8th meeting of the International Network of Drinking-water Regulators

14-17 September 2015 Nairobi, Kenya

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Contents Abbreviations and acronyms .......................................................................................................... 3

1 Introduction ................................................................................................................................. 4

Background .................................................................................................................................... 4

Meeting overview........................................................................................................................... 4

Meeting objectives ......................................................................................................................... 5

2 Summary of key discussion points ............................................................................................. 6

Session 1: Network update and summary of activities (2014/2015) ............................................. 6

Session 2: Current Regulatory Issues ............................................................................................. 8

Sessions 3 and 4: WHO Guidelines for Drinking-water Quality ................................................. 10

Aquaya workshop: Water quality monitoring and linking accountability to capacity development ................................................................................................................................. 11

Session 5: Linking Global Monitoring and Regulatory Information Systems ............................. 11

Session 6: Compliance and Enforcement of Drinking-water Regulations................................... 13

Session 7a: Priorities for Strengthening Regulatory Capacity ..................................................... 15

Session 7b: Priorities for Strengthening Regulatory Capacity (continued) ................................. 16

Session 8: Network Activities 2014/15 and Work-plan for 2015/16 ........................................... 17

3 Network work-plan 2015-16 ..................................................................................................... 19

4 Appendices................................................................................................................................ 21

Appendix 1: Meeting agenda ....................................................................................................... 21

Appendix 2: Developing / revising national standards based on the GDWQ .............................. 24

Appendix 3: Water Quality Monitoring: Linking Accountability to Capacity Development ..... 26

Appendix 4: Summary of the management of customer non-payment in various countries ....... 32

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Abbreviations and acronyms GDWQ Guidelines for Drinking-water Quality IWA International Water Association QMRA quantitative microbial risk assessment RegNet International Network of Drinking-water Regulators MDGs Millennium Development Goals SDGs Sustainable Development Goals WHO World Health Organization WSP water safety plan

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1 Introduction

Background The International Network of Drinking-water Regulators (RegNet) was established in 2008 as a platform to share experiences and to promote good practice relating to regulation of drinking-water quality. The network aims to increase access to safe-drinking water and ultimately, protect public health, through the improvement of regulatory systems. Specifically, the network serves to:

• Provide a discussion forum to address challenges and share best practice in regulation of drinking-water;

• Share experiences in relation to the development and enforcement of regulatory frameworks for drinking-water quality, and of different approaches to specific issues requiring regulation;

• Guide and share experiences on the role of regulators in supporting implementation of water safety plans within a water safety framework;

• Support the development of internationally-recognized guidance on the regulation of drinking-water to improve public health protection;

• Provide a connection from the periodic updates of the WHO Guidelines for Drinking-water Quality, from a regulatory perspective;

• Provide support and guidance to regulators to develop, update or amend a regulatory framework; and

• Advocate for improvement of drinking-water regulations. For the purposes of RegNet, a water regulator is defined as an entity tasked with ensuring the safety of drinking-water by undertaking all or some of the following functions at national and sub-national levels: establishing relevant regulations, carrying out independent surveillance of drinking-water quality; and enforcement. Membership is restricted to persons who carry out this task.

Meeting overview The 8th RegNet meeting was held in Nairobi, Kenya, on 14-17 September, 2015. The general theme of the meeting was strengthening regulatory capacity in drinking-water quality in the areas of:

• national standards development • risk management approaches, and • water quality monitoring.

The RegNet meeting consisted of a one and a half day closed session (spread over three days), which was attended by 11 RegNet members, representing the WHO regions of Africa, the Americas, Europe, South-East Asia and the Western-Pacific. In addition, three WHO Secretariat members were present and a WHO consultant. Rory McKeown (WHO consultant) served as meeting rapporteur. To ensure leverage on synergies between RegNet and other stakeholders, the RegNet meeting was held in conjunction with workshops organized by partner organizations, namely:

• a half-day workshop hosted by WHO on 14 September on the application of the WHO Guidelines for Drinking-water Quality for establishing or revising national drinking-water quality standards or regulations

• a one-day workshop hosted by the Aquaya Institute on 15 September disseminating the findings from the Monitoring for Safe Water programme and the application of a capacity rating diagnostic tool (WaterCaRD) for the assessment of water quality institutions, and

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• a half-day workshop on 17 September hosted by the International Water Association (IWA) and WHO on water safety planning (this formed part of a larger two-day workshop entitled Water Safety Planning and Sanitation Safety Planning Sensitization held on 17-18 of September; Note: detailed information on the content of this workshop is provided elsewhere in the workshop meeting report).

In addition to RegNet participation, each of these workshops were open to wider audiences. The following report summarizes the key discussion points from the meeting.

Meeting objectives The objectives of the meeting were to:

• to discuss emerging water quality and regulation issues • to develop strategies to strengthen regulatory capacity as it relates to drinking-water quality

in the areas of: o establishing and revising of national standards for drinking-water quality o implementation and scale-up of water safety plans (WSPs) o strengthening water quality surveillance efforts

• to review Network activities in 2014/15 and seek input for the 2015/16 work-plan. The detailed meeting agenda is attached as Appendix 1.

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2 Summary of key discussion points

The meeting was opened by Jennifer De France (WHO) who welcomed participants and reiterated WHO’s commitment to working with regulators to support the development and implementation of drinking-water quality regulations to promote public health protection. This commitment has been demonstrated through the allocation of additional funds to support RegNet training and capacity development activities, as well as the provision of additional human resources to support Network activities. Following this, a brief introduction from each of the meeting participants was provided, indicating their aspirations for the forthcoming meeting. Increased cooperation and sharing of experiences among regulators was a key theme of the group’s aspirations for the meeting. Batsirai Majuru (WHO) provided an overview of the meeting agenda, highlighting the key meeting objectives and expected outcomes. The key discussion items from the meeting are summarized in the sections that follow.

Session 1: Network update and summary of activities (2014/2015) Moderator: Pranav Joshi (National Environment Agency [NEA], Singapore) Objective: To provide an update on RegNet and drinking-water quality related activities Update on WHO drinking-water quality related activities (Jennifer De France, WHO) An overview of WHO activities related to drinking-water quality was presented, including a summary of the key WHO publications since the 7th Network meeting in Portugal in 2014. An update on the revision of the WHO Guidelines for Drinking-water Quality (GDWQ) was presented, including a summary of the key updates to the first addendum to the fourth edition (due in quarter 1 of 2016). Supporting activities include:

i. the preparation of a question and answer (Q&A) guidance document for the development/revision of national standards/regulations based on the GDWQ;

ii. the forthcoming publication of a quantitative microbial risk assessment (QMRA) guidance document and;

iii. initiating work on radiological aspects of drinking-water quality. A brief outline of the current programme for revision of the GDWQ Volume 3: Surveillance and control of community supplies was also presented, highlighting that the document would be revised with a clear distinction between information pertaining to policy frameworks (Part 1), and information relating to field-level activities (Part 2; including, for example, information on surveillance and water quality testing elements, WSPs and sanitary inspections; to be published in late 2016). Potential synergies between this work and Health Canada’s current programme to regulate small community supplies were flagged for future consideration. In concluding, the need for RegNet feedback on WHO GDWQ activities and guidance documents was communicated, to assist WHO to understand the Network’s needs and capacity gaps, to ensure relevant and accessible guidance materials continue to be developed. Review of 2014 meeting minutes and Network update (Batsirai Majuru, WHO) A review of the minutes and key discussion points from the 7th RegNet meeting in Portugal (2014) was presented1. The key commitments from the 2014 meeting by both RegNet members and the Secretariat, alongside their progress to date, are summarized below:

1 The meeting report from the 7th RegNet meeting in Portugal in 2014 is available from: http://www.who.int/water_sanitation_health/dwq/RegNet_meeting_report_2014_final_web.pdf?ua=1.

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• Input into a Q&A guidance document on developing or revising national standards or regulations for drinking-water based on WHO GDWQ: RegNet members have provided input and feedback on the framework of the Q&A guide.

• On-demand support on development/ revision of drinking-water standards/regulation: An informal roster has been established detailing RegNet members who can provide guidance on developing and/or revising national standards for drinking-water. To date, input has been provided to Bhutan on the development of their national drinking-water standards.

• Sharing of information resources related to WSP auditing, training frameworks for regulators and WHO publications on the burden of disease: the training framework from Drinking Water Inspectorate (DWI; United Kingdom) and the WSP auditing review (Environment and Sustainable Resource Development [ESRD], Canada) have been shared among RegNet members. In addition, the Secretariat has shared various literature, including the WHO summary report on the burden of disease caused by unsafe water, sanitation, and hygiene2.

• Finalization of the RegScan document has been ongoing, and is due in Quarter 2 of 2016. • Supporting the development of approaches for the use of regulatory data in global monitoring:

several RegNet members have provided input and participated in discussions and a case study aimed at developing a framework for the use of regulatory data in global monitoring of water supplies.

• Strengthening linkages and other initiatives related to water safety: The Secretariat continues to work towards identifying potential synergies between RegNet and other global water safety efforts, including linking the 8th RegNet meeting in Nairobi with a workshop hosted by The Aquaya Institute (Aquaya) and a further joint workshop by WHO and the International Water Association (IWA). This approach also provided the opportunity to enhance participation in the Network and potentially broaden RegNet membership to include new countries in East and West Africa.

