Upload
others
View
2
Download
0
Embed Size (px)
Citation preview
10th meeting of the WHO International Network of
Drinking-water Regulators (RegNet)
Geneva, Switzerland
27-29 November 2019
ii
Contents Summary and key outcomes ............................................................................................................ 1
Background ...................................................................................................................................... 3
Meeting proceedings ........................................................................................................................ 4
Session 1a: RegNet overview and update from Secretariat ................................................... 4
Session 1b: Updates from RegNet members .......................................................................... 5
Session 2a: Case study: Addressing fragmentation and gaps in regulation ........................... 6
Session 2b: Fragmentation and gaps in regulation and challenges in water quality
surveillance and water safety planning ........................................................................................ 7
Session 3: Learning exchange: Experiences and challenges in water reuse ............................ 8
Session 4: Emerging regulatory challenges ............................................................................. 9
Session 5: WHO update ......................................................................................................... 10
Session 6a: Managing chemical contaminants in drinking water ........................................ 12
Session 6b: Case study: Managing chemical contaminants in drinking-water .................... 12
Session 7: Operating and functioning of RegNet .................................................................. 15
Appendix 1: Meeting agenda ..................................................................................................... 17
Appendix 2: List of participants ................................................................................................. 22
iii
Abbreviations and acronyms
ADERASA Asociación de entes reguladores de agua potable y saneamiento de las Américas
CWSA Community Water Supply Agency
DWI Drinking Water Inspectorate
ENDWARE European Network of Water Regulators
ERSAR Entidade Reguladora dos Serviços de Águas e Resíduos
ESAWAS Eastern and Southern Africa Water and Sanitation Regulators Association
EU European Union
FAO Food and Agriculture Organization
GDWQ WHO Guidelines for Drinking-water Quality
GLAAS UN-Water Global Analysis and Assessment of Sanitation and Drinking-water
HRWS Human Right to Water and Sanitation
INFOSAN International Food Safety Authorities Network
JMP WHO/UNICEF Joint Monitoring Programme on Water Supply, Sanitation and
Hygiene
NWASCO National Water Supply and Sanitation Council
PURC Public Utilities Regulatory Commission
RegNet WHO International Network of Drinking-water Regulators
SDGs Sustainable Development Goals
UNICEF United Nations Children’s Fund
WASH water, sanitation and hygiene
WHO World Health Organization
WSRC Water Services Regulatory Commission
WSP Water Safety Plan
1
Summary and key outcomes
The 10th meeting of the World Health Organization (WHO) International Network of Drinking-
water Regulators (RegNet) was held on 27-29 November 2019, at the WHO headquarters in
Geneva, Switzerland. The overall objectives of the meeting were to share experience and best
practice in addressing gaps in regulation; managing chemical contaminants; and various
emerging regulatory challenges. This report summarizes the discussions and main outcomes from
the meeting.
Key discussion topics
The key discussions and recommendations / follow-up actions are outlined below:
• Regional regulators’ networks: Several RegNet members shared updates from regional
regulators’ networks in eastern and southern Africa, Europe and Latin America. Among the
main updates were the regional networks’ strategic focus on: climate resilient water supply
and sanitation services; regulation of on-site sanitation services; human right to water and
sanitation; micropollutants; and links between climate change, warmer water temperatures and
legionella.
• Improving public health communication: There is a lot a of media and public attention on
emerging pollutants such as microplastics, glyphosate, etc. Improving communication
strategies on these emerging pollutants is an increasing priority, and in particular, articulating
what is a public concern versus public health issue to avoid public panic. WHO’s report on
Microplastics in drinking-water was published in 2019, and Canada is working on a
microplastics report that is to be published in March 2020. As follow up, Yasir Sultan will
share the report on microplastics in drinking-water in Canada with RegNet.
• Addressing gaps in regulation: A case study of drinking-water regulation in Ghana
highlighted overlapping mandates in regulation of water supplies in urban areas and gaps in
regulation of tanker supplies and rural water supplies. As a result of these gaps, audit of water
safety plans (WSPs) and water quality surveillance for non-piped are weak. Input from
participants on how to address these challenges emphasized the need for political will from the
government to reform the sector, and a systematic and wholistic reform process that involves
at all key stakeholders. Discussions also highlighted that while the promulgation of a water
service act would not solve all the regulatory challenges, it would help in organizing the sector
by defining roles and mandates of stakeholders involved. As follow up:
2
o The Eastern and Southern African Water and Sanitation (ESAWAS) Regulators
Association could visit Ghana to conduct a peer review of the water sector and regulatory
landscape in the country
o Entidade Reguladora dos Serviços de Águas e Resíduos (ERSAR) in Portugal and Water
Services Regulatory Commission (WSRC) in the occupied Palestinian Territories will
continue to provide peer support in strengthening regulation of WSPs to Ghana
o WHO will share a summary of a RegNet discussion thread on regulating tanker supplies
o WHO will share the survey questionnaire for the Global Analysis and Assessment of
Sanitation and Drinking-water (GLAAS) for review by RegNet members ahead of the next
data collection cycle.
• Water quality monitoring for small systems / point sources: Members shared some of the
challenges related to water quality monitoring and small systems, as well as solutions that they
have implemented. The revision of the WHO guidelines for small water supplies is underway,
and the experiences shared would be useful to informing this revision.
• Regulating water reuse: Among the main challenges cited with regulating water reuse are
addressing public perception of potable reuse, and the complexities of engaging with a diverse
range of stakeholders. It was agreed that a practical guidance document on developing
wastewater regulations analogous to the Developing drinking-water quality regulations would
be useful.
o As follow up, WHO will share an outline of the proposed scope of the document for
feedback from RegNet, and seek potential reviewers of the draft document.
