The tragedy that took place in Bhagirathpura, Indore, a few weeks ago — municipal drinking water became contaminated with sewage, resulting in a widespread outbreak of waterborne disease that killed at least 20 people — had sent shockwaves across the country. While Indore’s crisis stemmed from a clear instance of municipal oversight — the incident undermined public confidence in municipal water systems in a city that has been repeatedly ranked India’s cleanest — it underscored the enormous threat that water-borne diseases pose across India, wherein poor water quality and inadequate sanitation already burden millions. The latest data shared by the Union government in the Rajya Sabha bear the extent of the threat: India has recorded a sharp increase in water-borne diseases over the last five years. Data collected under the Integrated Disease Surveillance Programme show that total Hepatitis A cases surged an astonishing 890%, from 4,089 in 2021 to 40,464 in 2025. Cholera cases rose 421% from 217 to 1,131 in the same period. Similarly, leptospirosis cases jumped from 6,086 to 20,888 cases — a 243% surge — while typhoid cases logged a 191% increase. Hepatitis E, which saw the lowest rise among these diseases, still managed to record a 87% hike. Madhya Pradesh reported the highest number of typhoid cases in the country, followed by Karnataka and Chhattisgarh. Delhi topped in cholera cases, while Kerala logged the highest leptospirosis cases.

Equally worrying is the fact that waterborne infectious diseases, which are primarily transmitted through contaminated water and food, are evolving on account of climate change. Rising temperatures linked to climate change are facilitating the survival, replication and virulence of many such pathogens. While cases of acute diarrhoeal diseases declined from just over six million in 2021 to 2.35 million in 2025, the government data show that heavy rainfall and extreme heat can rapidly reverse such gains. The increasing intensity of the Indian summer and the monsoon in recent years, therefore, exacerbates the risk. Rural areas with scant sanitation infrastructure are especially vulnerable; but Indore has shown that cities are no longer immune either. Compounding the crisis are educational, economic and health inequities. Illness means lost wages, missed school days and mounting debt. Existing government programmes, from the Jal Jeevan Mission, Swachh Bharat Mission to various water, sanitation and hygiene initiatives, aim to improve access to safe drinking water and sanitation. Yet Indore’s experience and the data on the rising incidence of water-borne diseases underline the need for better surveillance, infrastructure investment and climate-adaptive planning.