Desalination plants in the Middle East are increasingly vulnerable

MIT Technology Review Explains: Let our writers untangle the complex, messy world of technology to help you understand what’s coming next. You can read more from the series here.

As the conflict in Iran has escalated, a crucial resource is under fire: the desalination technology that supplies water across much of the region.

In early March, Iran’s foreign minister accused the US of attacking a desalination plant on Qeshm Island in the Strait of Hormuz and disrupting the water supply to nearly 30 villages. (The US denied responsibility.) In the weeks since, both Bahrain and Kuwait have reported damage to desalination plants and blamed Iran, though Iran also denied responsibility.

In late March, President Donald Trump threatened the destruction of “possibly all desalinization plants” in Iran if the Strait of Hormuz was not reopened. Since then, he’s escalated his threats against Iran, warning of plans to attack other crucial civilian infrastructure like power plants and bridges.

Countries in the Middle East, particularly the Gulf states, rely on the technology to turn salt water into fresh water for farming, industry, and—crucially—drinking. The mounting attacks and threats to date highlight just how vital the industry is to the region—a situation made even more precarious by rising temperatures and extreme weather driven by climate change.

Right now, 83% of the Middle East is under extremely high water stress, says Liz Saccoccia, a water security associate at the World Resources Institute. Future projections suggest that’s going to increase to about 100% by 2050, she adds: “This is a continuing trend, and it’s getting worse, not better.”

Here’s a look at desalination technology in the Middle East and what wartime threats to the critical infrastructure could mean for people in the region. 

A vital resource

Desalination technology has helped provide water supplies in the Middle East since the early 20th century and became widespread in the 1960s and 1970s.

There are two major categories of desalination plants. Thermal plants use heat to evaporate water, leaving salt and other impurities behind. The vapor can then be condensed into usable fresh water. The alternative is membrane-based technology like reverse osmosis, which pushes water through membranes that have tiny pores—so small that salt can’t get through.

Early desalination plants in the Middle East were the first type, burning fossil fuels to evaporate water, leaving the salt behind. This technique is incredibly energy-intensive, and over time, processes that rely on filters became the dominant choice.

Membrane technologies have made up essentially all new desalination capacity in recent years; the last major thermal plant built in the Gulf came online in 2018. Many reverse osmosis plants still rely on fossil fuels, but they’re more efficient. Since then, membrane technologies have added more than 15 million cubic meters of daily capacity—enough to supply water to millions of people.

Capacity has expanded quickly in recent years; between 2006 and 2024, countries across the Middle East collectively spent over $50 billion building and upgrading desalination facilities, and nearly that much operating them.

Today, there are nearly 5,000 desalination plants operational across the Middle East.

And looking ahead, growth is continuing. Between 2024 and 2028, daily capacity is expected to grow from about 29 million cubic meters to 41 million cubic meters.

Uneven vulnerabilities

Some countries rely on the technology more than others. Iran, for example, uses desalination for about 3% of its municipal fresh water. The country has access to groundwater and some surface water, including rivers, though these resources are being stretched thin by agriculture and extreme drought.

Other nations in the region, particularly the Gulf countries (Bahrain, Qatar, Kuwait, the United Arab Emirates, Saudi Arabia, and Oman), have much more limited water resources and rely heavily on desalination. Across these six nations, all but the UAE get more than half their drinking water from desalination, and for Bahrain, Qatar, and Kuwait the figure is more than 90%.

“The Gulf countries are much, much more vulnerable to attacks on their desalination plants than Iran is,” says David Michel, a senior associate in the global food and water security program at the Center for Strategic and International Studies.

There are thousands of desalination facilities across the region, so the system wouldn’t collapse if a small number were taken offline, Michel says. However, in recent years there’s been a trend toward larger, more centralized plants.

The average desalination plant is about 10 times larger than it was 15 years ago, according to data from the International Energy Agency. The largest desalination plants today can produce 1 million cubic meters of water daily, enough for hundreds of thousands of people. Taking one or more of these massive facilities offline could have a significant effect on the system, Michel says.

Escalating threats

Desalination facilities are quite linear, meaning there are multiple steps and pieces of equipment that work in sequence—and the failure of a component in that chain can take an entire facility down. Attacks on water inlets, transportation networks, and power supplies can also disrupt the system, Michel says. 