• Resource mobilization: some limited funds have been secured to support future capacity building activities within the Network. How this funding would be allocated would be decided based on the agreed follow-up activities from this meeting and the 2015/16 work-plan.

Following the review of the 2014 minutes and the Network update, a round table discussion was held regarding participants’ comments on the update provided and the Network in general. The following key points were raised:

• Regulation of non-piped water: represents a significant challenge amongst regulators, with every country experiencing different challenges; there remains a need for clarity and guidance for regulating services beyond utility contracts.

• Proposal to have benchmarking criteria established for RegNet: the use of benchmarking criteria was flagged as a means of enhancing the visibility of the Network as well as lending greater credibility to regulators through enhanced recognition of RegNet membership. Such criteria may also provide clear guidance for benchmarking for new Network members. Appropriate benchmarking criteria should now be established (for example, criteria on independence, data reporting practices, mandate for regulatory responsibilities). Such benchmarking criteria may also provide quality assurance for regulatory systems to support the future use of national data to assist global monitoring efforts.

• Need for more regular and open communication with RegNet members outside of formal meetings: the need was expressed for more regular guidance from the Network on regulatory issues faced by individuals within the Network; a format was proposed whereby a question

2 WHO (2014). Preventing diarrhoea through better water, sanitation and hygiene: exposures and impacts in low- and middle-income countries. Geneva; World Health Organization (http://www.who.int/water_sanitation_health/gbd_poor_water/en/)

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could be proposed to the Network by an individual on the RegNet online forum; once the collective responses have been reviewed and action has been taken, the approach and outcome should be presented by the individual back to the Network for discussion. It was encouraged that members do not wait for the annual meeting to raise issues that could be addressed in this fashion throughout the year.

• Another issue that was raised, but with insufficient time to resolve, included where the appropriate mandate for regulatory responsibility should reside, that is, to the meter or to the point of consumption.

Session 2: Current Regulatory Issues Moderator: Rick Johnston (WHO) Objective: To discuss current regulatory challenges, potential solutions, and key areas of work for WHO in strengthening regulatory capacity. A roundtable discussion was held to discuss current and emerging regulatory issues; key topics of discussion included the following: Chemical contaminants from mining activities: Luca Lucentini (Department of Environment and Primary Prevention [DEPP], Italy) discussed recent experiences with the management of a drinking-water chemical contamination incident involving thallium associated with mining activities within the drinking-water supply catchment. The incident highlighted the challenge that regulators face when attempting to balance public health risks against the cessation of drinking-water supply. More guidance on the management of drinking-water quality contamination incidents would be desirable. The significant, yet often underestimated, role that pipelines may play in water contamination incidents was highlighted. In this particular incident, the pipeline acted both as a significant sink, and source, for thallium. Appropriate strategies to control the influence of pipelines in drinking-water contamination events are required, which requires a fundamental understanding of the potential for the prevailing conditions to influence the sorption/desorption of contaminants in a particular situation (e.g., pH, presence of phosphates). In addition, this case study described a situation where key water quality monitoring data was available at a central laboratory, but was not reported to the relevant authorities, due to the absence of a reporting requirement for that particular parameter. During the discussion, it was flagged that regulatory approval was recently granted in Ireland to permit the use of phosphate to control lead release from aging lead pipes; more information on this is to be shared with the group once published. Asbestos contamination of drinking-water supplies: Idriss Kouotou (Ministry of Water Resources and Energy [MWRE], Cameroon) described recent experiences with the detection of asbestos particles in drinking water from asbestos pipelines. During this discussion, it was agreed that a robust risk assessment is key in such situations, as remedial efforts to remove asbestos may result in greater risks of exposure. The low public health risk of asbestos exposure from ingestion of contaminated drinking-water must be balanced against the potential risks associated with remediation efforts (such as removal of asbestos pipeline). It was recognised that the issue is complicated due to political and public concern. Portugal has recently reconsidered the establishment of an approval scheme for materials in contact with drinking water. As materials in contact with drinking water may significantly influence drinking-water quality, this topic should be explored as a future topic for discussion at the next RegNet meeting. Management of a Legionella outbreak in Portugal: Luís Simas (Water and Waste Services Regulation Authority [ESRAR], Portugal) shared experiences following a recent Legionella outbreak in Portugal that affected approximately 400 people. The source of the outbreak was thought to be ineffective cleaning and maintenance procedures for the cooling towers of a local

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factory, compounded by unfavourable climatic conditions (including high humidity, low winds and the presence of a recent dust cloud). Close coordination and regular communication between stakeholders was found to be critical to ensuring the timely identification of the cause of the outbreak and for the effective management of the incident. Emergency response plans were key to rapidly notifying and convening the relevant stakeholders and to ensuring that the correct communication protocols were followed, but it was noted that such plans were limited in their ability to guide the decision making process during the emergency situation. Ensuring that there was only one point of communication from the health agency was important to ensure clear and consistent communication with stakeholders. The outbreak has been documented in Eurosurveillance, and will also be published in a forthcoming article in the New England Journal of Medicine, which will be shared amongst the Network once available. Impacts of climate change on water resources: Peter Mutale (National Water Supply and Sanitation Council [NWASCO], Zambia) shared Zambia’s experiences with the challenges faced from the impacts of climate change, in particular, the impacts on water quality associated with depleting dam levels (such as elevated turbidity and iron levels) as well as the challenges faced with sourcing/treating alternative water sources such as groundwater. These issues were affecting public confidence in the water supply management, as well as impeding the enforcement of existing drinking-water quality regulations. Work is currently underway in Zambia to develop a screening tool for all projects relating to the impacts of climate change, which may be shared with the Network following completion in late 2015. Luca Lucentini (DEPP, Italy) shared his experiences with working with utilities to identify trends in drinking-water parameters quality over time attributed to climate change; recording trends that were frequently related to specific climatic events was found to be a useful tool for the integration of climate change risks into WSPs. In addition, Pranav Joshi (NEA, Singapore) shared Singapore’s experience with seasonal impacts on the concentration of dissolved organic carbon and disinfection by-products and the associated operational impacts for drinking-water suppliers, emphasising the importance of integrating climate change risks into WSPs. It was agreed that RegNet should be in a position to act in an advisory capacity on the potential impacts of climate change (i.e., providing advice to the wider regulatory community, water suppliers, media). Accordingly, a need was expressed for the development of guidance material for the Network on the integration of climate change considerations into WSPs. In response, Jennifer De France (WHO) provided a brief update on a forthcoming WHO publication on climate-resilient water safety planning which provides guidance on the management of drinking-water quality risks associated with climate change and variability (to be published in Quarter 4, 2015). Further, it was advised that IWA are at the early stages of developing climate-change related guidance materials. The aforementioned guidance materials guidance materials would be shared with the Network when published, and may act as an information source for RegNet members to provide guidance on the potential impacts of climate change on drinking-water quality and the development of climate resilient WSPs. The moderator posed a question concerning the impacts of climate change on drinking-water supply infrastructure. During the subsequent discussion, it was agreed that asset management programmes were the most appropriate strategy to manage the potential impacts of climate change and variability on water supply system infrastructure. In addition, it was advised that the WHO climate change team are examining the infrastructure-related risks associated with climate change to determine appropriate infrastructural requirements for climate resilience. This information will provide further guidance on this topic for the RegNet members when released and shared with the Network later this year.

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Other points were raised during this session but there was insufficient time to resolve; these included:

• the use of recycled water as a means to mitigate the water resource management challenges associated with climate change; the experiences of Singapore and Namibia in this regard were briefly shared; the question was raised regarding the need for additional standards for recycled water

• the significance of catchment characteristics on the potential for climate change-related impacts on source water quality (e.g., seasonal impacts associated with peat, mobilization of contaminants in ground-waters such as nickel-bearing deposits).

In concluding, the moderator summarized that climate change impacts on drinking-water quality and the enforcement of regulations is a complex issue, and should be considered as a topic for future discussion at the next RegNet meeting. RegNet members should communicate to the Secretariat if they feel there is an outstanding need for additional guidance materials and tools to support regulatory aspects of climate change and drinking-water quality. Key actions/next steps from Session 2:

• information to be shared on recent Irish regulatory approval for permitting the addition of phosphate to the water supply for the control of lead release from customer pipes (Responsible: Rory McKeown)

• ‘materials in contact with drinking water’ and ‘the impacts of climate change on drinking-water quality and the enforcement of regulations’ to be considered for further discussion at the next RegNet meeting (Responsible: Batsirai Majuru)

• article on the Legionella outbreak in Portugal in the New England Journal of Medicine to be circulated amongst the Network (Responsible: Luís Simas)

• Zambian climate change tool to be shared amongst the Network following development in late 2015 (Responsible: Peter Mutale)

• WHO to share forthcoming document on building climate resilience into WSPs once published (Responsible: Jennifer De France)

• RegNet to advise if additional climate change and WSP integration guidance materials are required to support the Network (Responsible: All).

