play a role, then researchers may have a better target for treatment.

And given mitochondria are inherited from the mother’s side, researchers may also want to further investigate the mitochondria dysfunction theory to better understand if this explains why people are at greater risk of developing Alzheimer’s disease if their mother had memory problems.

This latest study confirms the critical role that genetics play in the development of Alzheimer’s disease. But it isn’t the only risk factor. Many modifiable risk factors – such as diabetes, high blood pressure, cardiovascular disease and poor diet – are also known to be massive contributors to developing the disease.

Rahul Sidhu, PhD Candidate, Neuroscience, University of Sheffield

This article is republished from The Conversation under a Creative Commons license. Read the original article.