sharing negatives, making informed choices

Hello,

My name is Bruce Gordon, Technical Officer with WHO, and coordinating work on the International Network to Promote Household Water Treatment and Safe Storage. We are all aware of the vast potential of HWTS, but also that there is no "silver bullet" technology, nor implementation approach. Clearly, there are a lot of lessons to be learned from honestly appraising programmatic effectiveness in implementing HWTS. Unfortunately, failed approaches are not as frequently shared, and we all lose when the same mistakes are repeated. So the first point I wanted to make was that we could benefit from hearing some negative (and positive) experiences.

The second refers to the "open source" distribution model brought up by Michael. Indeed, the importance of expanding consumer options was underscored in recent Network meetings/events, but also brings with it the confusion associated with a myriad of choices. It is incumbent on us to ensure that consumers have choices, but also clear information to make an informed decision. In this regard, as CDC mentioned, WHO is preparing a document on "technology evaluation."

Open Source Alternative for Scaling Up

In response to the postings of Michael Lea and Bruce Gordon regarding range and cost of household drinking water treatment options, two things can be suggested in reply. The first is the need for a single Internet point of information for all who are working on drinking water solutions.

Those working in the field typically have only unreliable, low speed Internet access and cannot perform lengthy searches to reach desired information. Safe Water International has on its wish list the creation of an Internet site like “Craigslist” – the popular Internet site for searching out jobs, residences and purchases -- that could provide quick access to a broad range of information about HWTS. We cannot address this project soon. The potential power and efficacy of a central source of easily accessible information on HWTS options and strategies may make this a worthwhile project at the governmental agency level.

Secondly, cost itself should not be a limiter when assessing household level options. Paul Farmer’s work on treatment of infectious diseases may provide a relevant model here. Within the scope of household water treatment, efficacy should be the key feature. It is conceivable that high cost solutions that are operationally practical and effective in the settings of poor households can be accommodated with the right financing strategies. One such strategy may be to have household solutions considered as part of a public water distribution system with user rates that finance the purchase and maintenance of the household system. There is a version of this approach underway in eastern Bolivia, where state and municipal funds are being used to pay for single family rainwater storage tanks.

Financing Strategies - Subsidies

In continued discussion with Larry Siegel [1820], another excellent example of financing of a high cost solution also presently underway would be the UV Bucket (see below). Both the Mexican state and municipal governments have agreed to subsidize 200 pesos towards the total 300 peso ($30 US) cost per UV bucket. As Susan mentions in the e-conference background paper, "little research exists on subsidies as related to HWTS". This is an unfortunate situation as the arguments against subsidies are strong, examples being that communities may become too passive waiting for their service to arrive or individuals may buy a particular product because it is cheap instead of being appropriate for their needs. In spite of agents-of-change idealistic plans buying participation with subsidies or free give-aways (incentives) is community oppressive. Needless to say it will be interesting to follow both the eastern Bolivia and Baja, Mexico implementations. As Bruce Gordon [1818] suggested, the risk being that mistakes may unfortunately be repeated.

UV Bucket link:
[http://www.jalmandir.com]

Financing options

Larry:

I agree with you that efficacy is crucial and cost should not be a limiting factor. The case study presented for this econference, Pure Home Water in Ghana found that when they offered their products on credit, people purchased a system.

My organization, the Academy for Educational Development (AED), has been working to develop financing schemes for insecticide treated nets that ensures poor people have access but also does not undermine the commercial sector by offering subsidies to those who could afford to buy nets. It is an approach that could be adapted for many other applications, including HWTS

One way to achieve the goals of a targeted subsidy program while at the same time strengthening the commercial sector is to implement a discount voucher program that provides discounts to the poor and highly vulnerable. The vouchers can be distributed through government clinics and NGOs and then redeemed by the commercial sector, who commit to providing quality ITNs at reasonable prices. In this way, governments and donors can use their scarce funds to focus on delivering the subsidy directly to the poor rather than on doing a job that they are not well-prepared to do - procure, distribute, and market ITNs.

To date, the USAID NetMark Project has designed and implemented a dozen voucher programs in 6 countries that have achieved average redemption rates of 70%. These programs mainly focused on providing pregnant women with vouchers via the clinic system. Discounts varied from approximately 40% to 100% in the case of a Zambian program linked to a measles immunization campaign that wanted to provide free nets. Funding for these programs have been received from USAID, DFID, Red Cross, governments, and ExxonMobil. The discount voucher model has been adopted as a national program by Tanzania.

Field Access to HWTS Information

I second Larry's suggestion about the importance of having HWTS data for slow-speed or intermittent community online access. May I also suggest looking at open source software, TiddlyWiki [ http://www.tiddlywiki.com/]. One of the neatest features of TiddlyWiki is that it is entirely self-contained in a single HTML file - even including graphics, meaning that it is trivial to distribute a comprehensive HWTS website by email for later offline reading. Putting TiddlyWiki on a USB thumb drive lets you carry around a self contained notebook in the field that you can edit wherever there's a reasonably modern computer, whether it's a Mac, Linux or a PC.