Sessions 3 and 4: WHO Guidelines for Drinking-water Quality Moderator: Batsirai Majuru (WHO) Objective: To share an understanding of how the WHO GDWQ can be used to help develop national drinking-water quality standards, address specific technical issues or concerns and identify knowledge gaps in the application of the GDWQ.

Jennifer De France (WHO) provided an introduction to the session, stating requests have been made for guidance concerning the application of the GDWQ for informing the development or revision of national standards or regulations for drinking-water quality. Following this, a Q&A document was in preparation, being led by Darryl Jackson (United Mission to Nepal [UMN], Nepal) and John Fawell (GDWQ Advisor, U.K.). Sessions 3 and 4 took the form of a Q&A discussion, whereby 11 predetermined guidance questions were posed to, and answered by, the guidance documents lead authors. This was an open session, which, in addition to the core RegNet participants, included additional participants from Aquaya and the Kenya Ministry of Health (MoH). A summary of the key information that was contained within the presentation, and points raised during the subsequent discussion are included in Appendix 2. During the follow-up discussion, Jennifer De France (WHO) highlighted that WHO would continue to develop this guidance document and seek RegNet review and feedback at the

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appropriate time. As regulators are the primary target audience for this guidance, the importance of input from RegNet during the document development was emphasized. Key actions/next steps from Sessions 3 and 4:

• JECFA arsenic document to be circulated to the Network (Responsible: Jennifer De France) • RegNet feedback to be sought on the Q&A guide for developing/revising national

standards/regulations for drinking-water based on the WHO GDWQ (Responsible: All) • Portugal and Cameroon to keep the Network informed of any progress regarding the revision

and development of their national standards, respectively (Responsible: Luís Simas – Portugal; Idriss Kouotou - Cameroon).

Aquaya workshop: Water quality monitoring and linking accountability to capacity development Day 2 was an open workshop hosted by The Aquaya Institute (Aquaya), a non-profit research and consulting organization on issues related to water and sanitation. Among their initiatives is the Monitoring for Safe Water (MfSW), an action-research program conducted in collaboration with WHO and IWA. The objective of the programme is to evaluate factors that constrain regulated water quality monitoring across sub-Saharan Africa. The Aquaya workshop was aimed at sharing findings from the MfSW programme and developing a strategy for regulated water quality monitoring. Among the key points discussed are that:

• Preliminary analyses of the water quality data support the previous findings that improved sources3 are not always free of faecal contamination;

• Significant differences in the levels of faecal indicator bacteria were observed between improved and unimproved sources when data was aggregated for all countries; however, these differences were less pronounced when data was examined between countries.

• Future work is considering the use of additional surveillance tools (such as sanitary inspections) to compliment the water quality monitoring

As part of the outcomes, the programme identified that a comprehensive systems-based approach works best to identify constraints to water quality testing and to build capacity within the region, as such an approach may simultaneously address capacity deficiencies across several institutions. Capacity building grants were provided to the relevant institutions based on an application process and a needs assessment. Financial incentives for institutions achieving sampling/analysis targets, were used as catalytic tools, and not a long-term support mechanism for water quality monitoring. Further, these incentives were also employed as a research tool, such that the impact of removing established incentives could be assessed. In terms of scope, the programme did not include the link between water quality data and health outcomes, as the main goal of the programme was to improve capacity for water quality monitoring. Participants highlighted that the programme represents an important baseline, from which countries must now identify how to move forward. A summary of the workshop proceedings can be found in Appendix 3.

Session 5: Linking Global Monitoring and Regulatory Information Systems Moderator: Luís Simas (ERSAR) Objective: To provide an update on global monitoring and regulatory information systems, and identify mechanisms for advocating for sustained investment in water infrastructure

3 As defined by the WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation; http://www.wssinfo.org/definitions-methods/watsan-categories/

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Global monitoring and the Sustainable Development Goals (Rick Johnston, WHO) Rick Johnston (WHO) presented on the linking of national water quality monitoring data to global monitoring efforts for drinking-water services under the Sustainable Development Goals (SDGs). How the SDGs would attempt to address some of the key shortcomings of the Millennium Development Goals (MDGs) was discussed, namely, through the consideration of hygiene, addressing inequalities and adopting a broader scope beyond just the household level to assess the level and sustainability of water and sanitation services. Information was presented on SDG 6 (i.e., ‘Ensure availability and sustainable management of water and sanitation for all’), alongside the proposed indicators for Target 6.1 (drinking water) and 6.2 (sanitation and hygiene). With regards to Target 6.1 (i.e., ‘By 2030, achieve universal and equitable access to safe and affordable drinking water for all’), the proposed indicator is the ‘percentage of population using safely managed drinking-water services at home’; this may be defined by those have a basic drinking-water source which is: (i) located on premises (ii) available when required, and (iii) free from contamination by faecal material and priority chemicals. It was highlighted that realization of these ambitious goals will require monitoring at national and sub-national levels to track progress and focus and accelerate appropriate interventions. In this regard, it is envisaged that regulatory data will play an increasingly important role supporting global monitoring. Certain regulatory agencies may already have information on surveillance, risk management and service levels. Such information may complement existing household water quality survey information to provide an overall picture of the proportion of the population using safely managed drinking-water services at home (a case-study on how this process may work was presented for Zambia). The challenges associated with data quality were raised (e.g., characteristics and independence of regulatory authorities, accreditation of laboratories/analytical methods) alongside suggested qualifiers for benchmarking regulatory independence. Despite the challenges that remain (e.g., coverage in rural areas, involvement of multiple surveillance authorities, affordability, inequalities), it was highlighted that there remains huge potential to combine national and global monitoring approaches. Many mutual benefits may be realized through this linkage, including, for example, progressive improvement in regulatory and water quality monitoring systems. Achieving sustained decision-maker engagement for drinking-water infrastructure (Donald Reid, ESRD, Canada) The chronic underinvestment in sustainable drinking-water infrastructure was discussed. Overall, it was stated that the capital investment gap is widening globally: in the U.S. alone, capital investment shortfall is forecasted to be $84 billion by 2020, widening to $144 billion by 2040. Decision-makers often take a shorter-term view with regards to capital infrastructure spending. Failure to sustain drinking-water quality infrastructure in countries that achieved MDG targets may result in a regression of improvements and a re-emergence of waterborne disease. The potential role for RegNet in this process was explored as failure in drinking-water infrastructure will ultimately impact regulators. Consideration should be given to the integration of economic regulation of water services with sustainable investment to improve/maintain drinking-water infrastructure. Regarding the role of RegNet in drinking-water infrastructure, Pranav Joshi (NEA, Singapore) highlighted that in Singapore, public health comes under the domain of the Ministry of Health, whereas economic aspects come under the domain of the Ministry of the Environment; further, asset management is the responsibility of the water suppliers. It was suggested that the focus of RegNet should remain on public health, whilst taking advantage of existing forums that may focus on economic regulation. On this topic, Jenifer De France (WHO) stated that although the focus of WHO is on public health protection, economics plays a significant role and cannot be considered

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in isolation. To address this, the current revision of Vol. 3 of the GDWQ includes guidance on sustainability and financial aspects of drinking-water quality. To clarify, it was stated that the suggestion was not to broaden the focus of RegNet to include economic regulation, but merely to consider if the commitment of the Network to drinking-water quality management should include the consideration of sustainable infrastructure delivery, given its inextricable link to water quality and public health. Regarding the linking of national and global monitoring efforts, Luís Simas (ERSAR, Portugal) proposed consideration of a risk assessment approach for national regulatory agencies to rank the reliability of national monitoring data for use in global monitoring. For example, a traffic light system was proposed as a potential model (similar to that used in Portugal to assess the performance of utilities). In response, Rick Johnson (WHO) agreed that such an approach may be valuable, and echoes exiting WHO work on RegScan. However, caution must be exercised, as the typological considerations are important (i.e., consideration of equivalence; for example, in the U.S. and Australia, where guidelines are on a state level as opposed to the national level). Furthermore, it was reiterated that WHO must remain independent and cannot express a preference for one regulatory typology over another. The Network expressed a need for clarity on what the indicators may be for national level monitoring, so that the preparedness of national monitoring systems to support global monitoring programmes may be assessed. In response to the suggestion that a survey would be useful to document the typology of regulatory systems worldwide (including the presence/absence of national standards), Batsirai Majuru (WHO) highlighted that there are several projects currently being undertaken by WHO that may address this, including, for example, RegScan, GLAAS, and a typological review of regulatory frameworks. Consideration should be given to extracting/combining relevant information pertaining to national regulatory status, as such a document may be a useful advocacy platform to promote and accelerate the development of nations standards/regulations (e.g., in the case of Cameroon). Currently, the typological review is only focussing on two countries. Input from the Network into this document would be welcomed, particularly with regards to providing information on what the model/regulatory frameworks are in each country and how can these be used to develop regulatory frameworks globally. Key actions/next steps from Session 5:

• update the Network on what the SDG indicators may be, so the preparedness of national monitoring systems to support global monitoring programmes may be assessed (Responsible: Rick Johnson, WHO)

• RegNet to provide input on the development of the typology of regulatory monitoring frameworks document (Responsible: Batsirai Majuru [WHO] to circulate to the Network).

