© Copyright Medentech 2009 New Technologies & Techniques for Scaling-up Household Water Treatment Ulick Stafford PhD R&D Manager Medentech, Clonard Road,

© 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


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


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%


• 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


• 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


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


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


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:


• 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


• 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


• 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

© Copyright Medentech 2009(C) Copyright Medentech 200

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


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


• 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!


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.


• 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

Documents

© Copyright Medentech 2009 New Technologies & Techniques for Scaling-up Household Water Treatment Ulick Stafford PhD R&D Manager Medentech, Clonard Road,