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Conference Summary
International Network to Promote
Household Water Treatment and Safe Storage
Thomas F. Clasen* and Eric D. Mintz†
*London School of Hygiene and Tropical Medicine, London, United Kingdom;
and †Centers for Disease Control and Prevention, Atlanta, Georgia, USA
Suggested citation
for this article:
Clasen TF, Mintz ED. International network to promote household water
treatment and safe storage [conference summary]. Emerg Infect Dis [serial
on the Internet] 2004 Jun [date cited]. Available from: http://www.cdc.gov/ncidod/EID/vol10no6/04-0243.htm
On February 25, 2003, more than 30 representatives from United Nations
agencies, international nongovernmental organizations, research institutions,
professional associations, and private companies met in Geneva, Switzerland,
to establish the International Network to Promote Household Water Treatment
and Safe Storage, sponsored by the World Health Organization (WHO) (Figure).
The group has since convened at the Kyoto World Water Forum, Kyoto, Japan,
in Washington, D.C., and in Cape Town, South Africa. At the next plenary
meeting, in Nairobi, Kenya, on June 14–15, 2004, participants will consider
a 5-year strategic plan to reduce waterborne disease through specific
actions in research, advocacy, communication, and implementation.
This first phase has seen progress in the organization and expansion
of the network's participant base and real work in the field, building
on the evidence that household water management can significantly contribute
to meeting the Millennium Development Goals for child survival and water
security. This fieldwork has reaffirmed the conclusion of a WHO-sponsored
review: simple, low-cost interventions for home water treatment and storage
lead to dramatic improvements in drinking water quality and reductions
in diarrheal disease (1).
The Safe Water System, developed by the Centers for Disease Control and
Prevention (CDC), the Pan American Health Organization (PAHO), and WHO,
combines point-of-use water disinfection with locally produced sodium
hypochlorite, safe storage in narrow-mouth containers, and community education
and has consistently been effective in preventing diarrhea (2,3).
In recently published trials, the Safe Water System reduced diarrhea by
24% in Bangladesh (4) and 25% in Guatemala (5).
In a 2003 study, the Safe Water System reduced diarrhea by 30% among persons
with HIV infection in rural Uganda (6).
In 2003, accounts of field trials of a household-based flocculant-disinfectant
for water treatment were published for the first time. Developed by the
Procter & Gamble Company and CDC, the intervention combines a chemical
flocculant with a timed-release hypochlorite disinfectant. Through precipitation,
coagulation, and flocculation, the combined product physically removes
a broad range of microbial pathogens and chemicals, including arsenic,
and concurrently inactivates remaining microbes with free chlorine (7,8).
In a randomized, controlled trial in Guatemala, use of the product reduced
the incidence of diarrhea among intervention households by 24%, or 29%
when the treated water was stored in a vessel designed specifically for
safe storage (5).
In 2003, considerable progress was made in evaluating the impact of household-based
filtration. In a large field trial, Rita Colwell and colleagues showed
that simple filters made from sari cloth or nylon, combined with appropriate
education, reduced cholera by 48% compared to controls (9).
Locally produced slow sand and ceramic filters were evaluated by Massachusetts
Institute of Technology postgraduate students (10–12).
In a trial in Bolivia, locally fabricated filters that used imported ceramic
candles eliminated all detectable fecal coliform bacteria in household
drinking water and reduced levels of diarrhea by 64% (13).
In 2004, a systematic review of 57 studies assessed the extent and causes
of microbiological contamination of household drinking water between the
source and the consumer (14). The reviewers concluded
that water quality declines substantially after collection and recommended
household treatment and safe storage of water. A systematic review of
the health impact of improved water quality is under way, driven in part
by the burgeoning evidence indicating that substantial health gains result
when water is treated in households and protected against recontamination
(15,16).
In Nairobi, network members will review recent progress and plan their
next steps for advancing household-based water management. Stakeholders
from all organizations are urged to participate in, contribute to, and
take full advantage of, this important new movement in the battle against
waterborne disease. For more information on the network and to register
for the Nairobi meeting, readers are referred to: http://www.cdc.gov/safewater/network.htm
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