Session 6: Compliance and Enforcement of Drinking-water Regulations Moderator: Jennifer De France (WHO) Objective: To discuss challenges with non-compliance and share options for enforcement Challenges with enforcement of non-compliance to water quality standards (Peter Mutale; NWASCO, Zambia) During this presentation, it was highlighted that the role of NWASCO is to develop/enforce national guidelines and standards. In Zambia, non-compliance to these guidelines may result in the suspension of a utilities operating licence and/or criminal prosecution. As all costs (i.e., fines, legal fees) are ultimately borne by the consumer indirectly through tariffs, it was stated that this presents a challenge for NWASCO, given their mandate for customer protection. A further challenge lies

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with ceasing water supply in response to water quality issues, due to water being recognized as fundamental human right and the associated political implications. A new traffic light-based assessment system is under development in Zambia, which aims to address overall compliance and confidence in water quality monitoring results. A number of outstanding questions were raised to form the basis of future discussions, including: should service providers continue to be fined for non-compliance, given that the customer indirectly pays?; how long should non-compliant water be permitted to be supplied to customers due to poor infrastructure or the introduction of a new standard?; when should water suppliers be required to shut down a treatment plant due to poor performance?; how can you ensure service providers continue to operate within standards? During the discussion, Donald Reid (ESRD, Canada) offered insights into Canadian alternatives to fining utilities under the civil code, namely, ‘creative sentencing’, whereby a judge may reassign fines to address the issue/prevent the problem from re-occurring, rather than just being put into the treasury. Darryl Jackson (UMN, Nepal) commented that consideration must be given as to how support mechanisms may be put in place to assist poorly performing utilities to get out of the ‘red’. This comment was echoed by Luís Simas (ESRAR, Portugal), who stated that the context of the ‘red’ classification must be clearly understood, to determine if resolution may be achieved by the supplier or by the regulator. Luca Lucentini (DEPP, Italy) emphasized the importance of promoting the concept of ‘due diligence’, as opposed to merely assigning ‘compliance’ versus ‘non-compliance’ in certain situations. In concluding, the moderator summarized that due diligence is an important regulatory tool to support improvements without penalizing utilities. Further, the concept of constructive capacity development is the basis of the forthcoming WHO guidance on auditing WSPs4. Peter Mutale (NWASCO, Zambia) was encouraged to post his question to the RegNet forum regarding the enforcement of non-compliance. Pranav Joshi (NEA, Singapore) offered to share with the Network an issue sheet from Singapore on the enforcement of non-compliance. When consumers do not pay: the human right to safe water and challenges with access and affordability (Luís Simas; ERSAR, Portugal) It was discussed that, although this topic may appear to be an economic issue, in reality, non-payment may ultimately become a regulatory issue: if customers do not pay, less revenue will be generated, which may ultimately impact on a water utilities ability to provide reliable safe drinking-water services to customer. The basis for water as a human right was discussed. The roles and responsibilities of (i) government and public administrations (ii) regulatory authorities (iii) service providers and (iv) users were presented as outlined in the Lisbon Charter. The actions taken by water utilities in various countries following non-payment was presented. The details of this, alongside the subsequent discussion, are summarized in Appendix 4. During the discussion, the moderator commended the presenter on his efforts to compile this information remotely, and that this highlighted the value of the Network for information sharing. Rick Johnson (WHO) added that a forthcoming WHO report on the affordability of water recommends that disconnection should not occur unless the individual’s ability to pay has been assessed. It was agreed that the Network would benefit from future discussion on this topic to examine conditions for (i) non-payment (ii) failure of service on the part of the utility and (ii) what is considered to be an appropriate minimum daily supply to meet the basic health and hygiene needs of customers. The latter is anticipated to be complicated to assess, given that water for hygiene is an imprecise measure. It was put forward that that disconnections represent the ultimate failure: whether this is a failure of the regulator, or of the customer, may be difficult to determine. With regard to the question of affordability, Luís Simas (ESRAR, Portugal) offered information 4 WHO (2015). A practical guide to auditing water safety plans. Geneva; World Health Organization: http://apps.who.int/iris/bitstream/10665/204280/1/9789241509527_eng.pdf?ua=1

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relating to the Portuguese ranking system for affordability; this is based on an affordability formula which may be shared among the Network. Questions were raised regarding consideration of the affordability of connection fees (in addition to volumetric usage charges), as well as a potential role for RegNet to provide a recommend approach for the management of customer non-payment/disconnections. The point was raised for consideration regarding the availability/usefulness of national statistics pertaining to the number of disconnections. Key actions/next steps from Session 5:

• post question to RegNet forum regarding the enforcement of non-compliance with national standards (Responsible: Peter Mutale, NWASCO, Zambia)

• share issue sheet on enforcement of non-compliance with national standards (Responsible: Pranav Joshi; NEA, Singapore).

Session 7a: Priorities for Strengthening Regulatory Capacity Moderator: Rick Johnson (WHO) Objective: To review sessions on Guidelines for Drinking-water Quality and Aquaya meeting, and identify potential links with capacity needs within RegNet Roundtable discussion: Reflections from the sessions on Guidelines for Drinking-water Quality and Aquaya meeting (All) As the format for the 8th RegNet meeting has been different from previous meetings, (namely, the linkages with other workshops being hosted by partner organizations) an opportunity was provided for participants to provide feedback on the new format and the content of the workshop sessions. With regards to the WHO GDWQ session on developing/revising national standards/regulations (Sessions 3 and 4), Luís Simas (ESRAR, Portugal) commented that this guidance would be very useful for countries that are undergoing this process and that follow-up on this session via the preparation of a guidance document should follow (considering the inclusion of a case study on the Philippines current experience). It was suggested that such a document would have broad appeal to the regulatory community. This point was echoed by Idriss Kouotou (MWR, Cameroon), who stated that such a guidance document, along with RegNet support, would be of significant benefit to Cameroon, should they proceed with the development of national standards. Pranav Joshi (NEA, Singapore) identified that guidance material is required to support a regulators ability to perform risk assessment in the event of a water quality exceedance, in particular, guidance on how to communicate with the public in the case of an outbreak of waterborne disease. In response, Batsirai Majuru (WHO) advised that such guidance material would need to broad, as the circumstances and communication protocols would be different in every situation; this in turn may limit the usefulness of such guidance materials. However, the potential future need for additional tools/guidance for managing water quality exceedance/outbreaks was noted. Donald Reid (ESRD, Canada) flagged that quantitative microbial risk assessment (QMRA) may be considered as a means to develop standards. In response, Peter Mutale (NWASCO, Zambia) flagged concerns that such an approach may be beyond the resource capacity of lower income countries. These concerns were echoed by Luís Simas (ESRAR, Portugal), who stated that guidance on the application of QMRA is needed to encourage the adoption of this approach. Jennifer De France (WHO) advised the Network on the forthcoming WHO publication which provides guidance on the application of QMRA for water safety management (publication due Quarter 4, 2015). In regards to the Aquaya workshop, Donal Reid (ESRD) Comment on the need for clarity for the intended users/purpose of the approach, and highlighted that certain regulators may be inclined to

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use such a tool against a utility in the absence of robust application of the approach. Luís Simas (ESRAR, Portugal) advised the approach is a useful tool for self-assessment and benchmarking between institutions, and may be considered as a type of informal audit; these sentiments were echoed by Peter Mutale (NWASCO, Zambia). Idriss Kouotou (MWR, Cameroon) raised the question regarding the certification of laboratory methods for mobile laboratories. The Network advised that in many cases, test kits are considered acceptable for operational monitoring, but may not be approved for compliance monitoring or verification purposes. This viewpoint was supported by a recent document from the DWI (U.K.) examining the use of field kits for surveillance; this report was to be circulated amongst the group for information. Strengthening regulatory capacity (Batsi Majuru; WHO) By means of introduction to this session, WHO’s commitment to helping countries to apply the GDWQ was reiterated. It was stated that this may be realized through the provision of practical support for capacity building, and that this is a commitment of RegNet, as documented in the Terms of Reference5. It was highlighted that ways that RegNet can practically support capacity development would be explored in more detail in the next session. Luís Simas (ESRAR, Portugal) contributed that recent DWI support in developing the South African regulatory system was a prime example of the means by which regulatory capacity can be strengthened by sharing experiences. In this situation, sharing experiences helped the process to be executed more quickly, with less mistakes made during the development process. International cooperation was stated to be key to strengthening capacity development, and that documenting examples and case studies such as these are important to increasing the visibility and relevance of the Network.

Session 7b: Priorities for Strengthening Regulatory Capacity (continued) Moderator: Rick Johnson (WHO) Objective: To identify capacity needs within RegNet and potential mechanisms for addressing them Peter Mutale (NWASCO) described a peer review programme that exists in Zambia, whereby a regional regulators Network are engaged to peer review each other’s regulatory framework on a scheduled basis; this provides the means to support for capacity development and to share experiences. Luca Lucentini (DEPP, Italy) identified that a similar approach is common within the European Union, where twinning programmes between regulatory agencies are in place. Batsirai Majuru (WHO) concluded that enhanced peer to peer sharing may indeed be an appropriate mechanism for the RegNet to address capacity needs, and asked for the Network to consider how WHO may best support this. Donald Reid (ESRD, Canada) asked for clarification on the ownership of RegNet, and queried the need for the Network to be embedded within a specific structure to ensure continuity of activities. Jennifer De France (WHO) advised that such a requirement was not necessary, and that RegNet had the full support and commitment from WHO headquarters. Following this, it was raised that the RegNet Terms of Reference are due to sunset in 2015; this was flagged as an opportunity to position RegNet through the development of a new strategy. Both the current development of the GDWQ guidance document on revising/developing national standards/regulations, as well as consideration of the use of national monitoring to support global monitoring of the SDGs were flagged as key areas where RegNet input is required by WHO.

