point-of-use water treatment & lifestraw® christian connections for international health (ccih)...
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Point-of-Use Water Point-of-Use Water TreatmentTreatment
&&LifeStraw®LifeStraw®
Christian Connections for International Health (CCIH) Christian Connections for International Health (CCIH) 24 May 200824 May 2008
AttributionAttribution
Tom Clasen, London School of Tom Clasen, London School of Hygiene and Tropical Medicine Hygiene and Tropical Medicine (LSHTM), presentation (LSHTM), presentation Washington DC, February 2008Washington DC, February 2008
University of North Carolina (M. University of North Carolina (M. Sobsey, J. Brown)Sobsey, J. Brown)
LSHTM (S. Cairncross, V. LSHTM (S. Cairncross, V. Curtis, I. Roberts, T. Rabie, L. Curtis, I. Roberts, T. Rabie, L. Smith, W. Schmidt, S. Thomas)Smith, W. Schmidt, S. Thomas)
WHOWHO
3963
2777
1798 15661271
611
0500
10001500200025003000350040004500
De
ath
s (
00
0s
)Leading Causes of Deaths from Leading Causes of Deaths from
Infectious DiseasesInfectious Diseases2004 World Health Report
Childhood Mortality by CauseChildhood Mortality by Cause
Black RE, Morris SS & Bryce J (2003). Where and why are 10 million children dying every year? Lancet 361:2226-34.
1990s: Reduction in Diarrhea from Improvements 1990s: Reduction in Diarrhea from Improvements in Water Qualityin Water Quality
Expected reduction in diarrheal disease morbidity from Expected reduction in diarrheal disease morbidity from improvements in one or more components of water and improvements in one or more components of water and
sanitation (Esrey, 1991)sanitation (Esrey, 1991)
All StudiesAll Studies Rigorous StudiesRigorous Studies
No. StudiesNo. Studies ReductionReduction No. StudiesNo. Studies Reduction Reduction
Water and Water and SanitationSanitation 77 20%20% 22 30%30%
SanitationSanitation 1111 22%22% 55 36%36%
Water Quality and Water Quality and QuantityQuantity 2222 16%16% 22 17%17%
Water QualityWater Quality 77 17%17% 44 15%15%
Water QuantityWater Quantity 77 27%27% 55 20%20%
HygieneHygiene 66 33%33% 66 33%33%
Interventions at SourceInterventions at Source
Effectiveness Data: Cochrane Review
Clasen T, Roberts I, Rabie T, Clasen T, Roberts I, Rabie T, Schmidt W, Cairncross S. Schmidt W, Cairncross S. Interventions to improve Interventions to improve water quality for preventing water quality for preventing diarrhoea (A Cochrane diarrhoea (A Cochrane Review). In: The Cochrane Review). In: The Cochrane Library, Issue 3, 2006. Library, Issue 3, 2006.
Summary of Effectiveness—Under 5sSummary of Effectiveness—Under 5sIntervention Type Intervention Type
(no. trials)(no. trials)
EffectEffect
(random)(random)
% % ΔΔ
(1-RR)(1-RR)
95% CI of 95% CI of EstimateEstimate
Source (4)Source (4) 0.850.85 15%15% 0.71 to 1.020.71 to 1.02
Household (25)Household (25) 0.560.56 44%44% 0.39 to 0.810.39 to 0.81
Filtration (5)Filtration (5) 0.360.36 64%64% 0.24 to 0.530.24 to 0.53
Chlorination (12)Chlorination (12) 0.760.76 24%24% 0.67 to 0.860.67 to 0.86
Solar Disinfection (0)Solar Disinfection (0) nana nana nana
Flocc/Disinfection (7)Flocc/Disinfection (7) 0.520.52 48%48% 0.20 to 1.370.20 to 1.37
Flocc/Disinf (6)(Flocc/Disinf (6)(ex Doocy*)ex Doocy*) 0.710.71 29%29% 0.61 to 0.840.61 to 0.84
Impr. Storage (1)Impr. Storage (1) 0.690.69 31%31% 0.47 to 0.810.47 to 0.81
Interventions at the HouseholdInterventions at the Household
Continuing Challenges in Point-of-Use Continuing Challenges in Point-of-Use
No successful large-scale modelsNo successful large-scale models Little evidence that purely commercial strategies Little evidence that purely commercial strategies
reach the most vulnerable populationsreach the most vulnerable populations Questions about whether any HWTS product or Questions about whether any HWTS product or
implementation strategy has achieved consistent, implementation strategy has achieved consistent, correct and sustained use among the most correct and sustained use among the most vulnerable populationsvulnerable populations
Little success in attracting significant donor funding Little success in attracting significant donor funding (compared, e.g., to HIV/AIDS, TB, malaria)(compared, e.g., to HIV/AIDS, TB, malaria)
Scaling Up: 2005-2007Scaling Up: 2005-2007NUMBER OF HWTS USERS BY YEAR
0
5000
10000
15000
20000
25000
2005 2006 2007
Year
Num
ber o
f Use
rs (0
00s)
Aquatabs
PUR
Sodis
Biosand Filters
CWP-Cambodia
SWS-PSI
100% Coverage of 1.1B without access 100% Coverage of 1.1B without access to improved water suppliesto improved water supplies
NUMBER OF HWTS USERS BY YEAR
0
200000
400000
600000
800000
1000000
2005 2006 2007
Year
Num
ber o
f Use
rs (0
00s)
Aquatabs
PUR
Sodis
Biosand Filters
CWP-Cambodia
SWS-PSI
Coverage G
ap
Different Needs / Different DriversDifferent Needs / Different Drivers
TIMETIME
Development of Development of Commercial Commercial
MarketMarket
Subsidy / Time-Subsidy / Time-limited Interventionlimited Intervention
EquityEquity
Different Needs / Different DriversDifferent Needs / Different Drivers
TIMETIME
SOUTH SUDAN
CONGO (DRC)
PNG
ZAMBIA
CAMBODIA
NIGERIA
GHANA
SENEGAL
INDIA
CHINA
MEXICO
BRAZIL
1 2 3 4
LifeStraw FamilyLifeStraw Family Highly effective against all categories of Highly effective against all categories of
microbial pathogensmicrobial pathogens High output (150ml/min)High output (150ml/min) High capacity (>18,000 L)High capacity (>18,000 L) Operates in high and variable turbidity (15 NTU)Operates in high and variable turbidity (15 NTU) Low cost Low cost Easy to deploy, learn, use, maintainEasy to deploy, learn, use, maintain Portable, robustPortable, robust Improves water aestheticsImproves water aesthetics No chemicalsNo chemicals No replacement partsNo replacement parts Protects against recontaminationProtects against recontamination
Lab TestingLab Testing
LifeStraw Family: Congo LifeStraw Family: Congo