2015 Scheme Side Event Summary

October 27, 2015
Chapel Hill, NC, USA
Convened by the World Health Organization

On Tuesday, October 27th, the World Health Organization convened a side event on the International Scheme to Evaluate Household Water Treatment Technologies (“the Scheme”) from 8:30 – 10:00 am EST. During the event, participants were provided with an overview of Round I results, an update on Round II, and capacity building efforts of the Scheme. In addition, there was discussion of how Scheme results apply to regulatory processes and how the impact of the Scheme can be maximized.

Key Discussions:

Batsi Majuru, World Health Organization

Batsi provided an overview of Round I of the Scheme, communication and application of evaluation results, and strategic objectives to strengthen national capacity in HWTS. These objectives relate to: strengthening national regulation and certification of HWTs, support field monitoring and evaluation, and strengthening quality management of manufacture of local products and performance evaluation. Look out for the Round I report for results of products tested and details on capacity building activities..

Nikki Beetsch, World Health Organization

Nikki presented an update on Round II testing of the Scheme, and highlighted the amendments that have been made to the testing protocol. These changes are aimed at improving the efficiency and reducing costs of the Scheme while maintaining the technical rigor. The amended (Version 2) of the Harmonized Testing Protocol will be available from the Scheme webpage at: http://www.who.int/household_water/scheme/en/.

Lydia Abebe, University of North Carolina & Ashebir Gebeyehu, Ethiopian Public Health Institute

Lydia and Ashebir presented an overview of a training workshop on evaluating the microbiological performance of HWT technologies in Ethiopia as part of the capacity building activities of the Scheme. Lydia led training activities among staff from three national laboratories, including Ashebir.  A major challenge identified during the training is lack of fiscal and supply chain access to material resources required for testing. The training resources will be made available on the Scheme webpage at: http://www.who.int/household_water/scheme/en/.

Daniele Lantagne, Tufts University & Manuela Kräuter, Helioz Social Enterprise

Daniele and Manuela took part in a Roundtable Discussion on “Dissemination of Scheme Results and Maximising Impact,”  which focused on the fact that many low and middle income countries have neither the capacity, nor the resources to evaluate HWTs. To disseminate scheme results and to maximize impact by ensuring that poor and vulnerable groups are reached, country level needs and household-level and systemic/structural barriers should be taken into consideration. Other solutions to these barriers include incorporating HWTS into community health education and other public health campaigns, making low-cost products with minimal maintenance needs readily available, establishing communities of practice, and helping to build systems at the national level that ensure approval of suitable HWTS technologies, based on the WHO Scheme results.

Q&A Session:

Q: What does fast tracking of evaluations for emergencies mean? Would this imply distribution of unproven technologies during emergencies?

A: With increasing disease outbreaks and other emergencies, there is a growing need for timely and independent guidance on the performance of HWT products. Many of the requests for guidance that WHO is receiving are for products for which there is some existing information, but the key needs relate to independent guidance on performance and deciphering that information to understand how it relates to WHO performance criteria. Thus, mechanisms for rapidly reviewing such information and, if required, verifying through testing are essential.

Q: How will Scheme results be disseminated?

A: In addition to the main report and listing of results on the WHO webpage, WHO is working to develop a tool to guide the use of the Scheme results in product selection, considering contextual factors such as user preferences, availability, cost, etc., with a brief catalogue / list of products evaluated and results, which can be more readily used by national governments and procuring agencies.

Q: What do you mean by fail and pass of a technology?

A: WHO considers this important and will include it in the development of a harmonized protocol.

Q: Are there standards for material quality and safety in the chemical HWT options?

A: WHO requests information on the wetted components for devices and the ingredients and processing for chemical manufacturers. The material list provided is reviewed by a technical expert to ensure there are not red flags, however there is no material safety testing (leaching) performed, in most cases. The exception being that in Round 1 arsenic levels in the finished water was requested for ceramic pot products due to information known on the potential for this metals to be present in mined clay. If a product is a disinfecting chemical or includes a disinfecting component (iodinated resin, for example), the finished water is analyzed for the disinfectant.

Q:  Does clogging of a system result in a failure?

A: Clogging does not represent a reason for failing a product. The reasoning is that if a user cannot get water, they cannot get unsafe water – therefore it is a failsafe. The test is designed to accelerate clogging (high turbidity) as it is important to see performance under clogging/reduced flow conditions. If a system clogs with use, the evaluation does allow and, in fact, requires this procedure to be performed during testing to be certain the procedure does not result in downstream contamination or a stress on the system that would result in a failing microbiological performance. Although not a cause for a failure if the product evaluation does not reach the final test capacity, however it is important to the scheme to see some data to indicate performance in the challenge test water phase, therefore not clogging during the general test water (low turbidity) phase.

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