• Quality of service standards: Several members have introduced / updated standards for quality
of service. Members outlined standards for water pressure, continuity and approaches for
metering.
o As follow up, RegNet members will share their quality of service standards via email.
• RegNet engagement with review processes of the WHO Guidelines for Drinking-water Quality
(GDWQ): A number of chemical contaminants are under review as part of the development of
the second addendum to the fourth edition of the GDWQ. Discussions highlighted the need to
more systematically obtain feedback from regulators in preparation of background documents,
particularly on practical aspects and application of guideline values.
• Managing lead contamination in drinking-water: Invited participants from the Water Institute
at the University of North Carolina and World Vision International presented a case study of
lead contamination in water systems in Ghana, Mali and Niger. A positive relationship
3
between copper and lead in the samples analyzed suggests that the lead contamination is due
to corrosion of brass components. As follow up:
o WHO, in liaison with members of the Expert Advisory Group to the GDWQ (David
Cunliffe and John Fawell) will draft a briefing note on actions to be taken. These could
include, as an initial step, replacing the foot valves in the water systems that had higher
lead concentrations with those that have lower lead composition and evaluate whether this
leads to a reduction in the concentrations detected in water.
o RegNet members will contribute to the aforementioned briefing note with case studies of
how they have managed lead contamination in their own contexts.
• Operation and functioning of RegNet: There were mixed views on whether the scope of
RegNet should be limited to drinking-water quality only, or include quality of service,
wastewater and economic regulation. Discussions also highlighted the need to improve the
communications and provide a platform for easier sharing of documents / serve as a repository.
As follow up:
o WHO will draft updated terms of reference for the network for input from RegNet
o WHO will explore options for improving the communications platform of the network.
Background
RegNet was established in 2008 as a platform to share experiences and to promote best practice
relating to the regulation of drinking-water quality. The network aims to promote public health
protection by increasing access to safe drinking water through the continual improvement of
regulatory systems1. The Water, Sanitation, Hygiene and Health unit at the WHO headquarters
acts as Secretariat to RegNet and coordinates network activities.
The 10th meeting of the network was attended by approximately 30 participants including
members of RegNet, and invited participants from the governments of Ghana and Niger, the
United Nations Children’s Fund (UNICEF), the Water Institute at the University of North
Carolina, the World Plumbing Council, World Vision International and members of the expert
advisory group to the WHO Guidelines for Drinking-water Quality.
The objectives of the meeting were to:
1. Discuss emerging regulatory challenges among members.
2. Share experience and best practice in:
a. addressing gaps and fragmentation in drinking water regulations; and
1 For further information regarding the specific goals and objectives of RegNet, as well as information pertaining to eligibility for membership, please refer to http://www.who.int/water_sanitation_health/dwq/TORRegNet.pdf?ua=1.
4
b. managing chemical contaminants in drinking water
3. Review challenges and successes in water safety planning and water quality surveillance; and
4. Update on key WHO activities related to regulation of drinking water and waste water services.
The meeting agenda is attached in Appendix 1, and the list of participants in Appendix 2.
Meeting proceedings
The meeting was opened by Bruce Gordon (WHO), who welcomed participants and emphasized
WHO’s commitment to working with regulators to support the development and implementation
of drinking-water quality regulations to promote public health protection. Participants then
introduced themselves and outlined expectations from the meeting. Addressing fragmentation in
regulation; regulating water reuse and managing chemical contaminants were among the
expectations from the meeting. The proceedings of the various meeting sessions are outlined
below.
Session 1a: RegNet overview and update from Secretariat
Session 1a was an update on the network, including main discussion points and outcomes from
the 2017 meeting, new members, and recent publications that RegNet members contributed to.
Discussions at the 2017 meeting focused on the role of regulators in supporting achievement of
the Sustainable Development Goals (SDGs) related to water and sanitation; progressive
improvement in regulation, including targeted input to invited participants from Ethiopia and
Liberia on developing drinking-water regulations, and expanding the scope of RegNet to include
wastewater/onsite sanitation2.
New RegNet members include representatives from Health Canada; the Public Utilities
Regulatory Commission (PURC) in Ghana; Environmental Protection Agency in Ireland,
Ministry of Health in Malaysia; Water Services Regulatory Commission (WSRC) in the occupied
Palestinian Territories; and the Department of Energy in Abu Dhabi, United Arab Emirates.
Regarding publications:
• the Global overview of national regulations and standards for drinking-water quality
(‘RegScan’) was published in 2018 and has attracted a lot of interest. It summarizes
information from 104 countries and territories on values specified in national drinking-water
quality standards for aesthetic, chemical, microbiological and radiological parameters. The
2 The 2017 meeting report is available at: https://www.who.int/water_sanitation_health/water-quality/regulation/regnet_reports/en/
5
document is currently being updated to include information from additional countries, and the
updated version should be published in Q1 of 2020.
• The Developing drinking-water quality regulations and standards was published in 2018. It
provides practical guidance to support development/revision of customized national or
subnational drinking-water quality regulations and standards. The document includes
supporting examples from both lower- and higher-income countries.
Session 1b: Updates from RegNet members
Session 1b presented brief updates from regional networks of regulators, including recent
activities.
Eastern and Southern Africa Water and Sanitation (ESAWAS) Regulators Association
Peter Mutale gave an brief update on ESAWAS, whose objectives are to foster good practice and
enhance capacity in water supply and sanitation regulation3. As part of its 2019-2021 strategic
plan, the association is developing a common regulatory framework for onsite sanitation systems,
and developing a strategy to address non-revenue water (NRW) by documenting case studies of
bad and good practice in its management. In addition, ESAWAS is collaborating with the Climate
Resilience Infrastructure Development Facility to develop risk assessment and adaptation
measures for climate resilient water supply and sanitation services.
