Guidelines for summary reports in accordance with Article 7 of the Protocol on Water and Health

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Guidelines for summary reports

and WHO guidelines� What IS a WHO “guideline” and how is it supported?

� Drinking-water quality

� Outbreaks and incidence of water-related disease

� Freshwater resource management

� Re-use of treated wastewater

� Putting it all together: the Atlas on Water and Health

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How to make a WHO Guideline?

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Supporting the Guidelines @ WHO

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IMPORTANT !� WHO Guidelines are exactly that: guidelines� WHO Guidelines are not immutable standards or norms� Each guideline has

� Summary statement in the GDWQ� Detailed review document� Management guidance� Status in the technical achievability

� 3rd edition describes a “Framework for Drinking-water Safety”

� Countries are to set their own legal values, based on paramount consideration of protecting health of their population

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Not stand-alone� Often, ISO norms offer valuable operational guidance

on analytical methods, sampling and sampling preparation.

� Often, JRC manuals gives good guidance on specific problems, such as the sampling methodology for lead

� Often, WHO complements guidelines with specific handbooks on how guidance can be implemented in practice

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GDWQ � Introduction� Framework for safe

drinking-water

� Health-based targets

� Water safety plans

� Surveillance

� Specific circumstances

� Microbial aspects

� Chemical aspects

� Acceptability aspects

� Fact sheetsPart 1 General Aspects Sub 1 Formulation

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Part 2 I B Bacteriological quality� Water safety plan are aiming at increasing the

microbiological safety of drinking water

� TFWRDS: Policy paper for water-related disease surveillance

� TFWRDS: Technical guidance document

(reviewed Czech MOH and Belgian Federal Public Health Institute)

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Part 2 I C Chemical valuesGV LOD TA

F 1.5 mg/l 0.01 mg/l 1 mg/l

As 0.01 mg/l 0.1µg/l 10 µg/l

Pb 0.005 mg/l 1 µg/l

Fe 1-3 mg/l

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Part 3 V Levels of performance of

collective systems

� Implementation of risk assessment risk management tool – water safety plan approach

� Manual on water safety plans

� Assessment tool for water safety plan implementation

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Water Safety Plan Quality Assurance Tool

Water Safety Plan Quality Assurance Tool

Task Force on Indicators and Reporting Meeting

� 16 February 2010 Bruce Gordon

Background

� Mechanisms to facilitate continuous improvement are needed

� Growing demand for water suppliers to assess progress in WSP implementation

� Lack of international WSP tools

� Enable a consistent approach to evaluating WSP development and implementation efforts

Who is the WSP Quality Assurance

Tool for?

� Organised water supplies managed by a water utility or similar entity

� Water safety plan teams

� Utility senior management

� Internal assessors

� External assessors

WSP Quality Assurance Tool and

WSP Manual

� Based on the structure and guidance in the Water Safety Plan Manual

� WSP Manual provides the information and interpretation for completing the tool

WSP Quality Assurance Tool –

examples of WSP questions

Scoring� The Tool has a scoring system of 0 - 4

� 0 points – step not been started

� 1 point – step just started

� 2 points – step partly completed

� 3 points – step substantially completed

� 4 points – step fully completed and documented

� It is not the intention to put too much emphasis on the exact scores obtained

� The aim of the scoring process is to help identify where improvements should be made and where priorities should be directed

WSP Quality Assurance Tool –

examples of quantitative

questions

� Number of controls identified that are in place

� Number of controls validated as effective

� Number of microbial/non-microbial verification monitoring tests required or planned/carried out within the past year

� Number of microbial/non-microbial verification monitoring tests within the past year that met water quality targets

Pilots� Objectives:

� To evaluate the value and usefulness of the Tool for WSP development and assessment

� If the Tool is useful, would it be used?

� To identify if the Tool is suitable as the global norm for WSP QA tools

� A number of pilots have been or are being conducted

� UK, Portugal and other European countries (EUREAU, MWH)

� Oman

� India

� China

� New Zealand

� Australia

� Singapore

� Japan

� South Africa

� Uganda

Preliminary Feedback from

Pilots� The Tool is self-explanatory and easy to use.

� The Tool is really helpful in evaluating Quality Management Systems in place. Utilities starting with QMS would probably use it.

� Explanatory text provides good guidance and inspires consultation of the WSP manual

� Scoring scheme is clear and easy to use. Reporting function helps to monitor WSP implementation.

� The questions within the Tool are ambiguous

� The Tool could demonstrate good progress in WSPs without actual improvements in the water supply since the focus is on management.

