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This paper highlights challenges of water access in towns and cities of the global South and explores potential policy responses. These challenges are not new, although, we argue that they have been underestimated by policy makers due to a focus on global data, thus, resulting in decision makers paying insufficient attention to these problems. Policies need to be based on a more accurate assessment of challenges, specifically the need for continuous and affordable water service, and the need to provide services to informal settlements. We share findings from research on 15 cities across Latin America, Asia, and Africa.