Promoting Safe Household Water Treatment and Storage
New International Partnership Announced at 3rd World Water Forum

The 3rd World Water Forum recently highlighted more than 100 new initiatives to increase access to safe water and sanitation services, improve water resources management, and achieve a better balance among competing water uses around the globe. The forum, held March 16-23 in the neighboring Japanese cities of Kyoto, Shiga and Osaka, was designed to build on previous international water and sustainable development conferences, including last year's World Summit on Sustainable Development (WSSD). An estimated 24,000 participants from 182 countries discussed practical, on the ground programs to help achieve widely touted public goals - including the United Nations-backed goals to reduce by half the proportion of people worldwide without access to safe drinking water and sanitation by the year 2015.

One ambitious new partnership was announced during the World Water Forum session on Water, Sanitation and Health. The World Health Organization and a growing group of non-governmental organizations (NGOs), government agencies, research institutions and private companies have initiated an innovative program to bring in home water treatment products to communities not served by municipal supplies or safe household wells.

As was repeated countless times during the forum, more than 1.2 billion people currently lack access to safe drinking water. The health impacts of this situation are staggering. Diarrheal diseases, from cholera, E. coli bacteria and other bugs, kill more than two million children each year. Meeting the U.N. goal will require supplying safe water to 125,000 new people every day for the next 12 years. Even if this ambitious goal is reached, hundreds of millions of people around the globe will still be waiting for this essential service. While the ultimate objective should be safe water taps in every home, more modest, interim solutions are clearly needed now.

The International Network to Promote Safe Household Water Treatment and Storage comprises a diverse set of partners, including the U.S. Centers for Disease Control and Prevention, Population Services International, Johns Hopkins University, Proctor & Gamble, the Chlorine Chemistry Division of the American Chemistry Council, and numerous others. The Network's stated mission is:

To achieve a significant reduction in waterborne disease, especially among children and the poor, by promoting safe household water treatment and storage.

Household treatment systems have the potential to significantly reduce waterborne disease for hundreds of millions of people in developing countries. A substantial body of research suggests that point-of-use water disinfection with chlorine, combined with safe water storage and basic hygiene education, provides the biggest health benefit at the lowest incremental cost. To have a meaningful impact, household treatment must be readily available, easy to use, and affordable to populations with incomes well below $1 per day.

Collaborating through the Network, partners will work to:

• Develop and supply point-of-use treatment products;
• Build viable commercial markets;
• Promote local manufacturing and distribution channels;
• Develop programs that integrate water treatment with sanitation and hygiene initiatives;
• Promote and support independent, comparative research to assess these environmental health interventions.

A key component of the Network is a practice known as "social marketing." Social marketing combines the provision of needed health products and services to lower-income communities with education and outreach to motivate healthy behavior. Population Services International (PSI), a nonprofit organization working in more than 60 countries, is a world leader in social marketing, specializing in AIDS prevention, family planning and maternal and child health.

Through social marketing, products are made available for sale through distribution channels already in place for other commercial products. By selling products rather than giving them away, PSI taps the resources of the local commercial infrastructure, making products available at a variety of retail outlets. Products are marketed using mass media, such as billboards and radio advertising, and packaged with locally tailored instructions and messages.

Various household treatment products are currently available, and promoted by Network partners. One system designed by the U.S. Centers for Disease Control and Prevention has already been successfully used in a number of countries. The CDC "Safe Water System" consists of three components:

1. Disinfection using a dilute solution of chlorine bleach (sodium hypochlorite) packaged specifically for this purpose.

2. Safe water storage using a 20-liter plastic container with a spigot and a narrow mouth to prevent hands from touching the water.

3. Community educational and behavior change interventions to teach the causes of diarrheal diseases, how water becomes contaminated, and how to use the Safe Water System.

Working with nongovernmental organizations, such as CARE, and chemical companies, CDC scientists have been testing the Safe Water System since the mid-1990s. In multiple trials, people who use the chlorine solution and specially designed storage vessels experience roughly half as much diarrhea as neighbors who don't use the system. The storage vessel costs approximately $4.00, and the monthly cost of the sodium hypochlorite solution ranges from $0.15 to $0.30 per household. An additional benefit of chlorine is that some of the chemical remains in stored water and continues to work as an anti-microbial agent.

Another Network partner, the Proctor & Gamble Company, has developed its own household water treatment product. The PUR system uses a small sachet of powdered treatment chemicals to provide precipitation, coagulation, and flocculation as well as chlorination. Although more expensive, this combination provides superior protection to chlorine alone in turbid water. It also reduces organics and heavy metals, and improves the visible clarity of water.

Chlorination has the longest track record and most extensively documented benefits of any household treatment method. However, other in-home methods can be used to improve drinking water quality. Available practices include boiling water, using solar radiation (e.g., filling clear containers with water and exposing them to strong sunlight), filtration (with cloth, densely packed sand, or specially designed ceramic filters), or some combination of alternatives. There are varying amounts of research validating the benefits of these alternatives. In addition, the practicality and effectiveness of these alternatives will vary greatly from community to community. Clearly, more work is needed to understand where and when different methods may be most appropriate.

The initial scope and impact of Network activities will depend on the resources that partners are able to bring to the effort. As Network plans are formalized over the next few months, Network members will be asked to financially support specific projects and to recruit new partners. Hopefully, early successes documented by independent research will help build momentum to carry these initiatives into more countries, reaching more and more of the underserved communities around the globe.

More information on the World Water Forum is available at:
http://www.world.water-forum3.com/

More information on the CDC Safe Water System is available at:
http://www.cdc.gov/safewater/default.htm