Research priorities to improve water-associated global health problems should be derived through a formula reflecting burden of disease and intervention cost-effectiveness. This is far from the case, due to global inequality and also because of institutional lags which mean most populations and policy makers conceptualise the world as a myriad of small groups, rather than one interlinked system. The paper then discusses links between global change, water and health, including aquifer depletion and contamination and climate change associated alterations to rainfall (...) patterns. It calls for greater transparency of the tracking industry, and points out that the risk to water which tracking represents reflects the growing scarcity of fossil fuels. Finally, the paper recalls the “Limits to Growth” arguments, warning that civilization is on track to collapse, without massive changes. (shrink)