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Water-related disease surveillance and response

Water-related disease surveillance and response. Roger Aertgeerts Program manager WHO Regional Office for Europe. Targets are team work. Manage resources Provide water and sanitation Survey diligently Detect outbreaks Implement contingency plans Live and learn, and pass it on…. Agenda.

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Water-related disease surveillance and response

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  1. Water-related disease surveillance and response Roger Aertgeerts Program manager WHO Regional Office for Europe

  2. Targets are team work • Manage resources • Provide water and sanitation • Survey diligently • Detect outbreaks • Implement contingency plans • Live and learn, and pass it on…

  3. Agenda • Water use • Target setting • Access to water and sanitation • Target setting for water services • Water-related diseases • Target setting for surveillance systems

  4. Target setting • Effective demand management can be an important contribution to climate change adaptation. Possible targets include • Reduction of unaccounted-for-water • Reduction of leaks • Introduction of metering systems

  5. Agenda • Water use • Target setting • Access to water and sanitation • Target setting for water services • Water-related diseases • Target setting for surveillance systems

  6. Target setting in sanitation • Legal, institutional and administrative set-up • Issues of reliable information • Issues of infrastructure • Issues of economic capacity

  7. Examples of target setting • Finland • Universal centralized sewerage and wastewater treatment • Czech Republic • Compliance with EU 91/271/EEC • Construction of wastewater treatment facilities in small settlements with less than 2,000 inhabitants, where sewerage exists

  8. Target setting in access to safe water • Legal, institutional and administrative setup • Issues of reliable information • Issues of quality • Issues of economic capacity • Awareness-raising, education and training

  9. Examples of targets to safe water • Hungary • Nation-wide survey on population without access to drinking water, and exploration of feasible solutions • Development of social subsidies • Portugal • Affordability: 2% of family income as limit • Czech Republic • Facilitation of connection of residences in suburbs and small villages to public supply

  10. Agenda • Water use • Target setting • Access to water and sanitation • Target setting for water services • Water-related diseases • Target setting for surveillance systems

  11. “Water-related disease” means Any significant adverse effects on human health such as death, disability, illness and disorders, caused directly or indirectly by the condition, or changes in the quantity or quality, of any waters;

  12. Classes of water-related diseases • Classic water-related diseases • Cholera • Typhus • Typhus • Emerging water-related diseases • Cryptosporidiosis • Campylobacteriosis • Giardiasis • Legionellosis

  13. Classic: Typhus - Viral hepatitis A • Significant differences in incidence rate • Inconsistent reporting • Mostly decreasing trend

  14. Emerging: Cryptosporidiosis Legionellosis • Very uneven reporting system • Repeated cases of outbreaks

  15. Obligations under Art 6 par 2 (b) Parties shall establish and publish national and/or local targets for the standards and levels of performance that need to be achieved to realize The reduction of the scale of outbreaks and incidents of water-related disease;

  16. Aspects in target setting • Legal and administrative set-up • Availability and reliability of information on the water quality • Issues of water-related disease surveillance • Economic sustainability

  17. Obligations under Art 8 • Comprehensive national and/or local surveillance and early-warning systems established that • Identify outbreaks or incidents of wrd • Provide prompt and clear notification • Recommend preventive and remedial action • Plan response to outbreaks

  18. Target setting: focus and structure • Priority diseases – is the activity a real priority for the country? • Structure – is the structure of the national system effective and efficient?

  19. Target setting: processes and capacity • Detection (identifying cases and outbreaks) • Registration • Confirmation (epi and lab confirmation) • Reporting (early warning and routine) • Analysis and interpretation

  20. Targets: response capacity • Response • Control / response • Outbreak investigation • Programme adjustment • Changes in policy and planning • Feedback • Evaluation and monitoring

  21. Surveillance targets: support functions • Setting standards • Training • Supervision • Communication systems • Human resources • Material resources • Financial resources

  22. Assessing, mapping and communication • Laboratories • Availability, functionality and level of sophistication • Accreditation • Electronic data management and reporting • Health mapping • National capacity or at least database preparation

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