Comment on ‘Household Water Treatment in Poor Populations: Is There Enough Evidence for Scaling up Now?’

In their recent paper, Schmidt and Cairncross argue that promotion of household water treatment (HWT) among poor populations is premature. The paper makes useful points about the challenge of minimizing bias in assessing diarrheal disease that are relevant to studies of all water, sanitation, and hygiene interventions. However, their particular contention that the evidence does not support scaling up HWT is puzzling, not least because they reached the opposite conclusion—that it “should be strongly encouraged”—in a 2006 Cochrane review based mainly on the same evidence. Moreover, their assertion that HWT has not yet been shown to be acceptable and scalable on a sustained basis is difficult to reconcile with the fact that more than 850 million people in 58 low- and middle-income countries already report usually treating their water at home before drinking it.

Comment on ‘Household Water Treatment in Poor Populations: Is There Enough Evidence for Scaling up Now?’ T. Clasen, J. Bartram, J. Colford, S. Luby, R. Quick, M. Sobsey. 2009. Environmental Science & Technology, 43:14, pp. 5542–5544. doi.org/10.1021/es9008147