© copyright medentech 2009 new technologies & techniques for scaling-up household water...
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© Copyright Medentech 2009
New Technologies & Techniques for Scaling-up Household Water
Treatment
Ulick Stafford PhDR&D Manager
Medentech, Clonard Road, Wexford
NUI Maynooth, November 30 2010
© Copyright Medentech 2009(C) Copyright Medentech 200
1.1 billion people do not have access to drinking water from improved sources (18% of world’s population)
Up to an estimated 4 billion diarrheal episodes occur per year (1.2b associated with water), with up to 3.5 million deaths
Every day diarrheal diseases kill 5,000 young children
Unsafe water kills
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U.N. Millennium Development Goals
• MDG Goal No 7: to reduce by half the proportion of people without sustainable access to safe drinking water and basic sanitation by 2015 (UN World Summit 2002)
• To reach the MDG for drinking water requires 1.1 billion people to gain access in the next decade:
• 300,000 people every day!!!!!
• 84% are in rural areas
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Improved Drinking Water?
• Gundry et al study:• South Africa and Zimbabwe• Randomized study – 254
children, aged 1-2 years• Dry and wet seasons
> 10 CFU/100ml E.coli
Improved(standpipe, borehole, protected
well)
Unimproved(unprotected well/spring,
river/canal)
At Source 12% 71%
Household Storage 41% 81%
Drinking Cup 51% 82%
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• The burden of unsafe water negatively effects:• the healthcare system – at any one time half the
world’s hospital beds are occupied by people with water-borne disease1
• the income generation of households, community and, therefore, the nation as a whole
• the education capacity – children not attending school
• the absorption of nutrients, especially in young children, reduced resistance to infection and, potentially, long-term gut disorders 2 – contributes to malnutrition
• preventable mortality and morbidityHousehold water treatment can pay back US$60 for every US$1 invested (3)
1. Water for Life Decade. UN Factsheet
2. T. Clasen et al. Interventions to improve water quality for preventing diarrhoea: review, 2006
3. Water for Life. WHO/Unicef, 2005
Prevention is better than cure
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• Simple techniques for disinfecting water at household level are shown to considerably reduce diarrhoea: twice as effective as interventions at source 1)
• Because household water treatment techniques can be cheap and the impact of improving water quality dramatic, household water treatment and safe storage can produce huge health and economic benefits 2)
• The most cost-effective strategy evaluated was disinfection of unsafe water at the point of use
• This is a simple technology, is of very low cost, and would achieve substantial health benefits 3)
• Chlorination, at the point-of-use, has been shown to reduce diarrhoea by 39%1. J. Borazzo et al. Scrub a Dub Dub: Is there anything new in Hygiene Improvement. USAID
2. Water for Life, WHO/UNICEF, 20053. WHO World Health Report, 2002
Household Water Treatment
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Aquatabs meet all the criteria & sets the quality standards for HWTS products: Safety and consistent quality Biocidal effectiveness – > 15 field
evaluations Health-Impact / Water Quality Acceptable by indigenous peoples – > 10
studies Affordable by low-income earners
Asia: €0.03 to €0.05 US cents per 20 litre tabletIndia: €0.01 to €0.02 US cents for 10 litre tabletAfrica: €0.02 to €0.05 US cents for 20 litre tablet
Social marketing / commercial marketing Availability, Scalability – 2 sites/3 Billion
Aquatabs Shelf Life – 5 years Light & Portable – appropriate for rural
area distribution, the last mile.
Aquatabs – Criteria for HWTS
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Benefits to users in low-income countries
• Simple to use. No need to measure
• Can be purchased in amounts to suit
available funds
• Safe. Will not bleach or burn
• Light to transport & small to store
• Taste acceptability
• Cultural (Religious) acceptability (Halal
Certified)
• Quality assured (Active ingredient USEPA &
NSF certified)
• NaDCC is now in WHO drinking water
guidelines
* Joint Expert Committee on Food Additives
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Target Populations:• At the high risk of diarrhoeal
diseases from unsafe water • Base of the economic Pyramid (BOP)
Demand-driven model (Non Subsidised)• Commercial• Profitable Distribution Channels – 8
times the added value remains in country
• Sustainable & scalable
Social & Commercial Marketing • Health Education / Behaviour
Change• “Above the line” & “Below the line”
Aquatabs – Distribution Model
Objectives:
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• HWTS is the ultimate in education pre-preparedness for crisis situations. The full community is educated/trained for crisis (even if uptake is low).
• HWTS is the ultimate in deep prepositioning. Stocks readily available in most crisis prone areas.
• This secondary benefit equates to DALYs averted.• Brings down cost of crisis interventions for public
sector and NGOs • Post event continued use & net savings to the
public sector.• Recent examples, Haiti, Ethiopia & Vietnam. HWTS
products immediately available and population aware to self-dose.
Emergencies – the hidden success
of HWTS Network
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• Immediate availability and commercial sales channels in place result in most rapid deployment to crisis hit areas. Haiti – 50 million tablets shipped in within 10 days due to HWTS program availability. Pakistan 150 million within 3 weeks.
• Immediate availability of local text promotional / educational materials. A Langtane study has shown an uptake level 9 times greater with proper usage education than simply making product available in a crisis.
HWTS is pre-positioning
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• Behavioural Change Marketing – techniques
• Taste improved tablets• Long term double blind placebo
controlled Health Impact Trial India• Schools, Village & town level water
disinfection systems• Floc tablet • New “KISS” system
New Medentech Developments
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Self Chlorination – activated with flow of water
Attached to end of stand pipes or roof tanks inlets
Robust plastic design – exceptional long life unit
Zero maintenance
Example of HWTS related new product developments
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Chlorinates 20 litres per minute
200,000 litres at 1ppm Ideal for schools – low cost Active chlorination ceases
once flow of water stops. Can continuously chlorinate Adaptable to rainwater
harvest, standpipes etc. Adjustable chlorine delivery
0.5- 5ppm
Aquatabs EZ
Ball-cock mounting option
Simple adjustable chlorine dose
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• The global population is increasing faster than all our combined efforts are reaching
• The WHO International Network to promote Household Water Treatment and Safe Storage (HWTS) needs your support
• The mission is to support 750 million people with household water interventions by 2015
• Medentech is a Collaborating Organisation within the Network
10 billion litres is not enough!
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1
Medentech
Importer
Commercial“Retail”
Distribution
Emergency & Non
Commercial
Commercial“Community Based”
Distribution
Wholesalers/ Distributors
NGO’s / Government
NGO’s/FBO’s, Regional/ District
Networks & Micro-Enterprises
Kiosks / Pharmacies
Health Sales Agents & Direct
Sales
Social Marketing
Organisation
Social Marketing
Organisation
Government / National
Stakeholder Group
Government / National
Stakeholder Group
International Network
International Network
Special Risk Groups –
Schools, etc.
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• Support HWTS products and usage by promoting behavioural marketing
• Carry out a long term double blind placebo controlled Health Impact Trial
• Introduce taste improved tablets• Schools, Village & town level water
disinfection systems• Floc tablet • New disinfection systems
Medentech is Committed to