During the Gulf War in 1991, Iraqi forces pumped oil into the gulf, contaminating the water and shutting down desalination plants in Kuwait

The facilities are also generally located close to other targets in this conflict. Desalination is incredibly energy intensive, so about three-quarters of facilities in the region are next to power plants. Trump has repeatedly threatened power plants in Iran. In response, Iran’s military has said that if civilian targets are hit, the country will respond with strikes that are “much more devastating and widespread.” Other governments and organizations, including the United Nations, the European Union, and the Red Cross, have broadly condemned threats to infrastructure as illegal. 

But war isn’t the only danger facing these plants, even if it is the most immediate. Some studies have suggested that global warming could strengthen cyclones in the region, and these extreme weather events could force shutdowns or damage equipment.

Water pollution could also cause shutdowns. Oil spills, whether accidental or intentional, as in the case of the Gulf War, can  wreak havoc. And in 2009, a red algae bloom closed desalination plants in Oman and the United Arab Emirates for weeks. The algae fouled membranes and blocked the plants from being able to take water in from the Persian Gulf and the Gulf of Oman.

Desalination facilities could become more resilient to threats in the future, and they may need to as their importance continues to grow. 

There’s increasing interest in running desalination facilities at least partially on solar power, which could help reduce dependence on the oil that powers most facilities today. The Hassyan seawater desalination project in the UAE, currently under construction, would be the largest reverse osmosis plant in the world to operate solely with renewable energy. 

Another way to increase resilience is for countries to build up more strategic water storage to meet demand. Qatar recently issued new policies that aim to improve management and storage of desalinated water, for example. Countries could also work together to invest in shared infrastructure and policies that help strengthen the water supply through the region. 

Preparedness, resilience, and cooperation will be key for the Middle East broadly as critical infrastructure, including the water supply, is increasingly under threat. 

“The longer the conflict goes on, the more likely we’ll see significant water infrastructure damage,” says Ginger Matchett, an assistant director at the Atlantic Council. “What worries me is that after this war ends, some of the lessons will show how water can be weaponized more strategically than previously imagined.” 

The Most Effective OCD Treatment Reaches Almost No One: Here’s What We Can Do About It

Rebecca Deusser, MS, MBA and Sanjaya Saxena, MD

“It took me years to find out that what I was dealing with was OCD!”

This is a phrase all too often repeated by people living with obsessive compulsive disorder. Currently, individuals live with OCD for an average of 7 years (Dell’Osso et al, 2019) before they even receive a diagnosis, all while symptoms may intensify and daily life often becomes increasingly constrained. 

Clinicians, researchers, and advocates have long raised this concern. What has been missing is clear data behind how many people with OCD in the U.S. are missed in clinical settings or are not receiving the most effective treatment.

When the International OCD Foundation undertook this analysis, the scale of the problem became unmistakable. Millions of people in America are currently struggling with OCD without the most effective treatment.

The challenges we detail in our new white paper, America’s OCD Care Crisis: National Findings on the Failure of Effective OCD Treatment to Reach Patients, are significant, but fixable. They are symptoms of structural oversights that can be changed. Effective, evidence-based treatment for OCD exists, and through intentional action, we can dramatically change these unacceptable outcomes for people with OCD.

Where People With OCD Fall Through the Cracks

Well established prevalence rates for OCD indicate that nearly 10 million people in America — roughly 3% (Ruscio et al, 2010; Stein et al,2025; Ringeisen et al, 2025) — will have OCD at some point in their lives. Yet our findings suggest that 75% of them are never even identified, and up to 95% aren’t receiving the most effective treatment for the disorder.

In our analysis, we discovered significant systemic breakdowns at several key points of a patient’s journey: screening, diagnosis, referral, and treatment.

