WATER, SANITATION AND HEALTH (WHO/HQ)
Outline plan of work 2002-2003
Health policy and advocacy for
water management in development
(Policy and advocacy activities
focus on a limited number of targeted issues. These concern areas in
which: (i) major policy development is planned or in discussion with
potential health impacts arising from water management actions; (ii) a
change in policy would yield unusually high health gains; and (iii)
health gains are used to justify changes in water sanitation and
hygiene actions, which are not substantiated by available evidence.
Emphasis is placed on delivering outputs to major policy forums and in
collaboration with other international partners, when appropriate.)
- Water for people and health
- Promotion of access to safe water
supply and adequate sanitation as a major requirement to ensure a
healthy life and enable the social development of the poor and
unserved. Activities will focus on evidence-base policy development and
are closely aligned with the millennium declaration goals.
- Water for food and health
- Water for food is important for
health through food security, nutrition and effects of inappropriate
water use practices. Activities will mainly focus on the inter-agency
Dialogue on Water, Food and Environment. Emphasis will be on the
Dialogue establishing a knowledge base. Other activities will include
collaboration with the International Water Management Institute and
other centres of the Consultative Group on International Agricultural
Research (and, in particular, with the System-wide Initiative on
Malaria and Agriculture) on the development and promotion of water
management and other agricultural practices for vector-borne disease
control, in close conjunction with Roll Back Malaria and the Regional
- Water and human rights
- Several soft law and hard law
instruments refer to rights concerning water, but the "right to water"
remains unclear. Ongoing activities aim to clarify the status of this
right and to draw attention to this in appropriate forums.
- WHO contribution to Freshwater Year
2003 and the Third World Water Forum
- Planning, preparation and
coordination with related institutions of the International Year of
Freshwater Year (2003) and the Third World Water Forum (Kyoto, March
2003), which are major policy initiative events in the near future.
- Programme development and support
- Household water management policy
- To develop a policy analysis on
household water management, based on the outcome of burden of disease
and cost-effectiveness studies.
Information systems on water, sanitation and health
(Reliable information provides the
basis for informed policy-making and decision-taking. This area of
activity concerns collection and dissemination of information,
including major database resources. Its objective is to ensure
awareness of, and access to, high-quality information relating to: the
health burden associated with water, sanitation and health; the impacts
of actions in water, sanitation and hygiene upon health; concerning
present state of progress and trends; and concerning major areas of
activity in health protection, based on water and sanitation management
is an important focus of activity.)
- Water supply and sanitation
monitoring (JMP project)
- Through the WHO and UNICEF Joint
Monitoring Programme (JMP), report on global status and trends in the
water supply and sanitation sector; provide water supply and sanitation
coverage figures for the UN system; and provide support to monitoring
international targets, including millennium declaration goals.
- Sanitation Connection
- Create and manage content for
Sanitation Connection. Increase awareness, usefulness and utilization
of the inter-agency Sanitation Connection internet resource and oversee
its ongoing development.
- Database on legislation and
- Development of database on water
legislation and water-quality standards. The database is being
developed with FAO and is intended to be made available on the internet
to be readily accessible.
- Information dissemination
- Planning, coordination and
implementation of the programme of information for programme-specific
target groups, promoting knowledge about water, sanitation and health
and of WHO activity in this; managing and supporting the public
information component of Water, Sanitation and Health activities.
Environmental disease burden in water and sanitation
(Reliable information provides the
basis for informed policy-making and decision-taking. Ensuring
availability of high-quality information relating to the health burden
associated with water, sanitation and health and the impacts of actions
in water sanitation and hygiene upon health is an important focus of
- Drinking-water disease burden
- Drinking-water disease burden
arising from exposure to arsenic, fluoride and nitrate/nitrite in
- Evaluate the environmental disease
burden of several water-, sanitation- and hygiene-related diseases and
assess the effectiveness of interventions concerning flies; and on
disease burden arising from sewage pollution of the marine environment.
