In 2012, hospitals in New Delhi cancelled surgeries because they had no water to sterilize instruments, clean operating theatres or even wash their hands. Malls selling luxury brands were forced to switch off air conditioning and shut toilets. In Pakistan that year, Gwadar ran out of water entirely, forcing the government to send naval water tankers to relieve the port town.

Those problems are not going away. They present a microcosm for what is to come across all of the South Asian region. Asia’s potential rise as the center of the global economy is in danger of being circumscribed by the need for water, particularly as climate change is affecting the Tibetan plateau, where most of that water originates. At the same time, China is building or planning 28 dams on the Salween, the Mekong, the Brahmaputra and the Jinsha rivers, diverting waters from those rivers to China. There have been widespread calls for India to galvanize the support of its neighbors, particularly Nepal, Bhutan and Bangladesh to prevent Beijing from going through with plans for large-scale diversions that could affect water security across the entire South Asian region.

The shortfall, particularly in South Asia, is being exacerbated by population growth, industrialization, mismanagement and lack of cooperation among the riparian states. The region hosts major international watercourses including the Indus, the Ganges and the Brahmaputra, which both provide and hinder the way for easing the availability of fresh water.

Four countries in South Asia – Bangladesh, India, Nepal and Pakistan—cover 3.26 percent of the world's surface area and are home to about 21 percent of the world population. But they possess only 6.8 percent of the world’s replenishable water.

Against a world average of 7,000 cubic meters, South Asia’s per capita availability of water in 1995 was only 2,665 cu m indicating a further possible future shortfall. And while the South Asian countries have taken initiatives to cooperate in development and management of water resources, serious issues and disputes in this sector are continuing, adding weight to the American humorist Mark Twain’s observation that whiskey is for drinking, water is for fighting.

Although South Asia as a whole is expected to have a surplus of 2,737 billion cubic meters by 2025. the distribution is not even. Among the four countries, Pakistan, for instance, will have a shortfall of 102 billion cu m by that time.

That doesn’t mean other countries will have abundant water for consumption and other uses. High population growth rates, industrialization and lack of effective management of available water have and are continuously adding to the increasing problems. The region is one of the world's most water-stressed, yet the population is adding an extra 25 million people a year. South Asia's per capita water availability has dropped by 70 percent since 1950, according to the Asian Development Bank.

Small wonder, then, if there is any single issue that mars bilateral relations among the countries of South Asia, it is water. By 2025, these four states are expected to require a cumulative 1618.9 billion cu m of water annually, almost double their current 866 billion annual cu m. It is uncertain how demand will be met. The following table shows the countries’ current and projected use:

Country Area (sq. km.) Population (million)* Average Annual Water Potential (BCM) Present Use of Water (BCM/year) Projected Demand in 2025 (BCM) Bangladesh 1,47,570 149.7 373 40 161 India 32,87,240 1210 1870 629 1060 Nepal 1,47,181 26.49 237 39 60 Pakistan 8,03,940 177.1 236 158 337.9 Total 43,85,931 1563.29 2716 866 1618.9

Will the individual countries be able to arrive at a mutually agreeable management agreement? Will they be able to survive without enough water available to meet the needs of their ever growing population? The situation demands immediate attention. However, South Asia’s political realities tend to defy any such arrangement on mutually agreeable basis, making the lives of common people, the have-nots, extremely difficult.

Some reports estimate, 21 percent of communicable diseases in India are due to polluted water. As far as Bangladesh is concerned, the World Health Organization estimates that that while 97 percent of the people have access to water, only 40 percent have proper sanitation. With a staggering 60 percent of the population forced to endure unsafe drinking water, the nation is in danger.

Not only is the potable water limited but groundwater, which is used by nearly 90 percent of the population, is contaminated with arsenic. According to the WHO, the levels of arsenic have contributed to the largest mass poisoning in history, affecting an estimated 30-35 million people in Bangladesh. Exposure to arsenic can cause cancer and severely damage many integral systems in the human body. Arsenic has been shown to be the cause of death for one out of every five of Bangladeshis.

The case of Nepal is worse. According to the Department of Water Supply and Sewerage in Nepal, even though an estimated 80 percent of the total population has access to drinking water, it is far from safe. It is for this reason that many water-borne diseases can be found in the people of Nepal, as only 27 percent of the population has access to basic sanitation.

These issues need to addressed, and they can be. The question is how the individual states can settle them without involving too much of politics. Unfortunately, if political history is any guide, it predicts a difficult situation for cooperation. However, geographical configuration of water resources in the region is such that he states are being forced into a scenario wherein co-operation cannot simply be set aside.

For example, Bangladesh and India share 54 rivers, including the Ganges, the Brahmaputra and the Meghna. The 1996 agreement on Farakka Barrage, which diverts about 10 percent of the Ganges to the Hooghly River to flush sediment from the Koklata Harbor, is an example of such cooperation.

However, a problematic issue between Bangladesh and India is India’s major river-linking project. India has announced the project, which would divert water from “water-surplus areas” to “water-deficit areas.” Bangladesh has opposed this program tooth and nail because it would reduce the flow of water in parts of the rivers flowing inside her territory.

Water-rivalry between India and Pakistan plays a major role in all problems, including the Kashmir issue. Kashmir is important for both states just because of the fact that many major rivers that irrigate fields in India and Pakistan originate from Kashmir, and as such control over the flow of water can be translated into a potential power element. Although the Indus Water Treaty, concluded in 1960, did provide a regulatory and a water sharing formula, both states still continue to contest each other’s claims over different projects.

Notwithstanding disputes and conflicts, the fact that this treaty has survived three wars stands out as a welcome example of the possibility of cooperation between states which can not only be enhanced, given the water-short future the people of the region await, but also could be replicated wherever necessary. To make this and other such treaties more functional and less disputable, it would not be an exaggeration to suggest that other regional countries must be included in them. Many countries in South Asia dependent upon water of the shared rivers—those that originate from one country and flow into another. Such a complex geographical configuration demands co-operation at the highest levels of government.

Wars or lack of co-operation would only exacerbate the already fragile state of affairs. Only by negotiating and re-negotiating can this water-short future be averted and the bad omens for the “Asian Century” be changed.

Salman Rafi Sheikh is a Pakistani academic and regular contributor to Asia Sentinel