European Network of Drinking-water Regulators (ENDWARE)
Susana Rodrigues shared an overview of ENDWARE, an informal network of European
drinking-water regulators which provides a confidential space to discuss drinking-water issues
and share experience in implementing drinking-water guidelines. Current discussions in
ENDWARE include the recast of the European Drinking Water Directive; climate change and
increases in legionella cases due to increased temperatures of water in pipes; as well as
perfluoroalkylated substances (PFAS) and persistent, mobile and toxic substances (PMT) in water.
Under discussion is how to communicate with the public on topical issues that are of public
concern (e.g. microplastics), and distinguishing these from public health issues.
Asociación de entes reguladores de agua potable y saneamiento de las Américas (ADERASA)
Oscar Pintos presented an update from ADERASA, whose objectives are to facilitate the
exchange of good practice and training of technical staff in the Latin American and Caribbean
region4. Among the network’s current activities is a report on affordability of water and
3 More information on ESAWAS can be found on: http://www.esawas.org/ 4 More information on ADERASA can be found here: http://www.aderasa.org/v1/
6
sanitation services in the region. Alejo Molinari from Ente Regulador de Agua y Saneamiento
(ERAS) shared an update on the region’s work on assessing implementation of the Human Right
to Water and Sanitation (HRWS). Work is underway for regulation benchmarking to support
HRWS, and the regional network is also working to include climate change considerations in
regulatory frameworks.
Session 2a: Case study: Addressing fragmentation and gaps in regulation
Session 2a was a case study from Ghana aimed at sharing experience and best practice in
addressing fragmentation in drinking-water regulation
Suzzy Abaidoo from the Ministry of Sanitation & Water Resources and Millicent Mensah form
the Public Utilities Regulatory Commission (PURC) in Ghana gave an outline of the drinking-
water regulatory landscape in the country. The presentation highlighted overlapping mandates
and gaps in regulation of water supplies that had been identified through previous stakeholder
engagement fora, and more recently, during the 2018 UN-Water Global Analysis and Assessment
of Sanitation and Drinking-water (GLAAS) survey. Both PURC and the Food & Drugs Authority
(FDA) are mandated to regulate water supplies in urban areas, and there is seemingly no agency
mandated to regulate rural water supplies and other non-piped supplies, including tanker trucks
and boreholes. As a result, auditing of water safety plans (WSPs) and water quality surveillance
are for non-piped supplies is weak.
To date, Ghana has requested support from RegNet (through WHO) in strengthening capacity in
WSP auditing. ERSAR in Portugal and WSRC in the occupied Palestinian Territories have
agreed to mentor a local university, Kwame Nkrumah University of Technology (KNUST) in
developing training modules on WSP auditing.
Recommendations / follow up ensuing from the session were:
• Institute a comprehensive sector reform process: Peter Mutale from the National Water
Supply and Sanitation Council (NWASCO) in Zambia shared experience in the water and
sanitation sector reform that led to the establishment of NWASCO. The comprehensive review
that was conducted as part of this reform had been useful in identifying players in the sector,
understanding their roles and identifying the gaps to be addressed. ESAWAS conducts similar
peer-reviews of its members, and as representative of the association, Peter that ESAWAS
conduct a peer review visit to Ghana.
• Consider promulgating a Water Services Act: Input from members highlighted that while a
Water Services Act is not a silver bullet, it would help in outlining roles of the various actors
involved.
7
Discussions noted that twinning arrangements could be useful in addressing the aforementioned
and other regulatory challenges, with ERSAR outlining how they have used twinning
arrangements to strengthen regulation in Portuguese-speaking countries, and similar
arrangements exist between members of ADERASA. However, there was general consensus that
depending on the matter to be addressed, twinning has greater impact when it is between
countries in the same region.
Fiona Gore (WHO) presented an overview of GLAAS, including key findings from the 2019
report. These include: wide gaps between frameworks and practice, i.e. surveillance mandates are
defined but implementation is weak; there is a need to focus on meaningful use of data to effect
change: data is collected but not used for remedial action. In addition, inadequate funding and
staffing are major challenges that are limiting implementation of drinking water quality
surveillance activities in many countries. Discussions focused on how TrackFin (a component of
GLAAS which surveys national WASH sector financing) could be embedded in national systems;
dissemination of the GLAAS report to policymakers; and feedback on the regulation-related
questions in the GLAAS questionnaire. As follow up, WHO will share the GLAAS questionnaire
for review by RegNet members.
Session 2b: Fragmentation and gaps in regulation and challenges in water quality
surveillance and water safety planning
Session 2b built on the previous session, and shared experience and practice in addressing
members questions related to water quality monitoring, WSPs and small systems.
Challenges in water quality monitoring for small systems and point sources. Among the main
challenges in water quality monitoring for small systems are urban migration which leads to
attrition of trained staff; and the expense of transporting samples to laboratories for analysis. For
point sources in particular such as handpumps, there is a lot of information on functionality etc.
drawn from water point mapping, but no data on water quality. Members shared some of the
actions they have taken to address these challenges, which include:
• Using semi-quantitative portable test kits on site, and if positive, sending the samples to
laboratories for further analyses;
• Engaging local environmental health practitioners in water quality monitoring;
• Conducting sanitary inspections for point sources;
• Certifying laboratories that are closer to sampling locations; and
• Using public transport to transport samples to laboratories for analyses
8
An additional challenge cited is implementing WSPs in small systems. Members shared that they
have gone around this problem by starting off with voluntary implementation, and using the
successes from these volunteer small systems to encourage others. The WHO Guidelines for
Small Water Supplies are currently being revised. Many of the challenges and solutions cited
would be informative to the revision.
Increasing political will for regulation. Advocating for better resourcing for the water and
sanitation sector and strengthening regulation was cited as a challenge in the occupied Palestinian
Territories. Peter Mutale shared that in Zambia, NWASCO regularly meets with parliament as
part of its communication strategy, giving an opportunity to address / clarify issues and in this
way, have political buy-in. Alejo Molinari (ERAS) suggested approaching the issue through a
health economics lens to illustrate the savings that can be made from improved water quality.
