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Benefits of Integration of HWTS
into School, HIV/AIDS, WASH
and Nutrition Programs
Greg Allgood, PhD
PUR as Example of HWTS
• Reverse engineered current
municipal treatment process
• Small sachet to treat 10 liters
of water using coagulation,
flocculation and disinfection
• Uses same ingredients used
in municipal water treatment
– Calcium Hypochlorite as
Disinfectant
– Ferric Sulfate as Coagulant
Laboratory & Field Testing of PUR
• EPA approved as
“microbiological purifier “
• Meets WHO criteria for
“Protective” POU
7 log bacteria
4 log viruses
3 log chlorine resistant
parasites
• Reduce heavy metals
98% arsenic
Randomized controlled
trials show average of
50% reduction in diarrhea
Sustainable Provision
• P&G provides the packets at cost as
part of not-for-profit Children’s Safe
Drinking Water Program
• Provide for emergency relief and
sustained distribution through more
than 100 partnerships
Emergency Relief
• CDC monitored use of
packets in Haiti and showed
people used it correctly
provided simple training was
provided
• Developed trainer of trainer
video and SOP
• Used for many major
disasters including tsunami,
earthquakes, floods, cholera
outbreaks
Social Marketing
• Work with international social marketing experts including PSI/PACE
• Existing programs in 14 countries including East Africa (Ethiopia, Kenya, Rwanda, Tanzania, Uganda)
• Work with community based groups, schools, clinics to create habit change – Learned through trial and error
about effective integration
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Children’s Safe Drinking Water Program
HWTS Helps Keep Kids in School
• World Vision Malawi measured a
57% decrease in school
absenteeism and 90% decrease in
diarrhea in schools
• CDC measured in CARE Kenya
school programs a 26% decrease in
school absenteeism that was
sustained a year following
intervention
• Reached more than 1.6 million
children to date
HWTS Integration into WASH
• World Vision measured 75% increase in latrine building in Malawi school program
• IMC measured increased handwashing at correct times in DR Congo from 37% to 91%
• Africare measured increase in community building of latrines in Uganda (93% coverage)
HWTS Helps People with HIV/AIDS
• PUR removes chlorine resistant parasites that can be fatal to people living with AIDS
• UNC Med School in Malawi demonstrated 99% use of hygiene package in PMTCT program, low rates of diarrhea in mothers and babies at weaning, and increased retention in program
• Alive Medical, Child Fund Intn, and FXB incorporated PUR into HIV/AIDS programs and reporting high acceptance
• Cost effective at $0.02/day
• Providing 20 million PUR packets this year with PEPFAR support in Ethiopia, Malawi, Nigeria, and Tanzania
HWTS Helps Malnourished Kids
• Malnourished children are susceptible
to opportunistic infections
• CARE Ethiopia incorporated PUR into
program for malnourished children and
found less diarrhea and trend for
reduced time on therapy
• Cost effective at 40x less/day than
Plumpy Nut
Integration of HWTS into Health and
Hygiene Programs
• Clinically effective
– Absorption of ARVs and
improvement in nutritional
status
• Better overall outcomes
– Increased school attendance
and adoption of
hygiene/sanitation practices
• Cost-effective
– 40-50x less expensive than
ARV or nutrition therapy