Beyond Access: Ensuring Water Safety in Arsenic-Affected India

The arsenic crisis underscores the need to move beyond pipes and pumps toward a people-centred approach where safety, transparency, and community participation define India’s water security.

Beyond Scarcity: Rethinking India’s Water Crisis
When we think of water stress in India, we often picture dry riverbeds, erratic monsoons, and over-extraction of groundwater. However, an equally serious crisis flows quietly beneath our feet: contaminated drinking water, particularly due to arsenic. It doesn’t steal attention like a flood or drought, yet its effects ripple across health, productivity, and human dignity, especially in our poorest communities.

While arsenic contamination occurs naturally in many parts of the Indo-Gangetic Plain, its impact is intensified by unsustainable human activities and poor governance. In states like West Bengal, Bihar, Assam, and Uttar Pradesh, where millions of inhabitants already face climate-related vulnerabilities and where groundwater remains the primary source of drinking water, tragically, that source is often laced with poison. Reducing arsenic to safe levels could yield annual economic benefits of over INR700 million, with the poorest households bearing the highest health costs and standing to gain the most from clean water access. When the poorest pay the highest price, isn’t the real question how much longer we can afford to wait?

Arsenic Exposure: a Slow-onset Emergency
Field visits and surveys in high-arsenic states such as West Bengal, Bihar, and Assam reveal a painful reality. People often know their water is unsafe, but have no alternative. Either treated and piped water isn’t available, or it’s too expensive. Some rely on rainwater when they can, others share with luckier neighbours, and many do nothing, resigned to a reality they can’t afford to fix.

The slow, invisible nature of arsenic exposure, unlike the immediacy of a cholera outbreak, means it rarely triggers a quick response. However, experts now argue it’s time to reframe arsenic contamination as a slow-onset disaster, deserving of disaster management-level policy attention. This could unlock new pathways for coordinated governance, funding, and innovation.

A Hidden Poverty Trap 
Arsenic in drinking water doesn’t just harm health; it chips away at household income, one sick day at a time. A detailed field study from arsenic-affected districts in Bihar estimated that, on average, affected families lose INR2,438 per year in wages and spend nearly INR5,942 annually on treatment. That’s a total economic burden of over INR8,380 per family per year, a staggering cost for low-income rural households. Zooming out, the broader annual cost of illness to society in just two districts (Patna and Bhojpur) was pegged at INR266 million (approximately US$5 million). These are real, recurring losses, not just statistics. Money that could have been allocated for school fees or farm investments is instead spent on doctors, medicines, and managing a health crisis that should not exist in the first place. Without factoring in these hidden costs, water policies risk underestimating the actual burden faced by vulnerable communities. In economic terms, arsenic contamination represents a poverty trap.

Families Want Safe Water and Are Willing to Pay
Despite these challenges, people are not passive. In a willingness-to-pay (WTP) study in Bihar, 84 percent of households said they would pay for improved water quality. The average WTP was INR240 annually per household, and even higher among families that had experienced illness or received awareness messages. Importantly, this willingness to pay isn’t just about numbers - it reflects deeper motivations. Families want to protect their children, avoid the stigma of visible illness, and reduce reliance on overburdened public health systems. In many communities, cultural ideas around purity, dignity, and cleanliness also shape perceptions of water safety.

This implies awareness campaigns cannot rely solely on technical facts. They must appeal to emotion, trust, and social systems. Programmes that involve ASHA workers, school-children, or local influencers often see higher uptake because they tap into shared values, not just individual fears.

The Trouble with ARUs
India’s Jal Jeevan Mission aims to supply safe and adequate piped water to every rural household. In arsenic-affected areas — where this rollout is still incomplete — arsenic removal units (ARUs) serve as the interim solution. Unfortunately, many of these units don’t work well or stop functioning over time. A study in Gaighata, West Bengal, evaluated 12 groundwater-based ARUs and found that arsenic removal efficiency ranged from 35 percent to 83 percent. Even after treatment, 16.7 percent of samples still exceeded safety standards. Alarmingly, the cancer risk from arsenic exposure remained unacceptably high in many villages.

By contrast, a surface water treatment plant operated by a local NGO in the same area consistently delivered water within safe limits. This was possible due to a better iron-arsenic ratio in the water source and consistent maintenance. However, the cost of safe delivery via ARUs was estimated at INR286 million, raising questions about the long-term sustainability of such investments.

Transboundary Water, Transboundary Solutions
India’s arsenic crisis reflects a broader regional challenge. In Bangladesh, over 35 million people remain exposed to arsenic — yet the country has made notable progress through low-cost, community-driven interventions, such as colour-coded tubewell mapping, locally adapted filters, and widespread public education. These strategies have significantly reduced exposure in many rural areas. Globally, the World Health Organization (WHO) recommends an arsenic limit of 10 µg/L in drinking water. In India, however, while the Bureau of Indian Standards (BIS) sets the acceptable limit at 10 µg/L, it permits up to 50 µg/L in areas where no alternative source is available. This conditional tolerance reflects ground realities, while also underscoring the urgent need for long-term solutions that make safe water universally accessible.

The arsenic issue is also linked to cross-border aquifers and transboundary water governance, especially in the Indo-Gangetic region, where groundwater systems span across India, Bangladesh, and Nepal. India can benefit from regional collaboration, especially in technology exchange, joint surveillance, and citizen-led monitoring innovations that are already yielding results in neighbouring countries.

What Policymakers Can Do

Conclusion: From Water Access to Water Safety
India has made significant progress in expanding rural drinking water access through initiatives such as the Jal Jeevan Mission. However, access cannot be mistaken for assurance. When the water from a household tap still carries long-term health risks, we haven’t solved the problem; we've only changed its packaging.

Arsenic contamination exposes a deeper issue: the disconnect between infrastructure delivery and water safety. It reminds us that technology, without accountability and community trust, cannot guarantee health outcomes. The impact isn’t abstract; it’s deeply personal — visible in a child’s stunted growth, a family’s recurring medical debt, and a community’s quiet resignation. If we want meaningful, lasting change, we must move from a hardware-centric approach to one rooted in safety, transparency, and participation. This entails monitoring what flows through the pipes, beyond just accounting for quantities. It involves listening to the people who consume that water every day. This is not just about achieving targets. It's about restoring dignity, preventing needless suffering, and ensuring that every citizen, regardless of where they live, can trust the water they drink. A safe glass of water should not be a privilege; it should be the baseline promise of a just and resilient society.

Authors: Prof. Barun Kumar Thakur, Faculty of Economics, FLAME University; & Antara Das, Postdoctoral Research Fellow, FLAME University.