Livestock and human population pressures are increasing in the West Kilimanjaro ecosystem, leading to over-abstraction and contamination of surface water. Water abstraction forces large mammals to use high saline and mineral concentrated surface water in the dry season. Water scarcity also causes high-density aggregations around water points, increasing the risk of pathogen transmission. Understanding how water stress, poor quality water and parasites burdens adversely affect the physiology of wildlife and livestock is essential to improve resource management and to reduce human-wildlife conflicts.