5 For the full RegNet Terms of Reference, please visit http://www.who.int/water_sanitation_health/dwq/TORRegNet.pdf.

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In response to a query from Peter Mutale (NWASCO) regarding the limit on RegNet membership, Batsirai Majuru (WHO) clarified that there is no limit on the potential number of RegNet members. Further, it was added that there is a strong desire to expand membership and that the forthcoming IWA/WHO Water and Sanitation Safety Planning Sensitization workshops in East and West Africa presented an opportunity to recruit new membership to enhance participation within these regions. Improved communication of GDWQ revision activities to RegNet was flagged as a future opportunity for improvement. The Network was advised that the WHO’s WSH website is currently undergoing a redevelopment to enhance its user friendliness and to provide more up-to-date guidance on the progress of GDWQ activities. As a first step in enhancing communication link between the Network and the WSH unit, all RegNet members were to be added to the email distribution list for the WSH newsletter. The visibility of RegNet was identified as an area that could benefit from strengthening. Proposed mechanisms to enhance the visibility and raise the profile of RegNet included:

• establishing a regular RegNet presence at an appropriate annual event (e.g., Singapore water week)

• preparing an information brochure on the purpose/objectives of RegNet

• writing an information article for publication in a periodical industry publication (such as IWA’s Water21 journal)

• creating a RegNet social media presence (e.g., on Facebook and/or Twitter). Such approaches were identified as an opportunity to communicate the goals and objectives of RegNet to the public, and to clearly establish how RegNet is different from other regulator forums. Further, ways to enhance links between RegNet and regional regulatory forums were explored as a means to increase visibility of the Network and to strengthen ties and enhance knowledge sharing between various networks and forums. To facilitate this, an executive summary is to be prepared as part of the RegNet meeting report for dissemination to regional networks. Lastly, to improve the user friendliness and accessibility of the EZCollab forum, email notifications were to be reinstated such that all members would be informed of new postings/activity on the forum. Key actions/next steps from Sessions 7a and b:

• initiate update of RegNet Terms of Reference (Responsible: Batsirai Majuru)

• ensure all RegNet members are signed up to WSH newsletter (Responsible: Batsirai Majuru)

• prepare executive summary for the 8th RegNet meeting report for dissemination to regional networks (Responsible: Batsirai Majuru)

• reinstate email notification for EZCollab forum activity (Responsible: Batsirai Majuru).

Session 8: Network Activities 2014/15 and Work-plan for 2015/16 Moderator: Jennifer De France (WHO) Objective: To review Network progress and obtain input on Network work-plan Issue sheet on training framework for regulators (Singapore) An issue sheet entitled ‘Developing and Implementing a Training Framework for Drinking-water Regulators’ was presented by Pranav Joshi (NEA, Singapore). This issue sheet was developed out

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of an identified need for a formal training framework for regulators. The training framework proposed includes the following key elements:

• type of training and acquisition of knowledge and skills • delivery of training programmes • training resources • training record.

The proposed framework was identified as being compatible with, and easily integrated into, ISO 9001 quality management certification systems. The need for training of trainers was raised as a key consideration for the sustainability and quality of training frameworks, particularly in remote regions. During the subsequent discussion, the importance of appropriate training and personal attributes for regulators/auditors was raised. Jennifer De France (WHO) flagged that the forthcoming WHO guidance document on WSP auditing provided guidance on the appropriate personal attributes for constructive audits. In closing, feedback was requested from the Network on the proposed training framework.

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3 Network work-plan 2015-16

The proposed activities for the 2015/16 work-plan were discussed. A summary of the agreed work-plan is presented in Table 1. Table 1. Summary of agreed work-plan for 2015/16.

Topic Action(s) points Persons responsible

Enhancement of credibility and visibility of RegNet

• Establishment of benchmarking criteria for RegNet

• Review Terms of Reference • Develop RegNet brochure • Updates from regional regulatory

networks

Secretariat (initiate and share with RegNet for feedback) Luís Simas (ENDWARE) Peter Mutale (ESWAS) Oscar Pintos (ADERASA)

Guidance on regulation of non-piped supplies

Development of guidance material Secretariat

Management of non-compliance

• Seek feedback on non-compliance from wider RegNet on EZcollab;

• Collate responses for presentation

Peter Mutale

Impact of climate change on water quality

Network and WHO to circulate relevant documents on climate change and water safety planning

Secretariat, RegNet

Development/revision national standard

Follow-up on initiating the development and revision of standards in Cameroon and Portugal, respectively

Idriss Kouotou Luís Simas

Use of regulatory data in global monitoring

Clarity on the information needed from regulators to support JMP monitoring of SDGs

• Share detailed plan on collaboration between JMP and regulators

• Jointly develop case studies

Secretariat (initiate and share with RegNet for feedback and input)

Regulatory frameworks • Share and seek feedback on framework and associated case studies developed by WHO

• Develop case studies

WHO (initiate and share with RegNet for feedback)

Water quantities to fulfil basic needs

Review of evidence base of water quantity Information document to be prepared

Secretariat Luís Simas

Develop indicators on affordability

Input on definitions and indicators for affordability

Secretariat Luís Simas Donald Reid

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Guidance on tools for managing exceedances (e.g., derogations)

Update on the relevant section in the Q&A and share for feedback

Secretariat

Sustaining investment in water infrastructure

Convene webinar/discussion Secretariat

Closing remarks In closing, Batsirai Majuru (WHO) stated the review and revision of the existing Terms of Reference for RegNet affords an exciting opportunity to develop a new vision for the Network. The valued involvement of all participants in the meeting was gratefully acknowledged. The establishment of an ambitious work-plan for 2015/16 promised significant steps and new directions for the Network. Canada was proposed for consideration as the host nation for the next RegNet meeting (2016). Finally, WHO reiterated their commitment to supporting the RegNet goal of promoting public health protection though the development and continual improvement of regulatory systems.

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4 Appendices

Appendix 1: Meeting agenda Monday 14 September

RegNet 08:30 - 09:00 Registration of Participants 09:00 - 09:30 Opening remarks and meeting overview 09:00 - 09:10 Welcome and opening remarks Robert Gakubia,

WASREB 09:10 - 09:20 Welcome and introduction of participants Jennifer De France,

WHO 09:20 - 09:30 Meeting objectives and overview Batsi Majuru,

WHO 09:30 - 10:30 Session 1: Network update

Objective: Touching base: update on Network and water-related activities 09:30 - 09:45 Update on WHO activities Jennifer De France,

WHO 09:45 - 10:00 Review of 2014 meeting minutes Batsi Majuru,

WHO 10:00 - 10:15 Network update Batsi Majuru

WHO 10:15 - 10:30 Comments / feedback Moderator:

Pranav Joshi, NEA 10: 30 - 10:45 Coffee / tea break 10:45 - 12:30 Session 2: Current regulatory issues

Objective: Discuss current regulatory challenges, potential solutions, and key areas of work for WHO in strengthening regulatory capacity

Roundtable discussion: emerging regulatory challenges including:

• Impact of climate change on water resources • Chemical contaminants from mining activities, including

thallium and uranium • Managing outbreaks

Moderator: Rick Johnston, WHO

12:30 - 13:30 Lunch 13:30 - 15:00 Session 3: WHO Guidelines for Drinking-water Quality (GDWQ)

Objectives: share an understanding of how the WHO GDWQ can be used to help them develop national drinking-water quality standards; address specific technical issues or concerns; and identify knowledge gaps in the application of the GDWQ

13:30 - 13:40 Session introduction and objectives Jennifer De France, WHO

13:40 – 15:00 Developing or revising national standards for drinking-water quality

John Fawell, Darryl Jackson

15:00 – 15:15 Coffee / tea break 15:15 - 16:30 Session 4: WHO Guidelines for Drinking-water Quality (continued) 15:15 – 16:45 Developing or revising national standards for drinking-water

quality John Fawell, Darryl Jackson

16:45 – 17:00 Session summary, implications and next steps for RegNet Batsi Majuru, WHO

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Tuesday 15 September

The Aquaya Institute

09:00 - 17:00 Water quality monitoring: Linking accountability to capacity development Objective: Present findings from the Monitoring for Safe Water programme, discuss potential strategy for regulated water quality monitoring

18:30 - 21:00 Dinner event Venue to be advised

Wednesday 16 September

RegNet 09:00 - 09:10 Re-cap of Days 1-2 Meeting rapporteur:

Rory McKeown 09:10 - 09:15 Agenda for Day 3 Batsi Majuru

WHO 09:15 - 10:15

Session 5: Linking global monitoring and regulatory information systems Objective: Update on global monitoring and regulatory information systems, and identify mechanisms for advocating for sustained investment in water infrastructure