Session 3: Learning exchange: Experiences and challenges in water reuse
Session 3 focused on members’ experiences and challenges in regulating water reuse, and
presented overviews of WHO guidance on potable reuse and wastewater reuse for irrigation
Potable reuse
Lucia Bonnadonna (Ministry of Health, Italy) outlined how water reuse is an increasing priority
in the country, due to climate change and challenges with water availability. Only one region has
regulations for wastewater reuse for irrigation, and direct potable reuse is forbidden. Desalination
covers about 0.5% of water intended for human consumption on small islands and central and
southern Italy. The country is developing national guidelines on risk management / WSPs for
desalination plants.
Bruce Gordon (WHO) outlined the scope of the WHO document Potable Reuse: Guidance on
producing safe drinking-water. Only one country in the world (Namibia) currently practices
direct potable reuse. Barriers to implementing direct potable reuse cited include the possibility of
ineffective treatment in the case power outages or chemical spills, and public perception
(including religious concerns) of direct potable reuse.
Wastewater reuse
Kate Medlicott (WHO) presented an overview of the WHO Guidelines for Safe Use of
Wastewater, Excreta and Greywater, including linkages with sanitation safety planning. Peter
Mutale (NWASCO) shared that Zambia is developing regulations for wastewater reuse for
agriculture. Discussions focused on challenges and experiences in regulating wastewater reuse.
Among the challenges cited were: balancing behavioural and technical issues related to
9
wastewater reuse; and having to engage with multiple actors (more than in the drinking-water
sector), exacerbated by unclear mandates e.g. Mohammad Al Hmaidi (WSRC) shared that in the
occupied Palestinian Territories it is not clear who sets tariffs and monitors wastewater quality.
There was consensus that greater coordination is required between drinking-water and
wastewater sectors in order to have effective wastewater regulation. As follow up, there was
interest in having WHO develop guidance on how to develop wastewater regulations, possibly
analogous to the Developing drinking-water quality regulations and standards.
Session 4: Emerging regulatory challenges
Session 4 was an overview of drinking-water regulation in Switzerland, and a roundtable
discussion of various regulatory challenges that members are facing.
Drinking-water regulation in Switzerland
Pierre Studer (Federal Food Safety and Veterinary Office, Switzerland) presented an overview of
drinking-water regulation in Switzerland. WSPs have been implemented since 2005, with risk-
based surveillance in place. There are proposed guidelines for WSP implementation in small
systems, which have currently been self-regulated by suppliers. Among the regulatory challenges
are micropollutants such as pesticides and antibiotics, as well as legionella: cases have been
rising since 2000, and it is not clear what the underlying cause is.
Water pressure
Alejo Molinari (Ente Regulador de Agua y Saneamiento, Argentina) outlined pressure
requirements that have been set in Buenos Aires. To ensure sufficient pressure, buildings taller
than two stories should have an underground reservoir and their own pumps. Utilities are
responsible for water quality up to the meter. Thereafter, it is the responsibility of the building
owners to ensure the quality of the water, and there is a municipal regulation requiring building
owners to clean their reservoir twice per year, regardless of size. This is being reviewed, as the
argument has been that the water delivered has enough residual chlorine so cleaning could be less
frequent.
Related discussions were on how to deal with households adding their own pumps to boost water
pressure, as this exacerbates low pressure and leads to lower water consumption for surrounding
households. This led to a discussion on metering approaches, as in communal buildings where
there is only a single meter, the billing is not reflective of actual consumption for those
households with low water pressure. Khadija Hasan Bin Braik (Department of Energy, Dubai)
shared that to address this problem, a guard meter is installed for the whole building, in addition
10
to individual household meters. The difference between these meter readings is paid for by the
building administrator. Laura Moss from the Drinking Water Inspectorate (DWI) shared that in
the United Kingdom, metering is based on the size of the property.
Continuity of service
Rachid Wahabi (Ministry of Health, Morocco) outlined the new continuity of service
requirements that have been introduced in the national drinking-water regulations. Regulators
outlined the various metrics they are using for continuity of service, which include:
• Number of water cuts for which consumers do not have advanced notice;
• Duration of time that people do not have water during the year, and the number of people
affected; and
• per capita water consumption, as a proxy indicator
There was some discussion and debate as to the usefulness of per capita water consumption proxy,
and the extent to which it reflects continuity of service.
Defining an ideal utility
Mohammad Al Hmaidi (WSRC) raised the question of what is an ideal utility, from a regulator’s
perspective. Through an interactive online poll, members stated the three things that came to
mind when they thought of an “ideal” utility: one that plans ahead, is sustainable, and adheres to
a high quality of work. Additional comments from Pranav Joshi (Singapore Food Agency) and
Alejo Molinari (ERAS) emphasised that a utility should also be ideal from the perspective of the
consumer, and the importance of progressive improvements in utilities – there are no miracles.
Discussions led to benchmarking, and how this may help utilities to improve. Other comments
noted that while it can be used to learn best practice and improve, it should be kept as simple as
possible, with fewer indicators giving a clearer picture.
Members are agreed to continue the discussion on quality of service parameters by sharing their
standards via email.
Session 5: WHO update
Session 5 presented updates on key WHO activities related to water quality management
Updates on recent WHO activities and publications
Bruce Gordon (WHO) presented an overview of the WHO report on Microplastics in drinking-
water, and outlined the key messages from the report. The lack of standardized monitoring
approaches impacts on the data on occurrence of microplastics. Yasir Sultan shared that Health
11
Canada will be publishing a report a microplastics, including their presence in bottled water, in
March 2020. Lucia Bonnadonna (Ministry of Health, Italy) outlined that microplastics have been
proposed under the recast of the EU Drinking Water Directive and wastewater revisions, but
Member States disagree as there are no standard analytical methods, and propose to put the topic
on a watch list instead.
