Towards better monitoring: taking drinking water equity, safety and sustainability into account

While current figures indicate that access to improved drinking water has increased from 77 per cent to 87 per cent between 1990 and 2008, the real percentage of people with sustainable access to safe drinking water is likely to be significantly lower. This is one of the conclusions of a new report [1] that the UNICEF/WHO Joint Monitoring Programme for Water Supply and Sanitation (JMP) released on 20 December 2011.

If the maximum acceptable time needed to collect water is taken as 30 minutes per round trip, then drinking water coverage in Sub-Saharan Africa drops by eight percentage points, the report says. Similarly, if you include water quality as an indicator, then the 2008 JMP estimates of access to safe drinking water would go down by 16% for Nicaragua, 11% for Ethiopia, 10% for Nigeria and 7% for Tajikistan.

The new report analyses existing JMP statistics in more detail and includes increased disaggregation of water service levels and analyses of trends across countries and regions. It focuses on the three key challenges of equity, safety and sustainability. Disparities in terms of geography, wealth and gender are explored, as well as the role of household water treatment and safe storage in water safety, and the unique threats posed by climate change to the sustainability in rural and urban contexts.

National and global monitoring will require a major evolution, concludes the report, to meet demands for targets and indicators that take equity, safety and sustainability into account.

[1] WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation (JMP), 2011. Drinking water equity, safety and sustainability. (JMP thematic report on drinking water ; 2011). New York, NY, UNICEF ; Geneva, World Health Organization. 62 p. : 40 fig., 2 tab. 23 ref. <Available at: http://www.unicef.org/media/files/JMP_Report_DrinkingWater_2011.pdf>

Related news:

• Monitoring: new tools meet demand for more transparency in the water sector, E-Source, 05 Dec 2011
• Angelica de Jesus, First consultation on developing post-2015 monitoring indicators, Berlin: Refocusing the monitoring approach, E-Source, 02 Aug 2011

Related web site: WHO / UNICEF Joint Monitoring Programme (JMP) for Water Supply and Sanitation – http://www.wssinfo.org/

Source: UNICEF, 20 Dec 2011

Procter & Gamble: new factory will help expand worldwide distribution of PUR™ Purifier of Water packets

The Procter & Gamble (P&G) Company will build a new manufacturing facility for its PUR™ Purifier of Water packets in Singapore that is expected to be able to produce more than 200 million packets a year to help provide clean drinking water across the world.

P&G’s current manufacturing plant is based in Pakistan. The new site in Singapore will enable a significantly expanded supply of PUR packets and exceptional access to ocean and air shipping routes, which are needed to quickly reach P&G’s non-profit partners in Africa and Asia.

The announcement was made at Singapore International World Water Week. The P&G Children’s Safe Drinking Water Program (CSDW) program has provided more than 350 million liters of clean drinking water in Asia as part of ongoing disaster relief efforts like the October 2009 earthquake in Padang, Indonesia, the company said.

The PUR packets contain a water-purifying powder technology developed by P&G and the U.S. Centers for Disease Control and Prevention (CDC) to help reduce sickness and death resulting from drinking contaminated water. One small PUR packet produces 10 liters of drinking water.

P&G will also launch new Children’s Safe Drinking Water (CSDW) programs in Cambodia, the Philippines, Rwanda, and Zimbabwe with World Vision International; in Rwanda, Ethiopia, and Namibia with Population Services International (PSI); and, in Ethiopia and Kenya with CARE.

These CSDW programs are expected to provide an additional 400 million liters of clean drinking water in the next two years to enable P&G and partners to provide a cumulative four billion liters between 2007 and 2012.

P&G had originally intended to produce PUR packets commercially, but three years of test marketing in four countries returned mostly low penetration rates as well as a weak return on investment. P&G couldn’t sustain on its own the large-scale social marketing efforts needed to get poor consumers to adopt household water treatment practices using PUR packets. Since 2004, the company donates PUR packets or provides them at cost through its non-profit CSDW partners.

A 2009 scientific review concluded that the widespread promotion of household water treatment (HWT) is premature given the available evidence.