  • Screening and Diagnosis: Receiving a clinical diagnosis is an important step toward recovery as it promotes understanding and opens paths to effective treatment. Yet our findings suggest that this crucial initial step is missing for many millions of people. Of the 10.4 million patient records reviewed in our analysis, only 0.51% received a formal OCD diagnosis, far below the 3% expected prevalence rate. 
  • Referral to appropriate care: After a diagnosis is obtained, a handoff to appropriate care is needed to keep the patient from falling out of the treatment pathway. Here, too, we found an alarming gap within our sample: more than 72% of patients identified as having OCD did not receive a referral for cognitive-behavioral therapy (CBT), the most effective treatment for OCD.
  • Effective Treatment: Decades of research has established Exposure and Response Prevention (ERP) therapy, a specific form of CBT, as the most effective, first-line therapy for OCD. Yet, an astounding 95-98% of people with OCD had not received ERP treatment. Even when people seek help — and even when they are diagnosed — the vast majority never reach the treatment most likely to help them recover.

What We Can Do About It

The breakdowns seen in each step of the care pathway reinforce the focus of IOCDF’s Vision 2030, our five-year strategy to address the systemic barriers that keep effective OCD treatment out of reach.

While the findings are stark, they illuminate many opportunities for change:

  • Identify symptoms earlier by implementing routine OCD screening in primary healthcare and mental health settings.
  • Support clinicians in better understanding and treating OCD by expanding training in assessment, diagnosis, and evidence-based treatment modalities.
  • Help people receive care that works by strengthening adherence to existing professional treatment guidelines.
  • Increase the number of people with OCD who receive effective treatment  by supporting affordable access to ERP and other evidence-based therapies.
  • Let people know they’re not alone by raising accurate public awareness of what OCD really is — and that it is treatable.

Vision 2030 outlines how the IOCDF is committing its resources, partnerships, and expertise toward advancing these priorities — by increasing awareness and community, expanding access to effective treatment, and advancing research. Together, these efforts are designed to work in concert, improving clinical training, implementing screening for early identification, strengthening pathways from diagnosis to care, and increasing the likelihood that people receive evidence-based treatment.

At the same time, the scale of the problem revealed in this report makes clear that progress depends on collective action across the field. Clinicians, health systems, educators, researchers, policymakers, advocates, and people with lived experience all have a role to play. Together, these efforts can help ensure that people with OCD reach effective treatment sooner, reducing years of unnecessary confusion and distress. 

How You Can Help

Join us in building better access to effective treatment for people with OCD:

The current state of treatment for OCD in the U.S. is sobering, but it is not the end of the story. OCD is treatable, recovery is possible, and change can happen as awareness grows and access expands. With continued effort, the gap between how many are struggling and how many receive effective care can begin to close. A brighter future is possible — and we can build it together.

References

  1. Dell’Osso, B., Benatti, B., Grancini, B., Vismara, M., De Carlo, V., Cirnigliaro, G., Albert, U., & Viganò, C. (2019). Investigating duration of illness and duration of untreated illness in obsessive compulsive disorder reveals patients remain at length pharmacologically untreated. International Journal of Psychiatry in Clinical Practice, 23(4), 311–313. https://doi.org/10.1080/13651501.2019.1621348
  2. Ruscio, A. M., Stein, D. J., Chiu, W. T., & Kessler, R. C. (2010). The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication. Molecular Psychiatry, 15(1), 53-63. https://doi.org/10.1038/mp.2008.94
  3. Stein, D. J., Ruscio, A. M., Altwaijri, Y., Chiu, W. T., Sampson, N. A., Aguilar-Gaxiola, S., Al-Hamzawi, A., Alonso, J., Chardoul, S., Gureje, O., Hu, C., Karam, E. G., McGrath, J. J., Navarro-Mateu, F., Scott, K. M., Stagnaro, J. C., Torres, Y., Vladescu, C., Wciórka, J., Xavier, M., … Kessler, R. C. (2025). Obsessive-compulsive disorder in the World Mental Health surveys. Research Square, rs.3.rs-6090427. https://doi.org/10.21203/rs.3.rs-6090427/v1
  4. Ringeisen, H., Edlund, M., Guyer, H., Dever, J., Carpenter, L., Olfson, M., First, M., Geiger, P., Liao, D., Peytchev, A., Carr, C., Chwastiak, L., Dixon, L. B., Monroe-Devita, M., Scott Stroup, T., Swanson, J., Swartz, M., Gibbons, R., Stambaugh, L., Bareis, N., … Mental Health and Substance Use Disorders Prevalence Study Consortium (2025). Prevalence of past-year mental and substance use disorders, 2021-2022. Psychiatric Services (Washington, D.C.), 76(8), 720–728. https://doi.org/10.1176/appi.ps.20240329