Rick Johnston (WHO) updated on the status of global monitoring of water, sanitation and
hygiene services under the WHO/UNICEF Joint Monitoring Programme for Water Supply,
Sanitation and Hygiene (JMP). Regulatory data on indicators such as water quality, continuity of
supply, faecal sludge management have been useful in developing national estimates on safely
managed drinking-water and sanitation services in households, healthcare facilities and schools.
Batsi Majuru (WHO) outlined the objectives of the WHO International Scheme to Evaluate
Household Water Treatment Technologies, and presented results of the 30 products that have
been evaluated to date. The results of the Scheme are intended to guide procuring UN agencies
and governments in product selection.
Emerging low-cost assays for faecal contamination
Esther Shaylor (UNICEF) presented an overview of a target product profile that is being
developed for low-cost faecal contamination assays. Potential use cases for these assays include
water quality surveys (e.g. as part of the SDG monitoring by JMP); community-led monitoring /
emergency response; and regulatory and surveillance testing. The three emerging approaches are
based on nucleic acids, tryptophan and biosensors. WHO is developing a protocol to validate the
performance of the emerging faecal contamination assays against a reference method (membrane
filtration), similar to the aforementioned evaluation scheme for point-of-use / household water
treatment technologies.
As part of the discussion, members were asked: what technology they currently use for water
quality testing; barriers preventing them from doing more water quality testing; and what
evidence they would need to adopt new water quality assays. Most members indicated that they
currently use culture-based methods, thus requiring laboratory facilities. This is challenging when
testing for small water supplies, due to the need to transport samples. One of the barriers to
conducting more water quality testing is the bacteriological analysis: processing the media,
waiting for results etc. is tedious. In order to adopt new water quality assays, they would need to
compare results with those from the methods they are using. If the same results can be obtained
faster and at low cost, the assay could be adopted. Other members indicated that a rapid
12
presence/absence assay would be useful, as there would be follow up based on detection of faecal
contamination alone, so a quantitative assay is not critical.
Session 6a: Managing chemical contaminants in drinking water
Session 6a was focused on member challenges related to the management of chemical
contaminants in drinking-water.
Fluoride
Roundtable discussions on the management of fluoride highlighted the following:
• Kenya is in the fluoride belt, and many water sources have high levels of fluoride. With SDG
monitoring now including fluoride as a priority contaminant, these fluoride levels will likely
impact the estimate for safely managed drinking-water. There are currently limited options for
large scale removal, as most are household-level / point-of-use treatment technologies
• In Argentina, the fluoride problem is two-fold: naturally occurring fluoride in some
groundwater sources, and fluoridation of surface water by utilities. There is an ongoing public
debate on whether the latter should be discontinued
• In Ghana, the main challenge with fluoride is in small systems and point sources, as treating
for fluoride in these contexts is expensive. When the sources are decommissioned due to high
fluoride levels there is public pressure to reopen them. As fluoride cannot be tasted it is
difficult to communicate the safety concerns to communities, or obtain agreement to
decommission the sources.
Arsenic
• Arsenic is a problem in Argentina. While there is a provisory limit for arsenic of 10 ppb, Alejo
Molinari (ERAS) was interested in finding out whether there is new evidence for a revised
limit.
• In the Philippines the limit is 0.1 ppm. While there have been cases of arsenicosis, a concern
has been that shutting down the utilities would be more of a public health risk.
Session 6b: Case study: Managing chemical contaminants in drinking-water
Session 6b was a case study of lead contamination in water supplies in three countries, and
aimed to characterize the extent of the problem, and share experience in managing and
communicating the issue.
The Water Institute at the University of North Carolina (UNC) conducted an evaluation of World
Vision International’s projects in Ghana, Mali and Niger. Water quality surveys conducted as part
13
of the evaluation detected lead in over 50% of 261 water systems across the three countries. In
the water systems where lead was detected, 5-10% of samples exceed the WHO provisional
guideline value of 0.01 mg/L5. Positive correlations between copper and lead within the samples
analysed suggest corrosion of brass components of the water systems as a significant source of
the lead contamination. A journal manuscript reporting on these findings is forthcoming. Samuel
Diarra (World Vision International) also presented some findings on lead contamination in other
sites in Ghana, Mali and Niger that showed >10 µg/L at the time of drilling and installation of
boreholes. Follow up surveys showed decrease in the lead concentrations.
Country responses
Government representatives from two of the countries included in the survey were present at the
meeting, and shared the governments’ responses to the survey results. Worlanyo Siabi from the
Community Water Supply Agency (CWSA) and Suzzy Abaidoo from the Ministry of Sanitation
& Water Resources, Ghana outlined that responses to date include:
• addressing supply chains through dialogue with pump manufacturers regarding lead levels in
the pump components;
• reviewing standards for materials in contact with drinking-water, led by the Ghana Standards
Authority;
• initiating a process to identify a regulatory authority that would be responsible for overseeing
standards for materials in drinking-water; and
• improving surveillance by including lead and arsenic in routine water quality monitoring. The
latter has been challenging, due to limited laboratory capacity for trace metal analyses in many
of the rural districts. This has however led to more dialogue with the government on the need
to strengthen laboratory capacities.
Moussa Maman from the Ministry of Water and Sanitation, Niger outlined that there had been a
workshop with all countries involved in the survey, from which a report and recommendations
had been developed. This report was disseminated amongst service providers, technicians and
non-governmental organizations in the country. However, there is an equally pressing problem
with fluoride, which has affected 4 000 people in one city. As part of the response to the lead
findings, a survey was conducted to verify the results, and households with plumbing have been
advised to do a first flush of water before use.