Related web site: P&G – Children’s Safe Drinking Water Program

Related publication: USAID Global Development Alliance. (2010). Safe Drinking Water Alliance : experiences in Haiti, Ethiopia, and Pakistan : lessons for future water treatment programs. Baltimore, Maryland USA, Bloomberg School of Public Health, Johns Hopkins University. Read more

Source: Procter & Gamble, 30 Jun 2010 ; Erik Simanis, At the Base of the Pyramid, MIT Sloan Management Review, 20 Oct 2009

Gates Foundation awards $10.9 million to study impacts of sanitation on diseases

Researchers at the University of California, Berkeley, have received a five-year, $10.9 million grant from the Bill & Melinda Gates Foundation to evaluate several interventions to combat diarrheal disease in developing countries.

Dr. Jack Colford

Dr. Jack Colford, professor of epidemiology at UC Berkeley’s School of Public Health, will coordinate the project, working with the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) and Innovations for Poverty Action (IPA).

An estimated 2.2 million children under the age of 5 die from diarrhoeal diseases each year, according to the World Health Organization. Most of these diseases are thought to be preventable with improvements in sanitation, water quality and hygiene.

Due to the high cost of developing and maintaining large infrastructure projects, such as networked water, there is now a movement toward simpler, alternative methods to improve health in rural areas. However, there is almost no evidence that allows direct comparison of the health benefits or cost effectiveness of these simpler interventions, such as improved latrines, household water treatment and hand washing with soap.

The goal of the new project is to determine how sanitation interventions, delivered alone or as part of combined intervention packages, impact child health and well-being. In addition to improved sanitation, the intervention packages will include drinking water improvements and hand washing solutions. The results have the potential to influence how billions of dollars are directed towards long-term improvements in health and economic outcomes for millions of children each year, said Colford.

“Increasingly, foundations, governments, the World Bank and development agencies such as the MCC (Millennium Challenge Corporation) are demanding evidence of effectiveness when awarding development funds,” said Colford. “Right now, it is unknown whether single interventions are as cost effective as combinations of these interventions. This grant will fund the first large-scale, randomized impact evaluation designed to gather rigorous evidence about this question.”

The study will test the impact of these sanitation, water and hygiene interventions using a large-scale, randomized impact evaluation in Bangladesh and Kenya. These two countries are representative of the two regions that account for the majority of the world’s gastrointestinal disease burden: Southeast Asia and sub-Saharan Africa. The researchers expect to enroll a total of 23,000 children in the trials, which will be monitored by several institutional review boards.

Of the $10.9 million, about $7.9 million will be subcontracted out to the two field sites. Dr. Stephen Luby, head of the Programme on Infectious Diseases and Vaccine Sciences with ICDDR,B, and Michael Kremer, Ph.D., a research affiliate with IPA, will lead the trials in Bangladesh and Kenya, respectively. They will be joined by a team of experts from various disciplines, including public health, economics, behavioral change, nutrition, cognitive development and tropical enteropathy.

Source: Linda Anderberg, UC Berkely News, 05 Nov 2009

SODIS under fire: study pours cold water on solar disinfection

“Doubt has been cast on a much-lauded method of disinfecting water using only sunlight, after a study found that it doesn’t reduce diarrhoea among children in families using the technique” SciDev.net reports.

“Solar Water Disinfection (SODIS), a low-cost water purification method that uses only sunlight to disinfect water, is currently used by about three million people in 30 countries, according to the SODIS Reference Centre [at SANDEC] in Switzerland”.

“Laboratory and community studies have shown that the method is effective. But a PLoS Medicine study published [on 18 August 2009] on 22 rural communities in Cochabamba, Bolivia, found no significant reduction in diarrhoea among children aged five and under in families using SODIS”.

“The authors suggest that more research is needed into how the laboratory results can be replicated on the ground and until this is done they say that campaigners should be careful about advocating SODIS”.

“Mercedes Iriarte, co-author of the study and a researcher at the Water and Environmental Sanitation Centre of San Simón University, in Bolivia, told SciDev.Net that in the laboratory there is better control of all factors”.

“Iriarte says that in the laboratory, clean, clear, pH-neutral water is contaminated with known microorganisms to evaluate the method but that in the field researchers should consider other factors such as cloudiness of the water”.