- Disease burden: vector-borne disease
- Comprehensive literature reviews on
burden of disease of four vector-borne diseases in the context of water
resources development and the cost-effectiveness of water management
interventions (malaria, schistosomiasis, Japanese encephalitis,
filariasis). Developing and testing a methodology of fractional
attribution of BOD to water resources development components.
- Cost-effectiveness of water and
- To complete cost-effectiveness
analyses for: improved water supply and basic sanitation; disinfection
of water at point-of-use; halve population without improved water
supply by 2015; halve population without basic sanitation by 2015;
provide piped and regulated water supply and full sanitation coverage,
with partial treatment of sewage; and improve personal hygiene.
- Preparation of systematic review of
the role of global movement of ballast water by ships in long-distance
dispersal of viable Vibrio cholera spp.
Microbiological risk assessments and management tools
(Infectious diseases associated
with water sanitation and hygiene account for the majority of
water-related disease burden and affect developing and developed
countries world-wide. While some of the associated diseases are
well-described, information concerning causative agents is incomplete
and evidence concerning the effectiveness of control approaches and
measures continues to emerge.)
- Emerging pathogens in water
- Some of the important pathogens
known to be transmitted by water have only been recognized in the last
30 years and new pathogens continue to be recognized. This activity
comprises a cluster of actions intended to provide synthesized
information on such pathogens as they emerge and adequate information
becomes available. The work also includes other "emerging issues"
relating to previously unrecognized routes of exposure.
- Microbial risk assessment and
- Microbial risk assessment provides
a basis for understanding the control of a number of important
water-related diseases. This activity includes a number of actions
intended to foster the development and application of microbial risk
assessment to the prevention and control of water-related disease.
- Microbial safety indicator systems
- Important developments have
occurred in the use of different parameters and indicators in
water-safety management and in detection and quantification methods.
This activity seeks to critically review the actual potential
applicability of alternative indicator safety systems, with an emphasis
on cost-effective health protection.
- Legionella risk assessment and
- Organize expert working group in
control of Legionnaires' disease in collaboration with the PHLS;
preparation of normative guidelines on Legionnaires' disease for
incorporation into the WHO Guidelines on Drinking-water Quality,
the WHO Guidelines for Safe Recreational Water Environments and
the WHO Guide to Ship Sanitation.
Capacity building for health-care
- National capacities in health-care
- Conduct health-care waste
management assessments, convene national workshops and develop
health-care waste management national action plans.
- Pilot projects in regions and
- Initiate health-care waste
management pilot projects in regions and countries. Develop best
practices for the safe management of health-care wastes. Develop
regional and national HCWM training centres.
- Cooperation with GAVI
- Collaborate with GAVI to promote
safe HCWM and ensure that HCWM is considered as part of any application
for GAVI funds.
- Short-term staff
Support for emergency preparedness and response
(The frequency of occurrence of
natural disasters and those arising from human activity has increased
in recent decades. Water supplies may be directly affected
(intentionally or accidentally) during emergencies and the rapid
provision of minimum basic water and sanitation provision is critical
in minimizing the health impacts of disasters and emergencies.) Emergencies
may provide opportunity for increased transmission of water-based
- Water and sanitation in emergencies
- To support EHA and WHO Regional
Offices matters related to natural disasters and emergencies.
Preparation of guidance materials and direct assistance in the
normative aspects of prevention, preparedness, relief and
- Vulnerability reduction and
prevention of contamination
- Development of measures for
preparedness against intentional or accidental contamination of
- Responses to priority health threats
- Support for projects to mitigate
problems associated with hazardous chemical substances in
drinking-water, such as arsenic and fluoride.
- Evaluation of toxic cyanobacteria.
Health impact assessment of water
- Biodiversity and health
- Main activities come under the
Harvard/WHO/UNEP initiative on biodiversity and health, including
production of a health chapter. Collaboration with Danish Bilharziasis
Laboratory and WHO Regional Offices and Country Offices in the
organization of regional workshops on biodiversity and health.
Collaboration with IUCN in the development of a comprehensive,
country-oriented action plan on wetlands, biodiversity and health.
- WWAP and WWDR report (with UNESCO)
- Inputs into the WWDR process,
including a general health section, a section on health indicators in
the context of water resources development and management and a health
component in WWDR case studies.
