And yet waterborne threats remain under the radar. Exposure to unsafe drinking water and inadequate sanitation results in 3.4 million deaths, mostly poor children, each year from diarrhea, yet this fact never makes the news. Threats also are rising in rich countries like Australia. In January, after drenching rains, residents of Brisbane were asked to restrict water use after the city’s drinking water dwindled to just a six-hour supply. This occurred after the city’s main treatment plant became clogged with sediment washing down from poorly managed land upstream. Across the United States, despite advanced pollution controls, more than 200 million people live within 10 miles of degraded fresh water. Europe is a global hotspot of aquatic biodiversity loss.

It is ironic that many of today’s water problems arise from the very solutions we administer. Proliferation of costly, so-called hard-path engineering, like centralized sewers and large dams, provide undeniable benefits, such as improved hygiene and stable water supply. But they also degrade waters with pollution, obliterate natural flow cycles and block the migration routes of fish and other aquatic life. By throwing concrete, pipes, pumps and chemicals at our water problems, to the tune of a half trillion dollars a year worldwide, we’ve hung a huge technological curtain between the clean water flowing through our faucets and the background array of problems in our rivers, lakes and groundwater. It is no surprise that the public is largely unaware of this or its growing costs.

And virtually unknown to most is the collateral damage to freshwater biodiversity arising from mismanaged watersheds and waterways. Despite overuse and contamination, freshwater ecosystems host a trove of diverse life, almost 10 percent of all known species and one-third of all vertebrates. The 20,000 aquatic species now extinct or imperiled are sending us an important message about our stewardship of fresh water.

Although water has figured prominently in the U.N. development agenda for decades, the world is at a critical juncture as the Rio+20 Sustainable Development Goals take shape over the coming 12 months. In the wings looms a hastily designed and politically motivated post-2015 development agenda. The developing world argues for autonomy in pursuing whatever water-related goals it deems necessary for growth, with a more or less singular focus on the basics of clean drinking water and sanitation. In contrast, the developed world argues for all nations to adopt a broader perspective emphasizing environmental protection, yet is retreating from financial support for the poor to help realize this outcome.

These two perspectives can be reconciled. While it is imperative that we meet the water and sanitation needs of all people, it would be wildly counterproductive if success were achieved at the expense of nature. In a financially strapped world, it is hard to imagine how preservation and sensible use of the rivers, lakes and wetlands would not be a valued component of any long-term development plan. And with the specter of climate change, the very water systems we today abuse, if better managed, could climate-proof society, for example by employing wetlands as natural shock absorbers against floods.