HWT Use Litres of water treated in 2014 by predominant HWT technologies estimated at approximately 24.5 billion litres (non-emergency use) with approximately 24 million users. These HWT users represent only 3.16% of the population (748 million people) who continue to rely on unimproved drinking water sources. Summary Findings:  Sustainable scale-up of HWT product use has not occurred among at-risk populations.  Pricing and sustainability impacted by reliance on NGO and government distribution at greatly subsidized prices.  Manufacturers struggle with limited distribution networks, lack of consistent demand, and logistical barriers such as transportation.  Strong growth in filter markets in parts of Asia likely attributed to ability to pay by middle-income households, growing consumer awareness, variety of HWT products at multiple price points, and strong distribution networks.  Regulation of HWT is weak with regulatory frameworks largely fragmented. Filters were not regulated in any of the three countries and chlorine disinfectants were evaluated based on varying standards. Purpose Commissioned by World Health Organization (WHO) in support of the International Scheme to Evaluate Household Water Treatment Technologies (the Scheme). Market assessment provides findings on household water treatment (HWT) product use, market, and enabling environment in Africa and Asia. Assessment comprised a desk review and field visits to three countries (Ethiopia, Ghana, Viet Nam). 81 respondents were interviewed including manufacturers, distributors, international and local agencies, government officials, and research experts Conclusions To enable the scaling up of quality assured HWT products, governments and private partners have to work together to:  Educate and build consumer awareness about the health benefits of HWT and correct and consistent use.  Increase availability of HWT product options along multiple price points.  Work with distributors to support strong distribution networks and easy access to HWT products and replacement parts.  Support the development of sustainable markets with innovative financing schemes, smart subsidies, and targeted market approaches.  Develop strong and comprehensive HWT regulatory frameworks and create incentives for tested quality products. Acknowledgements References Ethiopia Demographic Health Survey (2011) Ghana Multiple Cluster Indicator Survey (2011) Viet Nam Multiple Cluster Indicator Survey (2011) Note: Priorities to support scaling up of HWT products was discussed at WHO HWTS strategic meeting in March, 2015 in Netherlands ( pplicant/en/) With grateful thanks to the World Health Organization for the opportunity to conduct the assessment and a special thanks to Dr. Batsirai Majuru for her guidance and support. Sustainability of Household Water Treatment Practices: Findings from a Market Assessment Roshini George, Sera Global Health Practice Findings from Ghana  9% of households report use of HWT methods and less than 2% report use of HWT products (bleach, filter, solar).  HWT use associated with emergencies or NGO specific programs.  Filters not easily found but imported brands (like Unilever’s Pureit) are sold in select supermarkets. Imported filters like LifeStraw, Hydraid filters and locally made ceramic and biosand filters largely depend on NGO demand and do not have a retail distribution network.  Sachet water is seen as the most important source of drinking water (MICS, 2011) that is easily available (street vendors) and relatively inexpensive. In the Greater Accra region, sachet water is consumed by 47% of households. Findings from Viet Nam  About 90% of Vietnamese households report using HWT methods with boiling the most common method (MICS, 2011).  Filters are the leading HWT product with 16.7% of households reporting use followed by chlorine disinfectants at 1.7%.  Chlorine disinfectants associated with emergencies and include SafeWat, Aquatabs, Chloramine B, P&G Purifier of Water.  Significant growth in filter market in urban/ peri-urban areas with widespread availability across multiple price points.  350% growth in Reverse Osmosis filter sales over the last four years and poised to double over next few years. Mineral pots popular among middle/ lower income families in urban/ peri-urban areas. Locally made sand filters common in rural households.  Strong retail distribution networks through multiple channels in urban/ peri-urban areas (brand storefronts, electronics trade shops, general trade shops, online). Methods Findings from Ethiopia  9.1% of households report using HWT methods. 6% of households use HWT products of which chlorine disinfectants are most predominant at 5.8% of households (DHS, 2011).  P&G Purifier of Water, Aquatabs, WuhaAgar, and BishanGari are the main chlorine disinfectants distributed.  HWT use linked with emergencies and lack of awareness on correct and consistent HWT product use.  Only.2% of households report using filters including imported products (LifeStraw, Tulip, Hydraid) as well as locally made ceramic (SMS filters) and biosand filters (Desert Rose etc.).  Filters have limited retail distribution and are mostly procured by NGOs PSI advertising campaign targeted at changing the emergency use perception of WuhaAgar Use of sand filters in rural Viet Nam Street vendor selling sachet water