The Safe Drinking Water Alliance was established by USAID to enlist private sector support for programmatic interventions in safe water. The alliance represents USAID’s latest effort to address the issue of over 1 billion people lacking access to an improved water source. Unsafe water, sanitation, and hygiene practices are responsible for the vast majority of diarrheal diseases, a leading killer of children under five and a cause of nearly 2 million deaths of children every year.
The alliance applies a market and programmatic test to marketing and distributing PUR Purifier of Water, a household water treatment technology reverse-engineered from a municipal wastewater treatment plant. In Pakistan, Procter & Gamble (P&G) employs existing marketing and distribution capabilities to implement a social marketing plan with Population Services International (PSI), while a broad-based public health campaign led by Johns Hopkins Bloomberg School of Public Health Center for Communications Programs (CCP) highlights the need to treat household water on a daily basis. In Haiti, PSI leads a social marketing model to overcome the economic and infrastructure restraints that limit commercial participation. Finally, in Ethiopia, CARE implements an emergency relief model to ensure temporary access to safe water in a humanitarian crisis situation that also tests product effectiveness.
Mere access to new water treatment technologies does not ensure their use; a major barrier to facilitating water treatment at the household level is failure to engender the behavior change necessary to inculcate the desired behavior into the daily routine of an individual or family. The Safe Drinking Water Alliance is thus both a technological and behavioral intervention – introducing a new technology in water purification and conducting outreach and training to populations in the behavioral changes needed to successfully adopt it.
The alliance partners deliver experience in strategic program design, behavior change, social and commercial marketing and distribution, community participation, and emergency relief service delivery. All of these measures are part of USAID’s battle to reduce child deaths due to inadequate water supply, sanitation, and hygiene in the world’s poorest countries. The alliance’s efforts are focused on increasing access to improved sources of safe water, which is essential for public health benefits.
Product development is a critical component of the alliance’s efforts. Multinational corporations such as P&G are well aware that the overwhelming majority of new consumers live in the developing world. P&G has developed products such as Nutristar, a micronutrient fortification additive, and PUR Purifier of Water, a small sachet containing a water purification technology for household use. PUR required product development and market-based learning costing approximately $15 million over six years.
The household water quality intervention presently implemented on the largest programmatic scale is the Safe Water System developed by Centers for Disease Control and Prevention (CDC). It consists of locally produced chlorine-based disinfectant coupled with safe water storage containers. Delivery is through social marketing and emergency relief, while hygiene promotion engenders sustained behavior change. The Safe Water System has been piloted in various countries, including Bolivia, Zambia, Madagascar, Kenya, and Malawi, and has proven to be an effective intervention as an emergency response tool.
However, P&G’s initial efforts to reach markets for PUR in Guatemala and the Philippines failed due to insufficient repurchase rate necessary to sustain a functioning market. This realization that public health efforts were needed to gain market share for its products was significant for P&G. By identifying a need for action that was consonant with a public health agenda, a private sector resource partner was to some degree jointly defining a development problem shared by USAID and other donors. This also had implications for activity implementation, where a corporation’s market priming overlaps with the public sector’s interest in promoting general health, efficiency gains could be realized through joint action.