New Technologies & Techniques for Scaling-up …hwts.web.unc.edu/files/2014/09/4-4-Stafford-New-Technologies... · New Technologies & Techniques for Scaling-up Household Water Treatment

© Copyright Medentech 2009

New Technologies & Techniques for Scaling-up Household Water Treatment

Ulick Stafford PhDR&D Manager

Medentech, Wexford, Ireland

Disinfection 2011, Cincinnati, April 11


Outline

1. Need for water treatment.2. Household water treatment is an effective solution.3. Aquatabs – now approved by EPA.4. Prepositioning for emergencies.5. New Medentech tablet developments.6. New Medentech system developments.7. Conclusion – the need and Medentech’s

commitment.

© Copyright Medentech 2009(C) Copyright Medentech 200

Ø 1.1 billion people do not have access to drinking water from improved sources (18% of world’s population)

Ø Up to an estimated 4 billion diarrheal episodes occur per year (1.2b associated with water), with up to 3.5 million deaths

Ø 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 morbidity

Household water treatment can pay back US$60 for every US$1 invested (3)

1. Water for Life Decade. UN Factsheet2. T. Clasen et al. Interventions to improve water quality for preventing diarrhoea: review, 20063. 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. USAID2. Water for Life, WHO/UNICEF, 20053. WHO World Health Report, 2002

Household Water Treatment


EPA approved Aquatabs label 71847-4 on February 4, 2011.AquatabsÒ is effective against bacteria, viruses and giardia in 30 min.Dose 2.6 ppm in clear water and 6.5 ppm in challenge water.

Aquatabs – Approved by EPA


Aquatabs meet all the criteria & sets the quality & safety standards for HWTS products:üBiocidal effectiveness – > 15 field evaluationsü Health-Impact / Water Qualityü Acceptable by indigenous peoples – > 10 studiesü 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

ü Social marketing / commercial marketingü Availability, Scalability – up to 3 Billion Aquatabsü Shelf Life – 5 yearsü 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


ü Target Populations:• At the high risk of diarrhoeal diseases from

unsafe water • Base of the economic Pyramid (BOP)

ü Demand-driven model (Non Subsidised)• Commercial• Profitable Distribution Channels – 8 times

the added value remains in country• Sustainable & scalable

ü Social & Commercial Marketing • Health Education / Behaviour Change• “Above the line” & “Below the line”

Aquatabs – Distribution Model

Objectives:


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

Government / National

Stakeholder Group

International Network

Special Risk Groups –

Schools, etc.


• 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 successof 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 Lantagne 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• Floc tablet • Schools, Village & town level water

disinfection systems• New in-line system

New Medentech Developments


Improved Taste Aquatabs

• Aquatabs with improved taste developed and tested.

• 67 mg Tablets on sale in Indonesia and Vietnam

• 12 months accelerated stability completed• Used in blinded chlorine efficacy study in

India• 33 mg tablets made for consumer trial in

Bangladesh


Flocculent Tablet

• Medentech is developing a flocculent tablet for turbid water with high chlorine demand.

• A tablet will pretreat 5-10L of water.

• The tablet is based on an aluminium coagulant that does not have a metallic aftertaste.

© Copyright Medentech 2009(C) Copyright Medentech 200

ØSelf Chlorination –activated with flow of waterØAttached to end of stand

pipes or roof tanks inletsØRobust plastic design –

exceptional long life unitØZero maintenance

Aquatabs EZ


Ø Chlorinates 20 litres per minuteØ 200,000 litres at 1ppmØ Ideal for schools – low costØ Active chlorination ceases once flow

of water stops.Ø Can continuously chlorinateØ Adaptable to rainwater harvest,

standpipes etc.Ø Adjustable chlorine delivery 0.5-

5ppm

Aquatabs EZ

Ball-cock mounting option

Simple adjustable chlorine dose


Aquatabs “ChloRun”• A chlorinator, using a granular

chlorine-donor (NaDCC) and dedicated dispensing system– US EPA/NSF approved NaDCC

(conforms to WHO guidelines) – Stable– No insoluble residues– No liquids/gas– Safe – no special handling– Non-hazardous for transportation – Cost-effective– Little storage space required


Aquatabs “ChloRun”• Operation:

– NaDCC granules are dosed from the drum into the flushing tank

– The granules are then sucked out into a cyclone system, that ensures complete dissolution

– The solution is then returned to the flushing tank, using a solenoid circulation pump

– Raw water is continually added to maintain a constant strength of chlorine solution (up to 10% -100,000 mg/l)

– The stock solution is proportionately dosed into the distribution network

– Dosing is switched off in the case of a fault– The Cl level in the drum is controlled. At a level of

ca 10 kg a signal is sent. A 2-3 kg remaining the machine is halted

– The control system governs all functions and sends an alarm (e.g. to a mobile phone) for a malfunction

2 2

Raw water in

NaDCC Drum

Flushing Tank

Cyclone

Control System


Aquatabs “ChloRun”• Other similar units available for community use• Smaller unit developed (on going trials in India) • Also case study for irrigation use, treating

waste water for edible crops– Plantation size: 17 acres– Flow rate: 35m3/hr– Chlorine demand: about 10mg/l– Annual water consumption: about 20,000m3

– NaDCC consumption 50kg/month


• 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 Organization within the Network

10 billion liters is not enough!


• Support HWTS products and usage by promoting behavioural marketing

• Carry out product testing including a long term double blind placebo controlled Health Impact Trial

• Introduce taste improved tablets• Develop a Floc tablet • Schools, Village & town level water

disinfection systems• New disinfection systems

Medentech is Committed to


Questions?

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New Technologies & Techniques for Scaling-up …hwts.web.unc.edu/files/2014/09/4-4-Stafford-New-Technologies... · New Technologies & Techniques for Scaling-up Household Water Treatment