Humanitarian need is increasing. Crises are becoming more complex through the interactions between climate change, disasters, and conflicts. Not only are humanitarian crises on the rise, but the nature of crises is changing, largely due to climate change-driven extremes such as floods, droughts and typhoons. Over 90 percent of disasters are believed to be related to climate.

In 2003, a scabies skin disease outbreak affecting mountain gorillas in Bwindi Impenetrable National Park was traced to people living around the national park—people with limited access to basic health and social services. To protect the people and wildlife of this special park, we launched Conservation Through Public Health (CTPH), an NGO that promotes biodiversity conservation by enabling people, gorillas, and other wildlife to coexist harmoniously through improved health and wellbeing.

Last summer, I stood on a cliff 100 feet above the Madre De Dios River, in Southern Peru near the Bolivian border, to watch the rosy gift of an Amazon sunset. It was quiet, in a tropical rainforest way, with the light clamor of parrots, macaws, and cicadas. Then, a peke-peke motorized canoe broke through the soft din. It arrived from the east, carrying a new supply of diesel fuel for the gold miners who were prepping the generator that would operate a suction-pump and dredge for gold across the river and around the bend. Before nightfall, the fuel ignited the baritone of a diesel generator. It moaned all night and all day, barely stopping. In subsequent days, instead of a light clamor of birds and primates, the thrum of a gold mining operation seemed like all I could hear.

For some time, it has been clear that a global population imbalance is emerging. High income countries, including nearly all of the Americas, Europe, and most of East and parts of South and Southeast Asia, have seen a dramatic, sustained fall in fertility. Already, this is resulting in shrinking labor forces and the oldest mean age populations seen in history. At the same time, the low income countries and even some lower middle-income countries—mainly in Africa but also in Central America, the Middle East, and parts of South and Southeast Asia—continue to have relatively high fertility. This is now, and even more in the coming decades, producing fast-growing labor forces and relatively young populations.

In the years ahead, climate change and the proliferation of new technologies and information availability will require us to reshape our vision of shared waters. Because these megatrends are experienced in concert, the opportunities, challenges, and uncertainties for shared water management will continue to compound over time.

While it is impossible to know precisely how shared water will look in the future, we should already be working to expand how we conceptualize shared waters, address inequities embedded within water management, and develop criteria and processes that successfully identify and include non-traditional shared water actors in decision-making. These shifts will strengthen our ability to generate creative and sustainable management strategies and help us avoid water-related conflicts.