09:15 - 09:40 Global monitoring and the Sustainable Development Goals (SDGs)

Rick Johnston WHO

09:40 – 09:55 Achieving sustained decision-maker engagement for drinking-water infrastructure

Donald Reid ESRD

09:55 - 10:15 Discussion Moderator: Luís Simas, ERSAR

10: 15 - 10:30 Coffee / tea break 10:30 - 11:30 Session 6: Compliance and enforcement of drinking-water regulations

Objective: Discuss challenges with noncompliance and share options for enforcement 10:30 - 10:45 Challenges with enforcement of non-compliance to water

quality standards Peter Mutale, NWASCO

10:45 - 11:00 When consumers do not pay: the human right to safe water and challenges with access and affordability

Luís Simas, ERSAR

11:00 - 11:30 Discussion Moderator: Jennifer De France, WHO

11:30 - 12:30 Session 7a: Priorities for strengthening regulatory capacity Objective: Review sessions on Guidelines for Drinking-water Quality and Aquaya meeting, and identify potential links with capacity needs within RegNet

11:30 - 11:45 Strengthening regulatory capacity Batsi Majuru, WHO

11:45 - 12:30 Roundtable discussion: Reflections from the sessions on Guidelines for Drinking-water Quality and Aquaya meeting

Moderator: Rick Johnston, WHO

12:30 - 13:30 Lunch 13:30 - 15:00 Session 7b: Priorities for strengthening regulatory capacity

Objective: Identify capacity needs within RegNet and potential mechanisms for addressing them

13:30 - 14:15 Group discussion: Capacity needs within RegNet 14:15 - 15:00 Feedback from groups Moderator:

Rick Johnston, WHO 15: 00 - 15:15 Coffee / tea break

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15:15 - 16:30 Session 8: Network activities 2014/15 and work-plan 2015/16 Objective: Review Network progress and obtain input on Network work-plan

15:15 - 15:30 Issue sheet on training framework for regulators Pranav Joshi NEA

15:30 - 15:45 Network work-plan 2015/16 Batsi Majuru WHO

15:45 – 16:15 Discussion Moderator: Jennifer De France, WHO

16:15 - 16:30 Closing session 16:15 - 16:20 Meeting summary Rory McKeown,

Meeting rapporteur 16:20 - 16:30 Final remarks Jennifer De France,

WHO

Thursday 17 September

IWA, WHO and RegNet

08:30 - 09:00 Registration and refreshments

Session 1: Opening – Day 1

09:00 - 09:15 Welcome and introduction Custodia Mandlhate, WHO Sarah Tibatemwa, IWA Jennifer De France, WHO

09:15 - 09:45 Self-introduction: Brief overview of your organization and water safety planning experiences Kizito Masinde, IWA

09:45 - 10:00 Workshop purpose Kizito Masinde, IWA

10:00 - 10:30 Coffee/Tea Break

Session 2: Overview of Water Safety Planning

10:30 - 11:15 Water safety planning basics: (1) What is a WSP? (2) What are the benefits of WSP? (3) Global status of WSPs, (4) WSP Resources

Jennifer De France, WHO

11:15 – 12:15 Overview of water safety planning steps Darryl Jackson, WHO Consultant

12:15 – 12:30 Questions and Discussion Darryl Jackson, WHO Consultant

12:30 - 13:30 Lunch Break and Networking

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Appendix 2: Developing / revising national standards based on the GDWQ The session was presented in a question and answer format, in which members of the GDWQ expert group presented key questions relating to standard development/revision processes and provided answers. Where relevant, RegNet participants who have developed or are currently developing / reviewing their national standards shared their experiences. The countries that are currently developing / revising national standards include: the Philippines, who are finalising the revision of their national standards; Portugal, who will be updating their standards relating to radiological aspects in 2016; and Cameroon, who will be initiating the development of their national standards in 2016. The questions presented by the GDWQ expert group were as follows:

1. When should national standards be upgraded? 2. How to go about developing/revising standards/regulations and how long would it take to

complete this task? 3. Who should be involved in preparing the new/revised standards/regulations? 4. How do you go about selecting the most appropriate parameters? 5. In addition to parameters, what other information should be included in

standards/regulations? 6. How do you adopt the WSP risk-based approach at a national level, as opposed to the

local (or supplier) level? 7. What is the difference between a ‘health-based Guideline value’ and a ‘health-based

value’? 8. What should we do in the event of a standard being exceeded and what should we say

about this in our standard? 9. What type of parameters should be set for acceptability and how should we set standards

for them? 10. What particular issues standout when developing and implementing national standards? 11. What are some of the emerging trends in drinking-water quality standards?

These questions are included in the guidance document on developing / revising national standards that is currently being finalised, and the related answers are provided. During the subsequent discussion, RegNet participants who have developed or are currently developing / reviewing their national standards shared their experiences and comments on some specific questions, which are summarized below:

• Who to involve when preparing the new/revised standards/regulations: Experiences from the Philippines Joselito Riego de Dios (DoH, Philippines) provided an overview of the recent approach taken in the Philippines to revise their national standards. The review was triggered based on feedback from water suppliers on mandatory parameters as well as the new mandatory requirement for water safety planning. For the revision process, the key stakeholders involved in revising the standards were a National Technical Working Group (and sub-committee) as well as local and international experts. It was anticipated that the process would be completed within an eight-month period.

• Selecting appropriate parameters:

Experiences from Singapore and Italy Pranav Joshi (NEA, Singapore) shared Singapore’s experiences, where there are approximately 98 parameters included in their standards. However, the regulations state that monitoring should only occur on a risk-based approach, which implies that monitoring for each and every parameter is not necessarily required. An alternative approach was offered by John Fawell (GDWQ Advisor, U.K.), whereby national standard may include a more focused range of parameters, stating in the standards that the WHO GDWQ should be referred to where a specific parameter is not listed within the national standards. It was indicated that this

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approach is common worldwide. Further, if standards for specific parameters are contained within national standards, then it is customary to state what actions must be taken in the event of an exceedance (e.g., penalties, sanctions etc.). The aforementioned approach of referencing the GDWQ would circumvent this issue. Luca Lucentini (DEPP, Italy) raised some recent issues experienced in Italy with regards to the setting of national standards, including standards for pesticides, which may sometimes be based on political considerations rather than on a scientific basis. In addition, standards for cyanobacterial toxins are absent in Italy, due to the fact that any concentration of toxin was deemed to be unsafe. It was suggested that the GDWQ may consider providing some guidance on the precautionary principle. In response, Jennifer De France (WHO) flagged that there is currently some limited text on the precautionary principles within the GDWQ, but that during the current revision process, consideration may be given to providing additional guidance on this topic.

• Information to include in standards/regulations, in addition to parameters: Experiences from Portugal, Italy and the Philippines. The question was raised by Ranjiv Khush (Aquaya, U.S.) regarding the level of evidence typically required before an analytical monitoring method is approved. In response, it was suggested that although important to maintain certain standards, it is advisable to avoid being over prescriptive, as analytical methods are continually evolving. Once this question was put to the group, Portugal, Italy and the Philippians advised that their respective standards include a requirement for accreditation of analytical methods/laboratories (e.g., to national/international accreditation standards). The important distinction was made between analytical methods for operational monitoring versus monitoring for compliance with national standards, where the latter may be a legal requirement depending on the national context. With regards to accreditation, it was discussed that some analytical field methods may be accredited (e.g., certain colorimetric/spectrophotometric methods), but field methods relying on visual interpretation of a colour change would not be considered for accreditation.

In concluding the session, Jennifer De France (WHO) highlighted that understanding the national context was key to supporting the development/revisions of national standards or regulations; as such, direct support for this process from WHO may be limited. However, if countries are embarking on this process, WHO may be able to support through the provision of some limited funding for capacity development in this area, and RegNet may be able to support in a guidance/peer review capacity as required. Luís Simas (ESRAR) flagged that Portugal would commence the revision of their national standards in 2016, and that support from WHO and RegNet may be sought at the appropriate time. Further Idriss Kouotou (MWE, Cameroon) identified that Cameroon does not currently have national standards, and that developing their first standards was currently under consideration. It was flagged that MWE may seek formal support for this process from WHO and RegNet at the appropriate time. A progress update would be provided to the Network by both Portugal and Cameroon.