IOCDF Training & Resources for Clinicians

When clinicians have easier access to best practices in OCD diagnosis and treatment, more people can receive effective care. The IOCDF’s Training Institute offers evidence-based programs for clinicians at every stage of practice, including:

  • A robust, on-demand webinar catalog (CE-eligible!) covering fundamentals, modalities, related disorders, and comorbidities. The catalog includes access to the free webinar, OCD Basics. 
  • IOCDF’s Training Institute offers intensive workshops and events, consultation groups, and more for clinicians of every level.
  • Professional Members at the IOCDF join a nationwide network of committed professionals, are eligible for listing on our Resource Directory, and have access to special pricing for Training Institute offerings.

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Social cognitive deficits and altered multi-brain dynamics during problem-solving in heroin abstainers: An fNIRS hyperscanning study

Despite extensive research on the neurobiology of addiction, little is known about how repeated drug use and withdrawal are related to social functioning impairments in humans, a highly social species. This obscures the broader societal impact of drug addiction and limits treatment efficacy. This study examined social cognitive impairment and its multi-brain neural underpinnings during socially interactive problem-solving in heroin use disorder (HUD), and further explored their co-occurrence with protracted withdrawal symptoms.

STAT+: NIH would get $5 billion cut under Trump’s 2027 budget, but Congress unlikely to go along

The White House is asking Congress to cut $5 billion from the National Institutes of Health and to downsize the number of its institutes and centers from 27 to 22 — a plan that is expected to receive a chilly reception from lawmakers from both parties. 

The president’s fiscal year 2027 budget request, released Friday, asks for $41 billion for the NIH and eliminates the National Center for Complementary and Integrative Health, the Fogarty International Center, and the National Institute on Minority Health and Health Disparities. The 2027 budget also proposes consolidating two institutes focused on research on drug and alcohol abuse into a new entity called the National Institute of Substance Use and Addiction Research, as well as relocating the National Institute of Environmental Health Sciences into the Centers for Disease Control and Prevention. 

The White House proposal also asks Congress to slash the budget for the Advanced Research Projects (ARPA-H), which funds cutting-edge science, from its current $1.5 billion to $945 million.

Continue to STAT+ to read the full story…

Relatix Health Applies for ARIA Funding to Build Digital Trust for Neurodiverse Communities

We’re proud to share that Relatix Health has applied for funding from the UK’s Advanced Research and Invention Agency (ARIA) under its Trust Everything, Everywhere programme. This initiative explores how trust can be built across the digital and physical worlds, and we believe that conversation must include people whose minds work differently.

Our proposal focuses on one of the most pressing and least understood challenges of the digital age: how people with neurodevelopmental and neurodiverse conditions, including autism, ADHD, schizophrenia, borderline traits, and psychopathy, experience, interact with, and build trust in AI systems. In a world increasingly mediated by algorithms, the ways these systems interpret, respond to, and store our most personal thoughts and data matter profoundly.

Throughout history, individuals living with stigmatized neurocognitive conditions have been marginalized or misrepresented by institutions, by society, and now, potentially, by AI. Some may over-trust technology that feels neutral or supportive; others may under-trust it because of past harm or bias. We want to ensure that digital systems meet people where they are, building trust rather than eroding it, while protecting privacy and supporting quality of life, health, and wellbeing.

Through this work, Relatix Health aims to lead the way in ethical and inclusive neuro-AI design: protecting privacy, reducing stigma, and helping define standards for responsible data handling in the era of AI. Our goal is to make sure that the next generation of AI-driven tools, from chatbots to diagnostics, truly serves everyone, regardless of how their brain is wired.

We know how often things have already gone wrong, from chatbots unintentionally encouraging depressive or paranoid thoughts, to credit and gambling platforms optimizing for addiction or impulsive behaviour. These systems were not built with sufficient safeguards for people with neurodevelopmental conditions, who may react differently to AI-optimized interactions. Many respond by disengaging digitally, and may feel that an AI-driven world is a minefield because it was not built for them.

Join us in shaping a radically different future where cognitive diversity and digital trust can coexist, and AI tools are built to truly support and empower. To learn more about our mission or to collaborate, contact our team.