“Margot Franken, a researcher with the environmental quality unit at San Andrés University in Bolivia, told SciDev.Net that low efficacy of the method could also result from inadequate exposure to sunlight”.

Compliance was also low, with only a third of families routinely treating their water in the recommended manner despite 80 per cent claiming to use SODIS at the beginning and end of the study and an intensive promotion campaign.

Link to full article in PLoS Medicine.

See a video about the study on SciVee.

Source: Cristina Pabón, SciDev.net, 31 Aug 2009

Earlier in 2009 Wolf-Peter Schmidt and Sandy Cairncross concluded that the widespread promotion of household water treatment (HWT) is premature given the available evidence. This is echoed by the latest review of impact evaluations examining effectiveness of water, sanitation and hygiene (WSH) interventions by the International Initiative for Impact Evaluation (3ie).

In a comment about the study on its website, the SODIS Reference Centre says that “numerous studies have reported health benefits of SODIS when it is correctly and consistently used”. They cite the example of a study where “the incidence of cholera during an epidemic in Kenya was 88% lower among SODIS than non-users”.

“A well-known weakness of the SODIS process is that it is often not used consistently or is used to treat only a fraction of the drinking water consumed”, the statement continues. “Beneficial health impacts associated with the use of SODIS may also be compromised by poor sanitation and hygiene. Nonetheless, we feel that people should not be discouraged from continuing to use SODIS or from adopting it unless an alternate supply of safe drinking water is available”.

The SODIS Reference Centre/Sandec has also had to respond to “allegations circulating in a number of print media in developing countries on the carcinogenic risk of (re-)using PET bottles”. These “unfounded media reports” are drawn from research that show that antimony and phthalic acid and phthalate esters can leach from PET bottles. Sandec conducts its own study, together with Empa (Swiss Federal Laboratories for Materials Testing and Research) on “the migration of organic compounds – with special focus on plasticisers – into the water contained in PET bottles bottles under typical SODIS conditions”. “According to the results of this study, the risk of negative health effects caused by reused PET bottles for SODIS treatment is negligible”. SANDEC plans to repeat the study in India “to confirm the harmless nature of the technology in a country where media reports on the dangers of PET bottles are particularly widespread”.

Source: Samuel Luzi, Reuse of PET Bottles for SODIS – Blessing or Curse?, Sandec News, no. 10, July 2009

But SODIS is not off the hook yet, as a new danger is looming. In April 2009, scientists at Goethe University found that PET plastics may contain hormone-disrupting chemicals that leach into the water, Discovery News reported. According to researchers, it now appears that some as-yet-unidentified chemicals in PET plastics have the potential to interfere with estrogen and other reproductive hormones in the same manner that bisphenol A (BPA) and phthalates are suspected of doing.

Household water treatment: scaling-up is premature say researchers

A critical review concludes that the widespread promotion of household water treatment (HWT) is premature given the available evidence. Further acceptability studies and large blinded trials or trials with an objective health outcome are needed before HWT can be recommended to policy makers and implementers, say Wolf-Peter Schmidt and Sandy Cairncross of the London School of Hygiene and Tropical Medicine (LSHTM) [1].

Point-of-use water treatment (household water treatment, HWT) has been advocated as a means to substantially decrease the global burden of diarrhea and to contribute to the Millennium Development Goals (MDGs). To determine whether HWT should be scaled up now, the LSHTM researchers reviewed the evidence on acceptability, scalability, adverse effects, and nonhealth benefits as the main criteria to establish how much evidence is needed before scaling up. These aspects are contrasted with the evidence on the effect of HWT on diarrhea. The researchers found that the acceptability and scalability of HWT is still unclear, and that there are substantial barriers making it difficult to identify populations that would benefit most from a potential effect. The nonhealth benefits of HWT are negligible. Health outcome trials suggest that HWT may reduce diarrhea by 30-40%, but current evidence does not exclude that the observed reductions are largely or entirely due to bias.

[1] Schmidt, W. and Cairncross, S. (2009). Household water treatment in poor populations : is there enough evidence for scaling up now? Environmental science & technology ; vol. 43, no. 4 ; p. 986–992. doi:10.1021/es802232w

Read the full review here