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Appendix 3: Water Quality Monitoring: Linking Accountability to Capacity Development Monitoring for Safe Water Programme and a systems-based approach to capacity building (Ranjiv Khush; Aquaya, U.S.) The Monitoring for Safe Water Programme was launched in 2012 to develop evidence-based strategies for improving water quality monitoring and management in Africa, and was led by Aquayain collaboration with WHO and IWA. The programme included six countries in sub-Saharan Africa: Ethiopia; Kenya; Uganda; Zambia; Guinea; and Senegal, involving 11 water suppliers and 15 surveillance agencies. Microbial water quality in Africa (Emily Kumpel, Aquaya, Kenya) Preliminary results from the programme indicate that water sources classified as ‘improved’ were found to be safer that those classified as ‘unimproved’; further, water from ‘improved’ sources was found to contain faecal indicator bacteria, implying that water from ‘improved’ sources does not necessarily equate to safe drinking-water. Overall the hierarchy of water safety in water sources assessed in this study was found to be as follows: piped water > other improved > unimproved > surface water sources. In conclusion, significant differences in the levels of faecal indicator bacteria were observed between ‘improved’ and ‘unimproved’ sources when data was aggregated for all countries; however, these differences were less pronounced when data was examined between countries. During the discussion, it was highlighted that future work is considering the use of additional surveillance tools (such as sanitary inspections) to compliment the water quality monitoring. The usefulness of such an approach was discussed, where it may capture important site-specific considerations to be assessed when analysing/interpreting the data (such as, for example, well depth, identification of groundwater under the direct influence of surface water as well as harmonization of country specific definitions for water supply schemes). What drives monitoring performance? The development of Water CaRD (Rachel Peletz, Aquaya, Kenya) Water CaRD was described as a validated capacity rating diagnostic tool that may be used for the assessment of institutional strengths and weakness with respect to water quality monitoring. The tool has been developed over a two-year period with input from over 26 institutions (water suppliers and health agencies) in the six aforementioned participating countries in Sub-Saharan Africa. To assess capacity, institutions are assessed and scored against five institutional areas, namely, accountability, staffing, finances, equipment/services and programme structure (with each institutional area further divided into sub-components). This tool was described as being able to identify gaps to focus resources on where capacity building is most required. The relationship between institutional capacity rating and monitoring performance was illustrated by plotting the WaterCaRD test scores for participating institutions against their water quality testing activity. Regarding next steps, means of weighting key sub-components will be assessed (using principle component analysis analysis). Piloting of the WaterCaRD is scheduled in September 2015, with the tool being disseminated for wider-use in Quarter 1, 2016 (potentially including the development of a supporting application for smart phones). Using WaterCaRD to score institutional capacity (breakout sessions facilitated by Aquaya) During the breakout session, participants were organized into groups to use the WaterCaRD tool to assess a particular institution (based on an anonymized real-life case study). Each group was assigned to different elements of the five aforementioned intuitional areas. Following completion of the breakout session, the WaterCaRD score was compiled based on the feedback from the

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individual groups; it was found that the WaterCaRD score was closely aligned with the monitoring performance for this particular case study. The key feedback provided during the post-breakout session discussion may be summarized as follows: • clear definition of terminology is required to minimise variability of scoring (e.g., between

regions, countries, assessors etc.) • phrasing of questions must show a consistent logical progression that is clearly associated with

the corresponding score • consistent and comprehensive development of the case study is a key consideration for

successful application of the tool • there remains a need to clarify who the intended users are for this tool; consideration should be

given to the need to customize the tool for utilities versus surveillance agencies • consideration should be given to capturing customer feedback aspects • the usefulness of the tool as a self-assessment exercise for an institution was discussed, with

subsequent comparison of the results to an independent external assessment • WaterCaRD would be a useful tool to share with regulators. Panel 1: Applying WaterCaRD – opportunities and challenges A p discussion was held, during which, questions were posed to a panel representing participants in the Monitoring for Safe Water programme. The panel consisted of the following members: Samwel Ogot – Association of Private Water Operators, Uganda; Kevin Kayando – Ministry of Health, Kenya; Simon Etimu – Ministry of Water and Environment, Uganda; Florence Kabinga – Ministry of Health, Zambia; Engineer Mungai – Ruiru-Juja Water and Sewerage Company Limited, Kenya. Q. 1) Describe your institutional approaches to building capacity around water quality monitoring and how may WaterCARD fit into this approach? Florence Kabinga (Ministry of Health, Zambia): Indicated that it is their mandate to look at how water quality monitoring may be sustained. It was stated that the local structures are in place for surveillance; however, all environmental health staff rely on a centralized laboratory. A clear need was expressed to decentralize laboratory facilities to support sustainable water quality surveillance at the local level. Through the Aquaya programme, two mobile laboratories have been acquired recently to build capacity in this area. Overall, the WaterCaRD was found to be a good tool to assess water quality monitoring capacity; consideration should be given to modifying/customizing the tool for surveillance institutions. Simon Etimu (Ministry of Water and Environment, Uganda): At the national level, a National Water Quality Monitoring Strategy was developed in 2006, which is key to guiding the management of water quality monitoring. As there are multiple stakeholders involved in the management of monitoring in Uganda, the strategy allows for a consistent approach to water quality monitoring. The Ministry of Water and Environment is responsible for capacity building, and provides training to local and central districts in the areas of water quality monitoring and testing, as well as a number of technical support units. At the lowest level, it was stated that there is close collaboration between the Ministry of Health and the Ministry of Water and Environment where testing is performed and the results are shared amongst the ministries. In their experience, WaterCaRD represented a good start to measure water quality monitoring capacity. The approach was found to address different institutional aspects together to provide an overall indication of gaps in capacity. Q. 2) Based on your experience with water quality management programmes, what are your biggest challenges and what has led to success?

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Engineer Mungai (Ruiru-Juja Water and Sewerage Company Limited, Kenya): Stated that their biggest challenges centred on intermittency in water supply schemes. Capacity building efforts have resulted in the provision of equipment, training and a fixed laboratory. These improvements in water quality monitoring capacity have resulted in improved system management and the ability to be proactive with regards to timely corrective actions for managing water quality. The Monitoring for Safe-water programme has ensured the organization exceeds the minimum water quality monitoring requirements laid out by the regulator. Kevin Kayando (Ministry of Health, Kenya): Stated that before the programme, water quality monitoring consisted of sporadic, reactive testing. The programme has since resulted in substantial capacity building in this area. However, with the recent cessation of financial incentives to complete monitoring, a reduction in the achievement of monitoring targets has been reported. In addition to capacity building, their biggest successes have centred on the development of a comprehensive database for all supplies, as well as now being in a position to inform the community regarding water quality testing results. The biggest challenges were found to lie with the future sustainability of the established programme in a resource limited/competitive environment; it was cautioned that this may result in a return to reactive testing only. In addition, procurement at a country-level was stated to be challenging, with long government procurement processes delaying programmes and the need to source equipment from the U.S. at significant cost. It was emphasized that the challenge in the future will be to find a cost competitive, efficient, local supply chain. Further, small financial incentives are not considered to be appropriate for long-term programme sustainability. In response, Ranjiv Khush (Aquaya, U.S.) emphasised that sustainability is a key consideration. Advocacy for water quality monitoring is key to achieving sustainability, and this was missing from the current discussion. It was advised that advocacy platforms must be established to ensure water quality monitoring is a key consideration (i.e., similar to World Bank loans, which address, for example, gender balance and environmental impact consideration). It was discussed that until water quality monitoring is included as a component of these funding streams, programme sustainability will not be realized – small financial grants will not achieve sustainability alone. Wamuwi Changani (Western Water and Sewerage Company, Zambia) echoed this point, highlighting that in Zambia, significant Asian Development Bank investment programmes are in place for water supply improvements (including treatment facilities) but do not mention water quality monitoring. Engineer Mungai (Ruiru-Juja Water and Sewerage Company Limited, Kenya) suggested that innovative ways should be explored to monetize drinking-water quality monitoring to ensure that people take notice (e.g., following the successful model to monetize non-revenue water losses in Kenya through mandatory reporting via the Auditor General). Samwel Ogot (Association of Private Water Operators, Uganda): Advised that the Aquaya programme facilitated capacity building through the provision of financial support and water quality testing assets. As a result, testing targets have been achieved and the supply of reagents has been greatly improved. The challenges they have experienced include staff migration following training. In addition, other authorities should have capacity to test for verification purposes, as this was stated to not currently be the case. Improving the cost-effectiveness of water quality monitoring (Emily Kumpel, Rachel Peletz; Aquaya, Kenya) Recent efforts to improve the cost effectiveness of water quality monitoring programmes were presented. During the Monitoring for Safe Water programme, the cost of testing was found to vary significantly between countries. Areas targeted for cost-efficiency gains included:

(i) optimizing the number of samples – the number of samples required may differ depending on whether sampling is being performed to detect changes within a system

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or to have confidence in achieving regulatory requirements; in many cases, small supplies were found to be over-sampling, whereas larger supplies were under-sampling

(ii) using more cost-effective testing methods – although quantitative microbiological analytical methods are most common (e.g., membrane filtration), presence-absence techniques are more cost-effective and may be appropriate in many instances; preliminary analysis in this area has been promising (a study of 7 suppliers performing quantitative and presence-absence testing in parallel has shown preliminary data indicating 98 % agreement between the methods).