5 The guideline value is provisional on the basis of treatment performance and analytical achievability. Concentrations should be maintained as low as reasonably practical. See: Guidelines for Drinking-water Quality: Fourth edition incorporating first addendum, 2017. Geneva: World Health Organization (https://www.who.int/water_sanitation_health/publications/drinking-water-quality-guidelines-4-including-1st-addendum/en/)
14
How serious is the problem?
Members of the expert of the advisory group to the GDWQ John Fawell and David Cunliffe
emphasized that there is no need for panic, and emphasized three points: (i) the study indicates
that water systems components are a significant source of lead contamination, so the source of
contamination is known; (ii) the health risk is relatively low: detected concentrations are unlikely
to be discernible in blood levels; and (iii) going forward, the health risk can be lowered even
further.
Member experiences
• In Argentina, regulators are responsible for water quality up to the property line. As most lead
is in the household connections, regulators are not involved in managing the lead
contamination;
• In Canada, corrosion control materials are added to water. A revision in the maximum
allowable lead concentration from 10 ppm to 5ppm led to a significant increase in exceedances.
Among the main lessons learned was the need to have a strong communications plan for both
utilities and households;
• In Morocco, the Ministry of Health is responsible for overseeing the quality of water up to the
point of use. There were problems with lead in water 20 years ago, and the government
decided to replace all pipes containing lead. To date, about 50% of the pipes have been
replaced, and regulations for materials in contact with water have been implemented;
• In the occupied Palestinian Territories, government subsidies have been offered to households
wishing to replace lead fittings. Source protection measures such as banning dumping of
batteries near water sources and battery recycling have also been implemented;
• In the United Kingdom, most utilities add polyphosphates for corrosion control. However, this
means that the wastewater utilities have to treat these phosphates. There is a plumber
certification/approval scheme, under which a plumber would be required use approved
components with low lead, but it is voluntary. There have been 60 reported incidences with
faulty toilet installations that have resulted in back-siphoning into the drinking-water supply;
and
• In Zambia, lead mining in some parts of the country has led to high lead concentrations in soil.
No health impact studies have been conducted.
Discussions also noted that in old buildings in which several plumbing modifications may have
been made over time, it is difficult to locate the lead fittings. Point-of-use filtration devices and
flushing recommendations may be the most feasible options.
15
Certification
Paul Bonsak (World Plumbing Council) presented an overview of the impact of non-compliant
plumbing and construction products, highlighting the importance of product certification. The
certification entails product review and certification of compliance with safety standards;
certification schemes of plumbers/installers; plumbing codes and standards; and manufacturer
audit to ensure compliance.
Discussions highlighted that the costs of such certification may be prohibitive in resource-limited
settings: it costs approximately $3 200 to process an application; $8 000-16 000 to test for lead in
components; and there is an ongoing annual audit fee of $3 000. In Niger, handpump components
are being source from a range of countries where there are no clear standards, and good quality
components with low amounts of lead are expensive.
Key recommendations and next steps:
• Have a clear communication plan that outlines the problem and short- and medium-term
measures to manage it, and is tailored to various target audiences;
• Pilot replacement of components in water systems that have higher lead concentrations, and
scale up if it helps address the problem. As the footvalves are thought to be the main
contributing component, this would mean replacing them with valves containing less lead and
monitoring to see if this addresses the problem. Similar progressive approaches have been
implemented in many settings including Europe, where the guideline values for lead were
progressively decreased from 25 µg/L to 10 µ/L; and
• Progressively address materials in contact with drinking-water, through implementation of
standards for these materials.
John Fawell and David Cunliffe noted that as a number of the RegNet members have had to
manage lead contamination in water, it would be useful to compile the various approaches as case
studies in a briefing note
Session 7: Operating and functioning of RegNet
Session 7 was reviewed how the operation and functioning of RegNet could be improved, and
what lessons could be learned from other networks
Lessons learned from INFOSAN
Peter Ben-Embarek (WHO) shared lessons from the International Food Authorities Network
(INFOSAN). The network is co-hosted by WHO and the Food & Agriculture Organization
(FAO). The objective is to disseminate food safety information to members during emergency
16
situations, and provide a platform to discuss topical food safety issues with experts from around
the globe. The network was set up in 2012 and now has over 600 network members in 180
countries. Among the lessons learned is the need to engage members on topics that are useful to
them, including engaging in different languages. Regional meetings have also enabled stronger
member engagement, as well as high level resolutions from the World Health Assembly, and
CODEX and EU resolutions that have encouraged countries to join the network.
Future directions and follow up actions
The meeting concluded with RegNet members reflecting on the future scope of the network and
the role that the regulators should have in relation to various WHO guidelines. The key
discussion points were:
• bridging the gap between science and practice is important, and RegNet should be involved in
the review of water quality guidelines in a more systematic way;
• the case studies presented in some of the meeting sessions were appreciated: members
indicated that such a format helped them learn a lot;
• membership of the network was key for some regulators to incorporate WSPs into their
drinking water quality regulations, and was highlighted as one of the successes of the network;
• future directions could include how to regulate for the most vulnerable, in line with SDG 6
principles on leaving noone behind; and
• in addition to drinking-water quality, there is appreciation for discussions on other areas of
regulation including quality of service, wastewater/sanitation and economic regulation.
Discussions on whether the scope should be on drinking-water primarily or encompass these
additional areas were mixed.
In terms of the operations of RegNet, the WHO Secretariat will work on improving
communications, including exploring the possibility of having the communications platform
hosted by INFOSAN; and draft a briefing note on how RegNet can move forward.
