Successful Programs to Increase Coverage of People Using Household

Water Treatment Water

Greg Allgood, MSPH, PhDGreg Allgood, MSPH, PhDProcter & GambleProcter & Gamble

P&G collaborated with CDC to develop technology that meets consumer and technical need for purifying dirty waterPUR uses same ingredients as municipal water waste treatmentVery effective in removal of turbidityRobust in removal of chlorine-resistant parasites (>99.9%), viruses (>99.99%), and bacteria (> 99.99999%)Proven to reduce diarrheal illness by average of 50% in randomized trials (n=25,000 people) in Guatemala, Kenya, Liberia, and Pakistan

PUR Purifier of Water

Summary of Social Market and Emergency ReliefCurrently used in 12 countries with ongoing social marketing; expansion plans underway for 2-4 more countries in 2008

• Congo, DR, DR Congo, Ethiopia, Haiti, Kenya, Indonesia, Malawi, Nigeria, Pakistan, Tanzania, Uganda

PUR used in more than 30 countries for emergency relief

100 million sachets or 1 billion liters of safe drinking water have been provided in 4 years

Commitments• Provide at least 2 billion liters within next 5 yrs• Reach 1 million children thru school programs

PUR’s Global Reach

Both Emergency Relief and Sustained Efforts are Viable for PUR

Commercial Institutional Thousands of Sachets Sold

Congo 1,469 797

Ethiopia 1,048 10,303

Uganda 2,113 2,081

Sales of Sachets in Social Markets

School Programs Can Increase Commercial Sales to Sustain Programs

More than 450,000 children reached in PUR school programs in 18 months• PSI monitoring of program in Uganda • CARE monitoring of program in Kenya• World Vision in Malawi

Overall response shows high acceptance, increased HH awareness and use, decreased school absenteeism

Key challenges• Proper targeting for water source and

affordability• Need to establish long-term impact

School Programs Result in Increased Usage and Decreased Absenteeism: CARE Kenya

Baseline Follow-up (n=630)

Awareness Among PupilsPUR 31 98Waterguard 91 99

Household Use Confirmed by ClPUR 0.5 8Waterguard 6 16

Pupil Absentee Rate Decreased 26%

PUR is helping people live positively with HIV/AIDS

• Benefit of robust removal of viruses, bacteria, and chlorine resistant parasites

• Piloted in healthy living kits in Haiti and SWAP, Village AIDS Clinics, and Living Missions in Kenya

• High level of acceptance and focus groups revealed desire to reduce intake of viruses

• Kenyan Red Cross • Leveraged home-based care • Wide acceptance by community

• Expansion underway• Family Health International in Ethiopia• Christian Children’s Fund in Uganda• AMPATH in Kenya• UNC Med School in Malawi and Congo• Seeking other partners

Role for People Living with HIV/AIDS

% Users of PUR

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

5 10 15Weeks

% U

sers

Free Distribution Can Result in High Use Rates for PUR: Samaritan’s Purse in Uganda

Lira, Uganda IDP Camp (n= 3,500 HHs)

Similar results in 1 year program by Kenyan Red Cross

Comments PUR(N=200)

Aquatabs (N=176)

1. Overall Satisfaction- Yes- No

982

8416

2. Taste of treated water - Ok- Not normal

937

8614

3.Smell of treated water- Ok- Not normal

47 53

30 70

4. Time required- No problem- Significant time

37 63

40 60

5. First reason treated: - Health-related- Not health-related

95 5

66 34

6. Preferred method- Yes- No

84 16

41 59

High Satisfaction of PUR and Aquatabs Distributed in Bangladesh by UNICEF/Oxfam (n = 4,800 HHs)

Multiple Approaches Can Co-exist and be Sustainable: SWAP Sales in Kenya

Safe Water and AIDS Program 2007 Unit Sales

PUR 68,343

Waterguard 53,769

Aquatabs 33,708

Targeted free distribution can help achieve widespread coverage and achieve immediate health impact

High use rates with efficient distribution of PUR

Commercial sales can lead to sustained programs

School programs can lead to higher use rates and decreased absenteeism

Multiple technologies are needed based on consumer preference

PUR seems to be consumer preferred in areas of turbid water

Conclusions