During the subsequent discussion session, Donald Reid (ESRD, Canada) welcomed the initiative on this work, but cautioned against a metadata approach to the analysis, due to system specificity considerations. Panel 2: Penalties versus incentives for water quality monitoring Panel 2 retained the same questions and answers format as the Panel 1 session, and included the following panel members: Peter Mutale - NWASCO, Zambia; Benjamin Murkomen - Ministry of Health, Kenya; Ayana Kelbessa - Water Bureau, Ethiopia; Irene Senir – National Water & Sewerage Company, Uganda; Wamui Changani - Western Water and Sewerage Company, Zambia). Q. 1) Can you provide examples of incentives and penalties to ensure that water quality monitoring programmes are implemented as required? Wamui Changani (Western Water and Sewerage Company, Zambia): Advised that in Zambia, water quality monitoring is one of the key regulatory indicators regulated by NWASCO (reported on quarterly). If programmes are performing poorly, this will be indicated on the rating for that particular utility. This provides a strong incentive to perform well. Indirect penalties may include the political fallout and/or public blame in the event of a waterborne disease outbreak. In such cases, if utilities are not performing water quality monitoring as prescribed by the regulator, then they cannot defend their position. This is seen as a strong incentive to perform the appropriate monitoring. Irene Senir (National Water & Sewerage Company, Uganda): Advised that the situation is similar in Uganda, where the government assign water quality targets, which are reported each quarter. Performance related staff bonuses are also in place as an incentive if targets are achieved: this may take the form of a fuel allowance. Q. 2) The provision of financial incentives was used as a research tool during the programme. Is offering this type of incentive a useful programmatic tool in your situation? Benjamin Murkomen (Ministry of Health, Kenya): It was advised that, although a good research tool, in Kenya, the use of small financial incentives is not considered to be a sustainable approach to supporting monitoring programmes in the longer-term. A community strategy approach would be more suitable. It was advised that work is currently underway on a scheme of service to support community workers and technical officers, incentivizing them to perform water quality monitoring in addition to their other activities, such as health surveillance. Peter Mutale (NWASCO, Zambia): A similar benchmarking (or ‘name and shame’) approach was described in Zambia, where the performance of institutions is ranked and tabled in parliament. In addition, recognition certificates are issued to institutions who are performing the best, thereby incentivizing good performance. Ayana Kelbessa (Water Bureau, Ethiopia): Indicated that incentives have been tried in the past but with limited success; the approach needed is to give government an enabling tool that can prompt action and be assessed. Policies and strategies have been developed but what was stated to be lacking was effective implementation. Water quantity was stated to be the primary focus of the

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government, not water quality. Enabling tools are required to support such programmes (e.g., training in logistics, monitoring as well as vehicles, reagents, mobile laboratories etc.). Q. 3) What type of experiences do participants have regarding incentives and penalties (open to the floor for responses)? Luís Simas (ESRAR, Portugal): Advised that the greatest incentive in his experience is public confidence in the water supply (and the associated feedback to this effect). In terms of penalties, in the event of a waterborne disease outbreak, the blame and failure for the regulator and the water supplier may be considered a significant penalty, as they are responsible for developing and implementing the regulations, respectively. A similar benchmarking system is in effect in Portugal (traffic light approach with green, yellow and red colour coding); this acts a powerful incentive. Peter Mutale (NWASCO, Zambia): Highlighted that positive customer surveys represented a strong incentive for water suppliers in Zambia. The important of communicating water quality information to customers was emphasized. This point was echoed by Irene Senir (National Water & Sewerage Company) based on Ugandan experiences. The question was raised during the discussion as to whether competition from bottled water may act an incentive? It was argued that people value bottled water, but do not value tap water. If a value can be placed on tap water (and its associated quality), then the ideal model would be to channel this extra revenue back into drinking-water quality monitoring and assurance. In conclusion, it was summarized that financial incentives were not deemed to be a necessity, and that public benchmarking and customer confidence in the drinking-water quality supply is a very important incentive. There is a strong desire to increase the value of tap water in the public eye. More consideration should be given to developing the intrinsic value of tap water. Closing Session (Ranjiv Khush; Aquaya, U.S.) The following key observations were made to summarize the workshop:

• larger suppliers have the capacity to achieve regulatory requirements for water quality; however, these larger suppliers face public relations challenges; as economies develop, they invariably shift to bottled water; this in turn may penalize the less well-off, due to the increased financial burden from increased water tariffs (to pay for improved water treatment services), as well as the cost of purchasing bottled water

• smaller suppliers and surveillance agencies lack the capacity to meet regulatory requirements; water quality in rural settings is unknown in many cases and, as such, regulations only benefit a small proportion of the population

• fragmentation of the water supply sector presents many challenges; understanding/clarifying roles and responsibilities is key; strengthening linkages between service providers may result in benefits with rest to surveillance

• suppliers of testing equipment/reagents are important plyers absent from this discussion; efforts must be made for them to understand the potential of these markets both now and into the future and their important role in supporting water quality monitoring programmes

• efforts must be made to improve the cost-effectiveness of water quality monitoring; this may be achieved through optimizing the methodologies adopted and the number of samples analysed

• efforts must also focus on the effectiveness of testing (i.e., not just testing for testing sake); maximum value must be derived from testing through improved data management and information flow for exiting testing data.

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In closing, Benjamin Murkomen (Ministry of Health, Kenya) advised that Kenya will now be taking the lead from Aquaya to ensure that sustainable water quality monitoring programmes remain in place. This will be achieved, in part, through the development of a policy brief based on the information derived from the Monitoring for Safe Water programme.

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Appendix 4: Summary of the management of customer non-payment in various countries

Country Obligation(s) on the part of the utility prior to taking action

Subsequent actions that may potentially be taken by the utility in

the event of non-payment

Comments

Argentina Not specified - May fit a flow restriction device - Supply may be cut in small towns and

a public tap located near the premises - Use of public supply tank with

disposable card permitting user to minimum amount of water per day

- In practice, flow-restriction devices offer little practical benefit as they are often illegally by-passed

- Typically, disposable cards permit users 20 L/person/day

Belgium (Flanders) Supply may only be cut following the decision of a local advisory board (responsible for independently assessing if the customer can/cannot pay)

If approved by local advisory board, customer may be cut-off from supply

Yearly social statistics are published publically detailing the number of cut-offs

Cyprus Customer must be provided with two months to pay the original bill

Late payment fee of 10 % of the original bill may be imposed After an additional two months, customer may be cut-off without further notice

Persons renting council accommodations must pay a €165 security deposit for non-payment of bills which may be returned to the individual once the lease is finished

Czech Republic Not specified Authority to cut-off supply without consideration of any minimum supply for health/hygiene

Same system in place for cut-off of gas and electricity

Germany Not specified Authority to cut-off supply Due to strong social system in Germany, cut-off scenario rarely occurs

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Country Obligation(s) on the part of the utility prior to taking action

Subsequent actions that may potentially be taken by the utility in

the event of non-payment

Comments

Hungary Must contact the customer at least twice (in writing)

May then limit consumption in time and quantity via:

- build in reducer unit to the pipe line - cut supply - build in pre-paid water meter

- Non-residential customer may be cut-off after 2.5 months

- For residential customers, utility must supply minimum amount of water to fulfil public health and livelihood requirements of the consumer (i.e., 20 L/person/day; must be within 50 m or 4 levels of the property)

- Different rules apply for disadvantaged/disabled residents

Italy In practice, utilities try to do everything possible to prevent a cut-off scenario

Not specified Legislation under review for a public fund for people who cannot pay water bills (for approval within the next 12 months)

Luxembourg Not specified Flow restriction device may be fitted Designed to allow minimum volume to be delivered to fulfil basic health/hygiene needs

Mozambique Must issue a 30 day warning notice After the warning notice has expired, the connection may be cut

- In practice, utilities tend to negotiate with the consumer to arrange payment plan

- Cannot cut-supply to certain critical institutions, e.g., parliament, jail, barracks

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Country Obligation(s) on the part of the utility prior to taking action

Subsequent actions that may potentially be taken by the utility in

the event of non-payment

Comments

Netherlands - One written warning - Evidence of attempt to make personal

contact with the resident - Offer provision of debt assistance - Make clear that medical conditions

can prevent cut-off of supply

Provided the aforementioned requirements have been fulfilled in agreement with the Dutch Disconnection Policy6, disconnection may occur

- The scheme has been prepared in accordance with the policy and rules for cut-off of gas and electricity

- The shut-off procedure is aimed at prevention of the disconnection of small consumers Disconnection of vulnerable customers is only permitted in exceptional circumstances

South Africa Not specified Flow restriction device may be fitted - Originally set at 25 L/person/day for a family of 8 persons (i.e., up to 6 kL per household per month)

- Subsequently sparked debate regarding what was minimum required for basic needs7

Sweden Contact the property in writing urging them to take corrective action Must give the property owner reasonable time to take notice

May cut-off supply The cost cut-off may be charged to the property owner

Switzerland Two reminders must be issued Supply may be cut

Customer invited to collect water directly from the water works (public tap available to fill containers)

Uganda Two week notification period with subsequent attempts to be made to contact customer for negotiation of payment plan

Supply may be cut Nil

6 http://wetten.overheid.nl/BWBR0031481/geldigheidsdatum_02-09-2015 7 For more information, refer to http://www.scielo.org.za/pdf/wsa/v36n5/v36n5a09.pdf.

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Country Obligation(s) on the part of the utility prior to taking action

Subsequent actions that may potentially be taken by the utility in

the event of non-payment

Comments

United Kingdom Not permitted under law to cut-off supply customer

Must work proactively with the customer to attempt to manage payment by offering different payment tariffs and schemes

Ultimately the water supplier can take consumers to court to recover costs

Zambia Two week notification period Supply may be cut within two days Culture of payment enforced