Terrence Thompson Regional Adviser Environmental Health World Health Organization/Western Pacific Regional Office. Philippines National HWTS Workshop

Transcription

1 National Household Water Treatment and Safe Storage Policies Towards scalable health solutions Annex 4 Terrence Thompson Regional Adviser Environmental Health World Health Organization/Western Pacific Regional Office Philippines National HWTS Workshop Outline Background and global strategy on HWTS National strategies on HWTS Examples of Approaches Opportunities/Challenges Supporting tools and resources 1

2 Toll of diarrheal diseases 1.9 million deaths each year attributable to diarrhoea (WHO, 2004 data) Second leading cause of death among children (Black, et al, 2010) Nearly 80% of the diarrheal disease burden is borne by children under five (WHO, 2004) 220,000 cases and 5,000 deaths due to cholera (WHO, 2009) WHO/Carolos Gaggero Diarrhoea rates in those living with HIV/AIDs 2-6 higher (Lule, et al 2005) 2011 World Health Assembly Resolutions Resolution 64/24 on Drinking- water, sanitation and health -First time in 20 years, water and sanitation resolution -Calls for greater and more integrated action Resolution 64/14 on Cholera: mechanism for control and prevention -Highlights importance of HWTS -Requests WHO to revitalize the Global Task Force on Cholera control 2

3 HWTS Global Strategy Mission Statement - To contribute to a significant reduction in waterborne and water-related vector-borne diseases, especially among vulnerable populations, by promoting household water treatment and safe storage as a key component of community-targeted environmental health programmes. HWTS Global Strategy Targets - By 2015, 30 countries have established policies on household water treatment and storage. By 2015, strengthened evidence to guide effective and replicable HWTS programmatic approaches to achieve long-term widespread use and public health impact. By 2020, 50 countries have achieved countrywide scale up of project-based HWTS. 3

4 HWTS Global Strategy Strategy components - Facilitate implementation of HWTS Broaden evidence base Address needs of most vulnerable Monitoring progress on uptake Establish links to other enviro health interventions - Identifying where HWTS fits in policy structure - Ministry of Health Strategies "Ensure water safety measures"-ethiopian Health Sector Development Plan "Provide adequate drinking-water for human consumption, basic hygiene and good sanitation for all by 2012-Thailand Environmental Health Action Plan 4

5 - Identifying where HWTS fits in policy structure- Ministry of Water and/or Environment "All people have increasing, equitable access to improving levels of sanitation, water and hygiene services"-draft Lao Rural Water Supply, Sanitation and Hygiene Strategy Intersectoral Initiatives-Development Strategies "Improvement of quality of life and well-being; everyone has access to safe water and sanitation"-tanzanian Vision 2025, Rwanda Vision 20/20 - Institutional structures - Designate lead ministry Often Ministry of Health, but varies by country Collaboration among all relevant ministries MoUs and technical working groups can facilitate collaborations (i.e. TZ has MoU with 4 ministries) Engage all levels of government National networks, local working groups National Advocacy Policy briefs on HWTS, especially among vulnerable groups 5

6 - Setting Targets, Examples- By 2015, increase from 7 to 77% of HWTS users (Ethiopia Health Sector Development Plan) By 2015, 65% of population will use HWTS (Tanzania National Action Plan on HWTS) By 2012, 100% of school children will have access to safe water (Thailand Environmental Health Action Plan) - Challenges with Targets- Meeting needs of vulnerable populations Availability of safe water varies Season Location Concurrent efforts to improve community supplies From , in Sub-Saharan Africa increased from 15-16% From in South Eastern Asia increased from 17-33% 6

7 - Consider HWTS within existing programmes- Integrated management of childhood illness Education on HWTS given as "package" to mothers at health care facilities HIV/AIDs treatment and care Of HIV/AIDs patients with diarrhoea, 40% due to Cryptosporidium in Cambodia (Chinn, S et al, 2006) Diarrohea primary cause of 25% of deaths of PLWA in Tanzania (Tillekeratne, et al, 2008) Healthy "Model" homes National, integrated package in Rwanda aims to reach 70% of homes by 2013 WHO/Heather Adair-Rohani Examples of regulation efforts Halal-certification Trusted, recognized Bureau of Standards In Kenya, standards for chlorine Bangladesh Environmental Technology Verification Confirmation of manufacturer claims More work needed on improving flexibility and costeffectiveness USAID/Virgina Foley 7

8 Governments - Resource mobilisation- Reduce or eliminate VAT on HWTS products, "essential medicine" Traditional donors Bilaterals (USAID), International organizations (UNICEF) Not-for-profit Health marketing (PSI) Support of local business and product development (PATH- Asia, Aquaya-Kenya) Private sector - Resource mobilisation, contin.- HWTS as a loan conditionality (India) Local distributors selling imported filters (Cambodia) Carbon credit approaches Kenya, "latent demand" Cambodia, financing for Super Tunsai filter and cookstoves 8

9 HWTS Challenges/Opportunities Emergencies Prior education and follow-up important Catalyze efforts post-emergency Use of subsidies Distribution of HWTS with HIV/AIDS care (PEPFAR) Chlorine dispensers at community sources Harvard University/ Daniele Lantagne Developing a HWTS Action Plan What specifically and realistically can be done? Who will take action on each item? How will it be done (process)? When will it be done (immediate and long-term)? WHO/Heather Adair-Rohani What resources will be used to facilitate action? 9

10 Supporting Tools and Resources -Evaluating household water treatment options- Audience: certification organizations, regulators, evaluators, manufacturers & implementers Target pathogens: viruses, bacteria and protozoa Derivation of targets: Based on GDWQ approach (QMRA models) Tiered approach: Highly protective, protective, interim Laboratory protocols: Methods to verify performance Health-Based Targets Target Log 10 reduction required: Bacteria Log 10 reduction required: Viruses Log 10 reduction required: Protozoa Highly protective Examples: Boiling, combined approaches Protective Interim Examples: Membrane filters, PUR Achieves "protective" target for two classes of pathogens and results in health gains. Examples: Chlorine, ceramic filters 10

11 Supporting Tools and Resources Get involved with the Network Learn from others via Network listserve Serve on a working group (M&E, knowledge advancement, policy/advocacy, capacity building) Share experiences in EzCollab discussions Participate in a webinar Download and use new tools and guidance online Attend Network event Stanford University/ Amy Pickering Network Activities in 2011 Fall 2011 Evaluating household technologies workshop-country TBD Oct 2011 Network Annual Meeting- North Carolina, USA Ongoing Working group activities, including global M&E indicators and recommendations Monthly Newsletter Regular HWTS Webinars 11

12 Thank You Questions? Stanford University/Amy Pickering 12