Polio’s Last Mile Starts with Global Action on Water

By H.E. Abdulla Balalaa, UAE Assistant Minister of Foreign Affairs for Energy and Sustainability

For decades, the global effort to eradicate polio has been one of public health's greatest success stories. Since 1988, cases of wild poliovirus have fallen by more than 99 percent. Vaccination, surveillance, and community outreach have transformed what was once a global threat into a disease that is now within reach of eradication.

However, as anyone who may have run a marathon before knows, the last mile is often the most difficult, both physically and mentally. Running towards the finish line requires resilience, tenacity, and unwavering self-belief. This is the type of focus and dedication that we need to sustain as the race to eradicate polio reaches its end game.

As we work together to finish the job, we also need to think beyond the vaccine itself to the systems that may inadvertently enable transmission - and one of those critical systems is water.

Polio can spread through contaminated water and food, making safe water and sanitation an important part of preventing transmission. To make progress permanent, we need to reduce the conditions in which the virus can circulate.

This is not about choosing between vaccines and water; instead, it is the understanding that health and water are part of the same equation. Disease prevention begins long before a child falls ill and visits a clinic – it begins with the water coming into the home and the systems carrying waste.

Today, 2.1 billion people still lack safely managed drinking water and 3.4 billion lack safely managed sanitation. More alarmingly, 1.7 billion people still rely on drinking-water sources contaminated with feces, with The World Health Organization estimating that inadequate water, sanitation, and hygiene (WASH) contributes to at least 1.4 million preventable deaths each year.

While these numbers are staggering, behind every statistic is something much more heart-wrenching: a child who should not have to get sick from the water they drink.

This is also where water presents one of the greatest opportunities to bolster global health.

We have traditionally thought of water infrastructure as something that delivers a basic service. Increasingly, we need to regard water infrastructure as preventive health infrastructure.

Clean water can prevent disease before it begins. Safe sanitation can break chains of transmission. Wastewater systems can tell us where pathogens are circulating. By studying both the presence as well as volume of pathogens present in wastewater, we can more closely track the movement of various diseases. Digital technologies and AI are also helping us identify risks earlier and monitor any uptick in concentrations in real time. Together, all of these mechanisms are enabling governments to evolve from responding to outbreaks to anticipating them.

Ultimately, water can become one of the world's most powerful early-warning and disease-prevention systems.

The UAE has seen the power of this approach through its own commitments to the last mile. For many years, the UAE and His Highness Sheikh Mohamed bin Zayed Al Nahyan have worked with The Gates Foundation and global partners to accelerate the eradication of polio as well as the elimination of neglected tropical diseases. For example, the Reaching the Last Mile Fund, established by the UAE and the Gates Foundation, is now working across dozens of countries to accelerate the elimination of diseases that disproportionately affect people living in poverty.

Together with our partners, our shared focus is on reaching some of the world's most underserved communities, particularly children living in areas where geography or insecurity can make access to healthcare extraordinarily difficult. The UAE’s commitment has never been simply about delivering vaccines – it has been about reaching the child who might otherwise be missed.

This is also the philosophy behind Reaching the Last Mile: if the hardest communities are the ones most at risk, they cannot be the ones we leave until last.

The last mile is not simply where the work is hardest – it is where investment can change the most lives.

That same thinking should equally be applied to water, because the opportunity with water is tremendous.

What if wastewater networks could detect a pathogen before a doctor sees a patient? What if AI can identify a developing public health risk, allowing communities the chance to act earlier? Imagine communities gaining access to safe water and sanitation while simultaneously strengthening their resilience to infectious diseases.

Much of this is already in process. Wastewater surveillance has become an important tool in the fight against polio because the virus can be detected in wastewater even when no cases of paralysis are being reported.

In Abu Dhabi, AI-enabled wastewater surveillance serves as an early detection system, able to identify potential public health risks and inform earlier intervention. In 2025, the European Commission unveiled the European Wastewater Surveillance Dashboard, a tool designed to track the spread of infectious diseases across Europe through wastewater monitoring and analysis.

This is the future we should be building towards: water systems that do more than move water. Water systems that help us see, predict, and prevent disease.

The same infrastructure that protects communities from poliovirus can help address other waterborne diseases. The same wastewater systems that detect one pathogen can potentially help identify others. The same investments in sanitation that improve public health can strengthen climate resilience, support economic development, and improve quality of life.

This is why water should no longer be seen only through the lens of scarcity. In fact, water is an opportunity: an opportunity to save lives, strengthen economies, and build healthier, more resilient communities.

And more must be done to bridge the divide between health and water policy. Too often, these sectors operate independently despite pursuing many of the same outcomes. We need greater collaboration, more integrated investment, and a shared understanding that progress in one area often depends on progress in the other.

This is the ethos underpinning the upcoming 2026 UN Water Conference. Taking place in Abu Dhabi, the Conference will bring the world together to accelerate action on Sustainable Development Goal 6 – ensuring the availability and sustainable management of water and sanitation for all.

And our ambition extends beyond accelerating access - we are envisioning a new world of possibility with water. This must be underpinned by a shared recognition of water as the critical thread connecting everything and everyone, from disease prevention to public health systems. It is about powering a new future and unlocking the value in the world’s water systems through innovation, collaboration, and financing in water infrastructure.

To achieve this, governments, philanthropies, development institutions, and the private sector must work together to bring vital solutions to the communities that need them most.

The global collaborations on the last mile of polio give us reason to believe that progress is possible. We should bring the same determination to the systems that make that progress sustainable. We have an opportunity now to apply that mindset to water, because the future of water is not only about securing a resource; it is about protecting people.

And if we get this right, the water flowing through a community tomorrow will do more than keep people healthy.

It will help us know when they are at risk, act before they become sick, and give the next generation something that should never have been out of reach: the chance to grow up healthy, safe, and free from preventable disease.