Two things:
1. The phrase has always been about fresh, usable water. I think that's apparent enough.
2. The phrase is referring to the value of water, not the abundance of it. It also started to show up when the price of oil was generally high, and when society at large started to really see through the media that water scarcity is a very tangible thing, especially in places that have insufficient volumes of it and/or can't import enough to support societal demands.
So yes, the phrase is populist in nature, I think most people would understand that the price of fresh water is what it's referring to. The UN (specifically the UN Food and Agriculture Organization) has identified this as a real threat across many parts of the world. One only has to look at the Falkenmark Water Stress Indicator to see that this is a major problem in and around the world. How much would Cape Town pay for a fresh water source? 500 million for a desalination plant? How many do they need? My guess is well into the tens of them to even support one city's requirements. This is a multi-billion dollar investment and not an easy one to just one day "turn on" for a number of reasons. Cape Town itself is also lucky to right near the ocean; more complications arise from inland urban centres.
Even in the Western world, this is a problem. Look at California: 95% of their water sources come from surface water or groundwater. Yet they continue to suffer repeated water shortages, with no signs of a silver bullet solution from government, industry or societal conservation efforts to prevent more in the future. Desalination plants are growing in nature, but not to to the scale of economics to solve the issue, especially as California has major irrigation and agricultural demands for usable water.
I think most people reasonably understand what water scarcity is; I don't think anyone is saying the oceans are going to dry up (now other things, such as oxygen levels, pollution, acidity and overfishing are also very valid issues in themselves).
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