17
Appendix 1: Meeting agenda
Wednesday 27 November 08:30 – 09:00 Arrival and registration of participants 09:00 – 09:30 Opening session
Chair: Bruce Gordon ¦ WHO Opening remarks
Review of agenda, plans for rapporteuring Introductions
Bruce Gordon ¦ WHO
09:30 – 10:30 Session 1a. RegNet overview and update from Secretariat Objective: recap on the vision of RegNet; update on activities since the previous meeting Chair: Bruce Gordon ¦ WHO
Overview of RegNet (vision and expectations) Network update and recap of 2017 meeting
Bruce Gordon ¦ WHO Batsi Majuru ¦ WHO
10:30 – 10:45 Coffee/ tea break 10:45 – 11:45 Session 1b. Updates from RegNet members
Objective: share updates on priorities & progress from regional networks of regulators Chair: Bruce Gordon ¦ WHO
10:45 – 11:45 Updates from regional regulators’ networks: ̶ Eastern and Southern Africa Water and Sanitation
(ESAWAS) Regulators Association ̶ European Network of Drinking Water Regulators
(ENDWARE) ̶ Asociacion de Entes Reguladores de Agua y Saneamiento
de Las Americas (ADERASA) (general update + role of regulators in supporting the Human Right to Water)
Peter Mutale ¦ NWASCO, Zambia Susana Rodrigues ¦ ERSAR, Portugal Oscar Pintos ¦ ENRESS, Argentina / Alejo Molinari ¦ ERAS, Argentina
11:45 – 12:30 Session 2a. Case study: Addressing fragmentation and gaps in regulation Objective: share experience and best practice in addressing fragmentation in drinking-water regulation; facilitate peer support of review of national water policies Chair: Bruce Gordon ¦ WHO
11:45 – 12:30 Regulatory landscape in Ghana, including role of PURC Suzzy Abaidoo ¦ Ministry of Sanitation & Water Resources / Millicent Mensah ¦ PURC, Ghana
12:30 – 13:30 Lunch 13:30 – 15:00 Session 2a. Case study continued: Addressing fragmentation and gaps in regulation
Objective: share experience and best practice in addressing fragmentation in drinking-water regulation; facilitate peer support of review of national water policies Chair: Laura Moss ¦ United Kingdom
13:30 – 14:10 Discussion / input from members How have other countries handled gaps / fragmentation in drinking-water regulation?
14:10 – 15:00 Assessing WASH systems: overview of GLAAS and links to regulation Lessons from WSPs + status of surveillance
Fiona Gore ¦ WHO Bruce Gordon ¦ WHO
15:00 – 15:15 Coffee/ tea break 15:15 – 17:05 Session 2b. Fragmentation and gaps in regulation and challenges in water quality
surveillance and water safety planning Objective(s): discuss implications of fragmented regulatory landscape on water quality surveillance + WSPs and how to address challenges Chair: Laura Moss ¦ United Kingdom
18
15:15 – 15:45 Discussion: What are concrete opportunities to increase political will to address resource gaps?
Roundtable
15:45 – 17:00 Related member questions 17:00 – 17:05 Wrap up Batsi Majuru ¦ WHO
19
Thursday 28 November 09:00 – 09:10 Reflections from Day 1 Rachid Wahabi ¦ Ministry of
Health, Morocco 09:10 – 10:30 Session 3. Learning exchange: Experiences and challenges in water reuse
Objectives: (i) share experience and challenges in regulating water reuse; (ii) present overview of WHO guidelines on potable reuse and safe use of wastewater and seek feedback on feasibility / challenges and successes in implementing guidelines Chair: Pierre Studer
09:10 – 09:20 Experiences and regulatory challenges in potable reuse of water
Lucia Bonnadonna ¦ Ministry of Health, Italy
09:20 – 09:50 Overview of WHO guidelines on potable reuse of water Bruce Gordon ¦ WHO 09:50 – 10:30 Related member question(s)
Overview of WHO Guidelines for Safe Use of Wastewater Kate Medlicott ¦ WHO
10:30 – 10:45 Coffee / tea break 10:45 – 12:30 Session 4: Emerging regulatory challenges
Objectives: Share experience and best in addressing emerging regulatory challenges among RegNet members Chair: Pierre Studer
10:45 – 11:50 Drinking-water regulation in Switzerland Member challenges
Pierre Studer ¦ FDHA, Switzerland Roundtable
11:50 – 12:30 Panel discussion: Defining an ‘ideal utility’ from regulators perspectives
Panellists: Pranav Joshi, Singapore Food Agency Alejo Molinari, ERAS
12:30 – 13:30 Lunch 13:30– 15:00 Session 5. WHO update
Objectives: Update on key activities + publications related to water quality management and seek input on regulatory requirements for low-cost water quality test kits. Chair: Pranav Joshi ¦ Singapore Food Agency
13:30 – 14:15 Brief updates from WHO staff + discussion: ̶ Microplastics ̶ SDG monitoring and country estimates for safely
managed services ̶ Evaluation of point-of-use treatment products
14:15 – 15:00 ̶ Emerging, low-cost assays for fecal contamination: regulatory needs & requirements
Esther Shaylor ¦ UNICEF
15:00 – 15:15 Coffee / tea break 15:15 – 17:00 Session 6a. Managing chemical contaminants in drinking-water
Objectives: (i) present overview of WHO guidance on chemical contaminants; (ii) seek feedback practicability of guidance on selected parameters; and (iii) discuss questions from RegNet members related to chemical contaminants in drinking-water Chair: Rick Johnston ¦ WHO
15:15 – 15:45 Information sharing, risk assessment and communication on chemical contaminants
Jennifer De France ¦ WHO
15:45 – 16:55 Related member questions Roundtable 16:55 – 17:00 Wrap up Batsi Majuru ¦ WHO
20
Friday 29 November 09:00 – 09:10 Reflections from Day 2 Joselito Riego De Dios ¦
Department of Health, Philippines
09:10 – 10:30 Session 6b: Case study: Managing chemical contaminants in drinking-water Objective(s): to consider a real-life case study of high-profile water quality and health issue, and exchange views on how to best respond in terms of overall appraisal of the situation, improvement plans and communication strategies Expected outputs / outcomes: (i) list of generic response actions that regulators should consider when faced with such situations; (ii) specific elements of monitoring and improvement plan for lead exceedances (iii) implications for regulation (e.g. interim limits, derogations); and (iv) communications strategy Chair: Rick Johnston ¦ WHO
09:10 – 09:20 Scene setting + objectives of case study + introduction of invited participants
Bruce Gordon ¦ WHO
09:20 – 09:50 - Context: countries & institutions involved in the water quality survey + roles
Samuel Diarri ¦ World Vision International Mike Fisher (tbc) ¦ Water Institute at University of North Carolina
09:50 – 10:10 What have been the responses to the findings? Interventions from national officials from study countries
10:10 – 10:30 Question 1: Is the current dataset adequate to inform a response? Question 2: If further actions are required to characterize the situation what are they?
