WHO International Scheme to Evaluate Household Water Treatment Technologies UNICEF International Network on Household Water Treatment and Safe Storage.

WHO International Scheme to Evaluate Household Water Treatment Technologies

UNICEF International Network on Household Water Treatment and Safe Storage10-13 November 2014Vientiane, Lao

Basis for Scheme

• Household Water Treatment– Implementable, cost-effective approach to improved water quality– May play an important role in protecting public health where

existing water sources are untreated, not treated properly, or become contaminated during distribution or storage.

• Important interim solution for:

– ~ 780 million without access to improved drinking-water supplies (http://www.unicef.org/media/files/JMPreport2012.pdf).

– Billions without access to safe and reliable drinking-water

Requires optimal choice, consistent and correct use!!!

How to make an optimal choice?

Technologies:

Physical removal (filtration, adsorption, sedimentation)

Chemical (chlorine, iodine, silver)

Disinfection by heat (boiling, pasteurization)

Ultraviolet (UV) radiation

Solar disinfection

Combination

Emerging technologies

Options! Options! Options!

How to choose: basis for Scheme

• Locally relevant performance specifications needed for decision-making for selection of technologies or approaches – Information is not always available

• To realize health gains associated with HWT– HWT technologies must sufficiently reduce pathogens to result

in significant health gains– Technologies must reach and be consistently and correctly used

by the populations most at risk for waterborne disease.

• Until recently: No international specifications to evaluate performance claims of HWT product against a health-based performance benchmark existed.

WHO Recommendations (WHO, 2011)

• WHO established an international evaluation scheme for HWT to fill the need for rigorous health-based assessments of HWT technologies (December 2012)

• First document that sets forth global criteria to

evaluate microbiological performance of HWT

(June 2011)

• WHO Scheme to Evaluate Household Water

Treatment (HWT) Technologies

• “The Scheme”

WHO Recommendations and the Scheme

Objectives: • Promote and coordinate independent and consistent testing for the

evaluation of household water treatment products based on WHO criteria

• Support national governments building technical capacity of research and laboratory institutions; especially in applying WHO Guidelines on Drinking-water Quality.

Aim: • Guide WHO Member States and procuring UN agencies in the

selection of technologies and support national governments in evaluation related functions.

Why a WHO International Scheme?

• Many countries do not have the capacity to evaluate HWT based on WHO recommendations

• Ensures criteria are appropriately adopted

• Effective mechanism to build national capacity

• WHO, global authority on public health

• Precedence: WHO Pesticide Evaluation Scheme, WHO Evaluation of Rapid Malaria Diagnostic Tests

Scheme Scope Products included in the Scheme

Household water treatment technology (definition)Products used in households or similar settings to remove microbiological water contaminants that may pose health risks.

Priority for testing: • Low-cost• Appropriate for developing country settings • Generally “free standing” products • Serve a limited number of individuals each

day.

Scheme ComponentsLaboratory Testing

Evaluation based on laboratory testing• Based on harmonized test protocol • http://www.who.int/household_water/scheme/HarmonizedTestProtocol.pdf?ua=1

• Microbiological reduction/inactivation performance specifications (not chemical)

• Tiered approach: series of health-based performance targets

Subsidized testing – funding secured for Scheme• Subsidy subject to availability of funds• Criteria: size and capital resources of manufacturer;

origin/location of manufacturer; local need; cost/liter treated

Scheme ComponentsDesignated Testing Laboratories

Selection criteria:• Institution with formal WHO relations• Not-for-profit, ISO certified• Stable income of core activities• Strictly adhere to harmonized test protocols/plans• Agree to WHO ownership of test results• http://www.who.int/household_water/scheme/laboratories/en/

Currently designated: • NSF International (USA); KWR (Netherlands)• Aim to designate labs in different geographic regions

Scheme ComponentsIndependent Advisory Committee (IAC)

• Advisory body to WHO on the Evaluation Scheme.

• Experts with demonstrated commitment to advancing public health

• Goal: attain an adequate technical distribution of expertise in drinking water quality, microbiology, water treatment technology and/or regulation, geographical and gender balance.

• http://www.who.int/household_water/scheme/IAC/en/

Scheme ComponentsPerformance - Tiered approach

WHO HWT: Series of health-based performance targets which allows for incremental improvements

Highly protective: 10-6 DALY/person/yearProtective: 10-4 DALY/person/yearLimited protection: Meets “protective” for two

classes of pathogens

Based on Disability-Adjusted Life year (DALY)

Target pathogens: viruses, bacteria and protozoa

Rating Log10 reduction:

bacteriaLog10 reduction:

virusesLog10 reduction

protozoa

Highly protective(10-6 DALYs/ P/yr)

≥ 499.99%

≥ 599.999%

≥ 499.99%

Protective

(10-4 DALYs/ P/yr)

≥ 299%

≥ 399.9%

≥ 299%

Limited protection

Achieves “protective” target for two classes of pathogens

Basis for assessing performance

Scheme Procedure

Invitation for expression of interest• Manufacturers to submit detailed information on product

WHO screening of dossiers• WHO will review with input from the Independent Advisory

Committee and determine which products are eligible for testing

Testing (or evaluation of exiting data)• Products and payment for testing sent to laboratories• Specific test plans, based on harmonized test protocol,

developed by laboratories in consultation with manufacturers

Scheme Procedure, contin

Testing Results and Reporting• Laboratory will report results to WHO• WHO with advice from IAC will determine level of performance• Summary of ALL results posted on WHO website

Use of Information • Manufacturers can discretely list performance level achieved in

technical material addressed to water and health professionals• May not use WHO name or logo in any manner

Maintenance • Manufacturers update WHO on changes in product/manufacturing

Challenges and Conclusion

• Starting simple; 2 laboratories and technically advanced protocols

• Future work on simplifying protocols and building national laboratory capacity

• Linking evaluation to new and innovative products

• Optimizing performance in tandem with achieving consistent and correct use

HWT only has health impact if used consistently and correctly by at-risk populations!

WHO/ M Montgomery

More information

Visit Scheme Webpage: http://who.int/entity/household_water/scheme/en/

Contact: Nikki Beetsch

Water, Sanitation, Hygiene and Health

World Health Organization

[email protected] or [email protected]