When municipal tap water turns toxic, it briefly shocks the public conscience, but the subject soon slips back into obscurity. What happened in Indore’s Bhagirathpura in December 2025, where contaminated water led to the hospitalisation of over 1,000 residents and the deaths of at least ten, appears to be a sudden systemic breakdown. It is not.Unlike Delhi’s winter air pollution – seasonal, measurable and headline-grabbing – unsafe drinking water has no recurring moment of reckoning. Contamination surfaces episodically through outbreaks, hospitalisations and deaths, before disappearing from public and political attention. This intermittent visibility shapes the response: reactive, short-term, and event-driven. Over time, it produces a structural lag in addressing the problem at its roots.The Indore incident illustrates this clearly. Residents reported foul-smelling and discoloured water for months. A major water pipeline ran beneath a public toilet, an obvious public health hazard. Leakages were known, samples had failed tests, and responses were delayed. What unfolded was not an accident, but the outcome of ignoring risks that were visible, reported, and normalised.Similar patterns recur across cities. In Delhi, a CAG performance audit of the Delhi Jal Board (DJB) for the period 2017-18 to 2021-22, tabled in March 2026, found that 55% of drinking water samples were unsafe for consumption. DJB tested only 12 parameters, far below the 43 mandated by the Bureau of Indian Standards (IS 10500:2012), omitting key checks for toxic substances, pathogens and heavy metals such as arsenic and lead. Further, 80-90 million gallons per day of untreated water from borewells and ranney wells were routinely supplied to reservoirs and, at times, directly to consumers during this period.Pune and peri-urban Chennai demonstrated similar conditions. The Guillain-Barré Syndrome (GBS) outbreak in Pune in early 2025, one of the largest recorded globally, was definitively linked to contaminated drinking water. The Lancet described it as a ‘human-made epidemic,’ highlighting critical failures in sanitation infrastructure, a result of weaknesses across the system. Technical failuresThe technical pathways of contamination in Indian cities are neither new nor ambiguous. Most cities operate intermittent supply systems, where pipelines remain empty or depressurised for long hours. When supply resumes, negative pressure draws in sewage, polluted groundwater and soil through leaks and illegal connections, turning every leakage point into a contamination risk. This risk is further obscured by how non-revenue water, i.e., treated water lost before reaching consumers, is framed primarily as a financial loss rather than a public health concern. Cities like Delhi, Indore, and Bhopal lose between half to two-thirds of treated water before it reaches consumers, indicating widespread leakage and heightened contamination risk.Leakage risks are compounded by fragmented infrastructure design. Water, sewerage, and stormwater systems are planned and executed in silos — often by different agencies, without accounting for how the three interact in practice. Stormwater drains, frequently carrying untreated wastewater, run along property edges, with water pipelines drilled through them to reach households, creating predictable contamination pathways, especially under depressurisation or leakage. Ageing, poorly mapped distribution networks deepen this vulnerability, with basic practices like pressure testing and leak detection undertaken inconsistently.The consequence is rising disease burden. Data shared by the Ministry of Health shows a sharp surge in water-borne diseases between 2021 and 2025 — Hepatitis A rose by 890%, cholera by 421%, leptospirosis by 243%, typhoid by 191%, and Hepatitis E by 87%. The prevalence of these cases across the country shows that they are not isolated failures. They point to a system that structurally permits contamination. Governance gapsIf technical systems enable risk, governance systems determine whether those risks are identified, reported and addressed, or ignored and brushed under the carpet.Urban water management in India is institutionally fragmented. Responsibilities are spread across Urban Local Governments (ULGs), Public Health Engineering Departments of state governments, state and city parastatal agencies handling water and sewerage, and pollution control boards. Core functions – planning, asset ownership, treatment, distribution, quality testing, health surveillance and public health – are split, with no single entity accountable for end-to-end service quality, leading to weak accountability.National programmes have largely focused on infrastructure funding. They have not defined outcomes and worked backwards from them to ensure operational accountability or long-term systems strengthening.What needs to changeThe tragedy of unsafe drinking water in our cities is as much a failure of governance as of technical systems. A well-functioning system must be reliable by design, be accountable to users, and prevent harm before it occurs. Indian cities fall short on all three.Reversing this requires two clear shifts. First, design urban drinking water systems to prevent contamination, not merely to respond to it. Prevention requires continuous, pressurised supply and infrastructure that physically separates potable water from sewage and stormwater. Pipe-and-chamber systems, realigned stormwater drains, and proper vertical separation of sewer and water lines are not incremental fixes – they shift the approach to water quality from detection-after-failure to protection-by-design.Second, establish clear, end-to-end accountability for water quality, backed by institutional capacity. No single institution today is responsible for the safety of drinking water. Fragmented roles lead to weak oversight, unclear accountability, and poor inter-departmental coordination. Cities need a unified authority responsible for ensuring drinking water safety across the supply chain — from source to tap — with the powers, staffing, and technical capability to regulate, inspect, assess risk, and act before harm occurs. Strengthening capacity is not a separate reform; it is what will make accountability real.Indore is not an outlier, but a warning of what urban India risks normalising if these reforms are delayed. The solutions are known. What is missing is the will to treat safe drinking water as a non-negotiable public responsibility and to organise governance around accountable city-systems.Karthik Seshan is Associate Director, State Programmes, Janaagraha and Surjyatapa Ray Choudhury is Associate Manager, Urban Policy, Jana Urban Space Foundation.