David Cunliffe ¦ South Australia Department of Health, and John Fawell ¦ Independent Consultant
10:30 – 10:45 Coffee / tea break 10:45 – 12:30 Session 6b continued: Case study: Managing chemical contaminants in drinking-water
Chair: Bruce Gordon ¦ WHO 10:45 – 11:20 Question 3: Is there information on regulation of lead (past
and present) or other country experiences that could provide useful context?
11:20 – 12:00 Question 4: Is there sufficient data to suggest that action to begin drafting an improvement plan? Materials in contact with water: standards and compliance practices
Paul Bonsak ¦ World Plumbing Council
12:00 – 12:30 Roundtable discussion on proposed response and management strategy
12:30 – 13:30 Lunch 13:30 – 15:00 Session 7: Operation and functioning of RegNet
Objectives: seek input and consensus on priority directions and mechanisms for improving functioning of the network Bruce Gordon ¦ WHO
13:30 –14:00 14:00 – 15:00
Optimizing network functioning: Lessons from the International Food Safety Authorities Network (INFOSAN) Roundtable discussion Optimizing functioning of RegNet, priority focus areas and developing an investment case for the Network
Peter Ben-Embarek ¦ WHO
15:00 – 15:15 Coffee / tea break 15:15 – 16:00 Closing session
Bruce Gordon ¦ WHO Meeting summary and next steps Bruce Gordon ¦ WHO
21
Closing remarks Maria Neira ¦ WHO End of meeting
Group photo in main foyer / Executive Board Room
22
Appendix 2: List of participants
Institution ¦ Country Participant
RegNet members
Ente Regulador de Agua y Saneamiento (ERAS) ¦ Argentina
Mr Alejo Molinari
Ente Regulador de Servicios Sanitarios de Santa Fe (ENRESS) ¦ Argentina
Mr Oscar Pintos
Health Canada Mr Yasir Sultan
Public Utilities Regulatory Commission (PURC) ¦ Ghana Ms Millicent Mensah
Water Services Regulatory Board (WASREB) ¦ Kenya Mr Richard Cheruiyot
Ministry of Health ¦ Italy Dr Lucia Bonnadonna
Ministry of Health ¦ Malaysia Mr Dzulkifli bin Mohamad
Mr Yahaya Bin Saad
Ministry of Health ¦ Morocco Mr Rachid Wahabi
Water Sector Regulatory Council (WSRC) ¦ occupied Palestinian Territories
Mr Mohammad Said Al Hmaidi
Department of Health ¦ Philippines Mr Joselito Riego de Dios
Entidade Reguladora dos Serviços de Águas e Resíduos (ERSAR) ¦ Portugal
Dr Susana Rodrigues
Singapore Food Agency Dr Pranav Joshi
Federal Food Safety and Veterinary Office (FSVO) ¦ Switzerland
Mr Pierre Studer
Department of Energy ¦ Abu Dhabi, United Arab Emirates Mr Abdulrahman Alalawi
Ms Khadija Hasan Bin Braik
Drinking Water Inspectorate (DWI) ¦ United Kingdom Ms Laura Moss
National Water Supply and Sanitation Council (NWASCO) ¦ Zambia
Mr Peter Mutale
Partners / invited participants
Ministry of Sanitation & Water Resources ¦ Ghana Ms Suzzy Abaidoo
Community Water Supply Agency (CWSA) ¦ Ghana Dr Worlanyo Kojo Siabi
Ministère de l’Hydraulique et de l’Assainissement ¦ Niger Mr Moussa Maman
International Association of Plumbing and Mechanical Officials (IAPMO)
Mr Seán Kearney
South Australia Department of Health Dr David Cunliffe (connecting remotely)
United Nations Children’s Fund (UNICEF) Ms Esther Shaylor (connecting remotely)
Water Institute at University of North Carolina Dr Mike Fisher (connecting remotely)
World Plumbing Council (WPC) Mr Paul Bonsak
World Vision International Mr Samuel Diarra (connecting remotely)
23
Dr Ray Norman
Independent Consultant Dr John Fawell (connecting remotely)
WHO
Coordinator, Water, Sanitation, Hygiene & Health Mr Bruce Gordon
Coordinator ai, International Food Safety Authorities Network (INFOSAN)
Dr Peter Ben-Embarek
Technical Officer, Water, Sanitation, Hygiene & Health Ms Jennifer De France
Technical Officer, Water, Sanitation, Hygiene & Health Dr Fiona Gore
Technical Officer, Water, Sanitation, Hygiene & Health Dr Rick Johnston
Technical Officer, Water, Sanitation, Hygiene & Health Dr Batsirai Majuru
Technical Officer, Water, Sanitation, Hygiene & Health Ms Kate Medlicott
Intern, Water, Sanitation, Hygiene & Health unit Ms Botho Motlhanka