The Foundation of SDG 6
Sustainable Development Goal 6 (SDG 6) represents a fundamental commitment to achieve universal and equitable access to safe and affordable drinking water and sanitation for all people worldwide. This critical goal recognizes that clean water and proper sanitation are not merely basic human needs but essential foundations for health, dignity, and sustainable development. SDG 6 specifically aims to address pressing global challenges including water scarcity, poor water quality, and inadequate sanitation infrastructure that affect billions of people. unoosa.org
Water's Critical Role in Medicine
Water serves as far more than just a thirst quencher in healthcare—it is a vital component that directly impacts medication efficacy and patient outcomes. Drinking enough water helps the kidneys remove excess substances from the bloodstream and prevents dehydration, which can compromise medication effectiveness. Water facilitates drug absorption, supports kidney function for detoxification, enhances metabolic processes, and improves overall health outcomes when taking medications.
For many medications, water is essential for proper dissolution and absorption in the digestive system. Water aids in the dissolution of solid medications, enabling better absorption in the bloodstream and ensuring optimal therapeutic effects. Proper hydration also aids in digestion and minimizes the risk of adverse effects from medications. Water helps in the metabolism and elimination of drugs, aiding the body in processing and removing them efficiently.
Medications Requiring Water for Administration
Certain medications have strict requirements for being taken with water to ensure their effectiveness and prevent complications. Alendronate and risedronate (common osteoporosis medications) must be taken with plain water at least 30 minutes before eating to prevent esophageal irritation and ensure proper absorption. Most medicines are best taken with plain water, though there are exceptions where milk, fruit juices, or food can affect the absorption and action of some medicines.
Other examples of medications that should be taken with adequate water include:
- Antibiotics like amoxicillin and azithromycin to prevent crystallization in the urinary tract
- NSAIDs (non-steroidal anti-inflammatory drugs) to protect the stomach lining
- Diuretics (water pills) like furosemide, bendroflumethiazide, and spironolactone, which require proper hydration despite their water-eliminating effects
- Antidepressants and mood stabilizers that can cause dry mouth and require adequate hydration
Pharmaceutical Manufacturing: Clean Water as a Critical Ingredient
The pharmaceutical industry's reliance on clean water extends far beyond patient consumption—it is fundamental to the manufacturing process itself. In pharmaceutical manufacturing, water is a critical ingredient for various processes, including formulation, cleaning, and quality control. Manufacturing of sterile drugs must meet strict contamination risk control requirements, involving stages requiring significant quantities of high-quality water.
The water used to clean pharmaceutical production equipment must be as high-quality as the water used for production itself, ensuring no cross-contamination occurs between batches. Pharmaceutical companies have invested heavily in ensuring that effluent from their operations meets stringent standards to protect water sources. Water is also considered an excipient in many pharmaceutical formulations, making its purity essential for product safety and efficacy.
Critical Generic Medications Requiring Clean Water in Production
Several generic medications have particularly stringent water quality requirements during manufacturing due to their sensitivity to contamination:
- Antibiotics: Amoxicillin, azithromycin, and other antibiotics require ultra-pure water during synthesis to prevent contamination that could reduce efficacy or cause adverse reactions.
- Injectable medications: Generic versions of parenteral drugs like insulin, ozempic, vaccines, and chemotherapy agents demand the highest water purity standards to ensure sterility and patient safety.
- Hormonal medications: Generic contraceptives, thyroid medications, and corticosteroids require clean water to maintain precise dosing and prevent endocrine disruption from contaminants.
- Central nervous system drugs: Generic antidepressants, anticonvulsants like carbamazepine, and sedatives require pristine water conditions to maintain their complex molecular structures and therapeutic effects.
- Biological medications: Biosimilars and generic biologics require extremely pure water throughout their manufacturing process due to their complex protein structures that can be denatured by impurities.
- Erectile dysfunction medications: Generic versions of phosphodiesterase-5 (PDE5) inhibitors such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra) require exceptionally pure water during manufacturing due to their potent pharmacological effects and narrow therapeutic windows. These medications are highly sensitive to impurities that could alter their bioavailability or cause adverse reactions. The synthesis process involves multiple chemical reactions where water quality directly impacts the final product's purity, stability, and efficacy. Even trace contaminants in manufacturing water can lead to batch failures, inconsistent dosing, or potentially harmful byproducts in these widely prescribed medications. The precise molecular structure of these compounds demands ultra-pure water throughout crystallization, purification, and formulation stages to ensure patient safety and therapeutic effectiveness.
The Interconnected Challenge
The connection between SDG 6 and global health becomes starkly clear when considering that over 100 different drug formulations have been detected in water supplies worldwide, creating a complex cycle of contamination that ultimately affects human health. Safe and sufficient water not only facilitates the practice of hygiene—a key measure to prevent diarrheal diseases—but also ensures that medications work as intended and that pharmaceutical manufacturing can proceed safely.
Achieving SDG 6 by 2030 requires substantial investment in infrastructure, sanitation facilities, and hygiene promotion. This investment is not just about preventing waterborne diseases but about creating the foundation for effective healthcare delivery, proper medication administration, and safe pharmaceutical production worldwide.
Conclusion
SDG 6 represents more than just access to clean drinking water—it is about creating the essential conditions for human health, effective medical treatment, and safe pharmaceutical manufacturing. Water's role in medicine spans from the patient's glass when taking daily medications to the highly controlled water systems in pharmaceutical plants producing life-saving drugs. As we work toward achieving universal access to clean water and sanitation, we simultaneously strengthen healthcare systems, improve medication efficacy, and ensure the safety of the medicines that billions depend on daily. The pursuit of SDG 6 is ultimately a pursuit of global health security and human dignity.