Water-related diseases remain a significant public health challenge globally, with effective governance critical for prevention. In South Africa, complex interactions between environmental, agricultural, veterinary, and health sectors create opportunities for controlling diseases linked to contaminated feshwater sources. Despite multiple overlapping mandates, there is limited understanding of how constitutional, legislative, and policy frameworks collectively support cross-sectoral governance for preventing these water-associated health risks. Existing governance analyses often overlook the systemic integration of environmental surveillance and communicable disease control, particularly regarding how statutory and policy instruments operationalize cooperation across sectors for waterborne disease risk management.
This study aims to assess how South Africa’s constitutional, legislative, and policy frameworks define and support cross-sectoral governance structures, surveillance obligations, and reporting pathways relevant to preventing diseases associated with freshwater water contamination.
A qualitative, desktop-based research design was employed, combining doctrinal legal analysis with document analysis. Key national laws, regulations, and policy documents from health, water, agriculture, veterinary, and environmental sectors were systematically reviewed. Analytical focus was placed on identifying formal surveillance obligations, mandated reporting pathways, sectoral roles, and governance mechanisms facilitating integrated disease risk management.
The review revealed that while no single framework explicitly addresses waterborne disease prevention, multiple legislative instruments establish surveillance, environmental monitoring, and communicable disease control mandates that collectively underpin such efforts. These frameworks define hierarchical governance roles, formalize multi-level reporting channels, and promote coordination across sectors through mechanisms that can be aligned with One Health principles. However, operational gaps exist, particularly concerning detailed reporting procedures and integration of environmental data into disease surveillance. Incident-based reporting under water and disaster laws complements system-wide monitoring, while health and veterinary statutes mandate disease notification and environmental health investigations. Therefore, there is the need for enhanced policy coherence and the development of integrated operational protocols to translate legal mandates into effective cross-sectoral action against water-related disease risks. Strengthening collaboration, data sharing, across health, environmental, agricultural, and veterinary sectors will be essential to operationalize One Health governance in South Africa’s water governance landscape. This study provides a foundational understanding for policymakers and practitioners aiming to advance holistic disease prevention strategies at the human-environmental water-animal interface.