Water safety frameworks in developing countries: science-policy linkagesPolicy and sciencePolicy and science – fraught with mis-understandingWater safety framework – science and policy in actionHealth-based targets and quantitative risk assessmentBangladesh contextPolicy contextRisk substitutionRAAMO method (abbreviated)Model architecture (Howard et al 2007)Results: Microbial DALYsResults: arsenic DALYsWHO reference level of riskRAAMO findings reference riskChanges in practice & policyWater safety plans and surveillanceWater safety plansThe process that was followedDeveloping the WSPsTechnologies consideredPilot projectsKey findingsSlide Number 23Water quality risk grading schemeSlide Number 25Slide Number 26Evidence to practiceKey lessonsSurveillanceImplications and conclusionsImplicationsConclusionsWater safety Water safety frameworks in frameworks in developing countries: developing countries: sciencescience--policy linkagespolicy linkagesDr Guy Howard, DFIDDr Guy Howard, DFIDAdapted from a presentation at: a Symposium entitled:“Sustainable and Safe Drinking Water in Developing and Developed Countries: Where Science Meets Policy”, November 5-6, 2008, Chapel Hill, NCPolicy and sciencePolicy and sciencePolicy requires evidence Policy requires evidence ––the role of sciencethe role of scienceBUT BUT other factors other factors ––social, ethical, political also social, ethical, political also importantimportantSO SO policy often policy often evidenceevidence--informed informed rather than rather than evidenceevidence--basedbasedPolicy works through formal and informal Policy works through formal and informal processes processes dondon’’t get fixated on policy documentst get fixated on policy documentsPolicy and science Policy and science –– fraught with fraught with mismis--understandingunderstandingScientists think policyScientists think policy--makers do not follow makers do not follow evidenceevidencePolicyPolicy--makers think scientists narrow makers think scientists narrow technicianstechniciansFurther complicated when science isFurther complicated when science isLimited in its development inLimited in its development in--countrycountrySmall number of Small number of ‘‘voicesvoices’’dominatedominateLimited operational research of policy relevanceLimited operational research of policy relevanceWater safety framework Water safety framework –– science science and policy in actionand policy in actionWater safety framework comprises (WHO 2004):Water safety framework comprises (WHO 2004):HealthHealth--based targetsbased targetsWater safety plansWater safety plansSurveillanceSurveillanceDriven by improving public healthDriven by improving public healthAlso Also allows transparent tradeallows transparent trade--offs offs Applied in BangladeshApplied in BangladeshHealthHealth--based targets and based targets and quantitative risk quantitative risk assessmentassessmentBangladesh contextBangladesh contextIn early 1990s reached 97% In early 1990s reached 97% coverage in rural areas (WHO coverage in rural areas (WHO & UNICEF 2000) & UNICEF 2000) ––contribution to reduced contribution to reduced diarrhoeadiarrhoea1993 arsenic first detected1993 arsenic first detectedSurvey (1999Survey (1999--2000) indicates 2000) indicates 27% 27% tubewellstubewells>50>50µµg/lg/land and 46% >10 46% >10 µµg/lg/l(BGS& DPHE (BGS& DPHE 2001)2001)Blanket testing shows 29% > Blanket testing shows 29% > 5050µµg/lg/l(about 20% of country (about 20% of country total)total)Policy contextPolicy contextTechnologies identified for use Technologies identified for use in mitigation in mitigation Dug wells Dug wells Rainwater harvesters Rainwater harvesters Pond sand filters Pond sand filters Deep Deep tubewellstubewellsArsenicArsenic--removal removal technologiestechnologiesSurface water use prioritisedSurface water use prioritisedPriority given to 1Priority given to 1stst3 3 technologies technologies Others only to be used when Others only to be used when these failedthese failedRisk substitutionRisk substitutionThese policy choices equate to These policy choices equate to ‘‘Specified Specified Technology HealthTechnology Health--based targetsbased targets’’BUTBUTno consideration given to risk substitutionno consideration given to risk substitutionPathogensPathogensCynaobacterialCynaobacterialtoxinstoxinsOther chemicals (natural or anthropogenic)Other chemicals (natural or anthropogenic)QHRA undertaken to estimate impact of QHRA undertaken to estimate impact of these risks and benefits of policy choicesthese risks and benefits of policy choicesRAAMO method (abbreviated)RAAMO method (abbreviated)Representative set of main technologies tested in Representative set of main technologies tested in monsoon & dry season using cluster samplingmonsoon & dry season using cluster samplingModel developed with output in Model developed with output in DALYsDALYsfor microbial for microbial & arsenic risks& arsenic risks3 3 ‘‘referencereference’’pathogens pathogens Composite model bacteria, cryptosporidium and Composite model bacteria, cryptosporidium and rotavirusrotavirusInput data from indicator organisms Input data from indicator organisms --derived derived relationships to pathogensrelationships to pathogensArsenic disease burden input data direct arsenic Arsenic disease burden input data direct arsenic measurement and focus on main health outcomesmeasurement and focus on main health outcomesInfection with Rotavirus, Shigella, CryptosporidiumVolume of water consumed unboiled locally[Pathogen] in sewageDose of pathogens[E. coli] in sewageRatio [pathogen]:[E. coli]Ratio [TTC]:[E. coli]Measured [Arsenic] for optionMeasured [TTC] for optionPredicted [E. coli] for optionPredicted [pathogen] for optionCancer of lung, bladder and skinMeasured [TTC] locallyMeasured [E. coli] locallyDisease Burden for optionInputs to or outputs from the modelModel process stepsModel architecture (Howard et al 2007)Model architecture (Howard et al 2007)Results: Microbial Results: Microbial DALYsDALYsTechnologyTechnologyDry seasonDry seasonMonsoon seasonMonsoon seasonDug wellDug well1.111.11--221.341.34--22Deep Deep
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