Whether it is New York City, Mexico City or Ho Chi Minh City, enabling equitable access to clean drinking water, and adequate drainage and storm run-off must overcome multiple challenges. Burgeoning urban populations need increasing amounts of water, but the changing climate is impacting primary sources. “What we have considered sustainable water management for decades is untenable when we consider continuing pressures on supply and quality,” Dr Anna Robuck warns us. Enrique Iomnitz explains the “perverse” vicious cycle of Mexico’s leaky grid. As in many Global South cities, supplying water intermittently reduces water loss, but when the flow stops, the pressure causes even more leaks - exacerbated by earthquakes. Regenerative systems operate on a circular budget with more limited releases of water than the linear model industrialised countries are accustomed to. Enabling safe regeneration - even beyond consumer servicing - requires upgraded infrastructure, and also trust. Balancing safety with sustainability is a challenge even in the United States, where policies do not take into account the slew of chemicals pouring out of households, farming and industry. Governance and funding are often key differentiators between the Global North and South, but cities such as Lingyuan in China are leading the way. The new generation of solutions need to treat water at a lower energy and chemical cost. The ‘sponge city’ concept and retaining increasingly heavy rains are starting to be taken on. To scale and speed up solutions, academics need to collaborate more closely with the private sector and governments. Local community engagement and education, public private partnerships and new distributed marketplaces for the commercial sector, as demonstrated by Romain Joly and Enrique Iomnitz’s enterprises, must also be integrated.  Speakers: Dr. Anna Robuck, Researcher, Icahn School of Medicine at Mount SinaiEnrique Lomnitz, Co-Founder & Director, Isla UrbanoRomain Joly, CEO at O-We Water Vietnam & Director of business development at 1001fontaines