- Health impact assessment of water
- Develop and mobilize resources for
a comprehensive proposal for the institutionalization in Africa of an
HIA capacity-building programme. This will include training of
trainers, problem-based training courses and national policy seminars.
- Advocacy for HIA at Regional Office
level, including support in HIA guidelines formation.
- Produce and promote the Training
Manual on HIA.
- Basic Water Supply and Sanitation
with Regional Offices
- Support the WHO Regional Offices in
activities dealing with water supply and sanitation for low-income
communities. Identification of best practice materials, support to
project preparation, fund-raising and project implementation.
Evidence-based guidelines for water and health
(WHO environmental quality
"guidelines" are normative products intended to inform the development
of efficient and effective disease control by countries at all levels
of development. They are intended primarily to assist national
development of regulations and standards and are used also by
practitioners in various areas.)
- Guidelines for drinking-water
quality, 3rd edition
- WHO Guidelines for Drinking-water
Quality are used in countries at all levels of development. The second
edition, published in 1993, superseded previous Guidelines and
international standards. Actions in hand primarily concern the
collation and synthesis of the relevant information base and the
development of the third edition of the Guidelines.
- Guidelines for safe recreational
- Guidelines for Safe
Recreational-water Environments are in development, for application to
coastal and freshwaters and to swimming pools, spas and similar
environments. Both areas will be finalized during the 2002-2003
- Guidelines for the safe use of
wastewater and excreta in aquaculture and agriculture
- Develop guidelines and guidance
material for the safe use of wastewater and excreta in agriculture,
aquaculture, aquifer recharge, and related areas.
- Guidelines for sanitation on ships
- Preparation of revised WHO Guide
to Ship Sanitation.
- Preparation of revised WHO Guide
to Hygiene and Sanitation in Aviation.
- Guidelines for urban environmental
management for vector control; commissioning of guidelines for
integrated vector management and for vector control needs assessment.
Participation in the inter-cluster working group on DDT, production of
a guidance document on alternatives to POPs pesticides.
- Short-term staff
Tools for good practice in drinking-water quality control
(Drinking-water quality is a
concern for health protection in developing and developed countries
world-wide. Information on the effectiveness of control measures is not
readily available for several priority hazards and for several control
measures. This product brings togther a series of activities concerned
with critical evaluation of the effectiveness of control measures and
- Control of hazardous chemicals in
- Preparation and publishing of
UN-system-wide "synthesis report" on arsenic; monograph on fluoride;
and monograph on nitrate/nitrite in drinking-water.
- Protection of source waters
- Protection of source waters is of
proven effectiveness in water-quality and health protection. Critical
information concerning the efficacy of measures for the protection of
water sources is little available in many areas and has been
under-evaluated from a health perspective. Preparation of guidance,
based on critical review of available evidence, is under way.
- Quality control in drinking-water
- Coordination of preparation of
guidance concerning: materials and chemicals used in the production and
distribution of drinking-water; desalination; and on monitoring and
assessment of drinking-water supply and quality.
- Guidance on household water
treatment and storage
- Development of guidance on good
practice in household water treatment and storage.
- Short-term staff
Tools and good practice in
health-care waste management
- Decision-making guide for primary
- Develop a decision-making guide on
HCWM for primary health-care centres in less-developed countries.
Incorporate comments into draft document and create easy-reference HCW
- Technical guidance on treatment
(including blood disposal)
- Develop good practice guidelines
for the safe handling and ultimate disposal of blood.
- Support for application of guidance
- Support for application of HCWM
guidance, including development and updating of the HCWM website.
General management and
administration of WSH programme
- To incorporate expenditures for
office communications, such as fax and mailing.
- Informatics support and hardware
- For expenditures linked to any
information technology/computer services required, as well as purchase
of computer software and hardware. Obligations to be raised if and when
special purchases/contracts required.
- Miscellaneous support and coded
- To cover expenditures for all
miscellaneous office purchases, such as coded articles (e.g.
transparencies), general books (those not related to specific
- Programme Support Costs
- Ad hoc cost-shares for previous
27 November 2002