Next steps� Continue pilots of Tool (end of Feb 10)

� Develop WSP evaluation reports, update excel-based Tool and start development of web-based Tool based on the piloting experiences (end of April 10)

� Finalize excel-based Tool and develop a roll-out strategy (Sept 10)

� Finalize web-based Tool (2011)

Part 2 II Reduction of outbreaks� Global Alert and Response (GAR) transfers

information from formal and informal sources to meaningful data. Designation of international event:� Unknown disease

� Potential for spread beyond national borders

� Serious health impact or unexpectedly high rates of illness or death

� Strength of national capacity to contain the outbreak

� Suspected accidental or deliberate release

� WHO Disease Outbreak News

� Weekly Epidemiological Record (cholera)

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Part 2 II Reduction of incidence

� Health for all database reports

� Mortality from diarrhoeal diseases in below five year and

� Incidence (number of cases per year) of selected diseases

� CISID reports incidence of all Protocol-relevant diseases

� All countries in EURO are reporting at least one year after on priority diseases– in 2010, you will find complete reports as of 2008.

� Only about 1/3 report on emerging diseases2316/02/2010 TFIR

Part 2 II Zoonoses � WHO/FAO/OIE Global early warning system for

major animal diseases, including zoonoses (GLEWS)

� Improve early warning and response capacity to animal diseases

� Reduction of the global zoonotic disease burden

� Global Outbreak Alert and Response Network (GOARN) aims at ensuring that appropriate technical assistance reaches affected states, and contributes to long-term epidemic preparedness.

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Part II 2 IHR 2005

Global legal instrument

� Adopted at the 58th WHA May 2005

� All European countries are Party to the IHR(2005)

� Global legal framework for the detection of and response to international public health risks and potential health emergencies of international concern

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Part II 2 IHR 2005

Obligations

� Designate or establish a National IHR Focal Point

� Strengthen and maintain the capacity to detect, report and respond rapidly to public health emergencies of international concern

� Respond to requests for verification of information regarding potential public health emergencies of international concern

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Part II 2 IHR 2005

Strengthening national systems

� Strengthen national disease prevention, surveillance, control and response system

� All Parties able to assess national alert and response systems, perform gap analysis, and implement national action plans to prevent, detect, and respond to public health threats, taking into account the most likely events

� WHO to provide technical support through guidelines and in-country joint assessment

� Regular training activities on surveillance

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Part II 2 IHR 2005

From June 2009 for three years� Ensure implementation of national action plans

� Mobilize necessary resources from the national budget and international partners

� Conduct drills on a regular basis to test the operational capacity for national surveillance and response systems

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Part 2 III & IV Access� WHO UNICEF JMP

� Demographic and Health Surveys

� Multiple Indicator Cluster Survey

� World Health Survey

� Publication of summary reports� Urban / rural

� Access in dwelling / communal

� Types of sanitation

� Individual country sheets available with greater wealth of information

� Countries are invited to endorse or comment

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Part 2 V Management of freshwater

resources� Guidance documents� Water pollution control� Water quality monitoring

� Field work� AQC� Microbiological methods� Biological monitoring

� Water quality assessments� Strategies� Selection of variables� Rivers, lakes, reservoirs,

groundwaters� Data management

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Guidance document TFEWE� Climate change, extreme weather events and water

services

� Basic disaster preparedness and early warning

� Climate proofing of utilities in extreme weather events

� Impact on coastal areas

� Impact on health

� Integrating weather in risk assessment

� Adaptation measures for water services

� Adaptation measures for sewerage services

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Part 3 XII Reuse of sewage sludge� 2006 Guidelines for safe use of wastewater, excreta

and greywater

� Flexible approach to risk assessment risk management linked to health-based targets that can be established at a level that is realistic under local conditions.

� 2008 WHO/FAO/IWMI/ IDRC information kit with targeted fact sheets and policy briefs to further clarify methods and procedures

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Part 3 XV Quality of waters used for bathing

– Guidelines for safe recreational waters

� Coastal and freshwater

� Faecal pollution

� Algae and cyanobacteria

� Chemical issues

� Monitoring and assessment

� Application of guidelines and management options

� Swimming pools

� Microbial hazards

� Chemical hazards

� Managing water quality

� Guideline implementation

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Supporting documentation

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Putting it all together: the Atlas on

Water and Health� www.waterandhealth.eu� To be launched on Protocol Day 2010� Web interface providing maps and factsheets.� Access through local browser. Online with existing server,

offline with local USB stick� Consolidation of water and health data from different

sources in one application� Waterwiki – natural resources, esp shared resources and

water use� JMP Summary data� Health for All database� Centralized Information System for Infectious Diseases

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Atlas maps� Background information

� Water resources and their use, including drinking-water abstraction

� Health issues

� Morbidity of primary and emerging diseases

� Mortality diarrhoeal diseases below five age group

� Sanitation and water supply access

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Access factsheets� All the information for one country

� Comprehensive overview of all water and health themes

� All information on one theme for all countries

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THANK YOU

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