5 – 7 July 2023: 7th Ministerial Conference on Environment and Health

The 7th MCEH in Budapest brings together health and environment ministers from the 53 countries of the WHO European Region and representatives from international, regional, and non-governmental and youth organisations. The focus is on addressing the health dimensions of the triple environmental crisis of climate change, biodiversity loss and environmental pollution. At the 7th MCEH side event Integrating the Environment into One Health, WHO CC director Ana Maria de Roda Husman (in photo) delivered a keynote speech on how the Netherlands has adopted the One Health approach to reduce antimicrobial resistance.

In the Netherlands, organisations collaborate closely to combat the threat of emerging zoonoses and antimicrobial resistance. A complex interplay between antibiotics, antibiotic-resistance genes and resistant bacteria occurs in the environment involving water, soil, air, plants, animals and humans. RIVM collaborates with Dutch medical health professionals, veterinarians and experts from other disciplines, such as entomology, food safety and environmental sciences. The use of antibiotics in the veterinary sector has been drastically reduced. In addition, we contribute to international collaboration and capacity building amongst others with UN United Nations  (United Nations  )(United Nations ) organisations such as WHO and through the WHO Collaborating Centres and in the quadripartite group on Integrated Surveillance on Antimicrobial Use and Resistance. We actively conduct environmental surveillance for AMR in sewage to track circulation in the population. And we perform quantitative assessments to estimate the risk from exposure to AMR in the environment, for example, from bathing. This knowledge drives further prevention of environmental pollution from wastewater treatment plants.

March 2023: Second edition of the Water safety plan manual now available

The World Health Organization (WHO) Guidelines for Drinking Water Quality (GDWQ) recommend a proactive and systematic approach to assessing and managing risks to ensure the safety of drinking water supplies. To support the implementation of Water Safety Planning (WSP), the Water safety plan manual has been updated to its second edition. Targeted at water suppliers and organisations supporting water safety planning programmes, the manual provides practical guidance for the implementation of WSP in accordance with the principles outlined in the GDWQ. The second edition has been enriched with over a decade of global experience with water safety planning since the first edition was published in 2009. This new edition also focuses on equity and climate change, with the aim of enhancing the resilience of drinking water services for all users.

Ana Maria de Roda Husman and Harold van den Berg, two members of staff from the WHO CC,  provided peer review, additional text, and insights based on their expertise in the field of WSP. The updated Water Safety Plan manual serves as a valuable resource for drinking-water suppliers seeking to implement effective risk management strategies to safeguard the safety of their water supplies. Water safety plan manual; Step-by-step risk management for drinking-water suppliers is available for download. 

18 – 24 November 2022: World Antimicrobial Awareness Week (WAAW)

This global campaign is celebrated annually to improve awareness and understanding of antimicrobial resistance (AMR) and encourage best practices among the public, One Health stakeholders and policymakers, who all play a critical role in reducing the further emergence and spread of AMR. For RIVM and our WHO CC, AMR is a core component of our work. The Collaborating Centre has extensive knowledge with respect to detection and typing of AMR bacteria, genes and residues in food and environmental matrices. In particular, WHO CC experts have contributed to important AMR products such as the WHO protocol for integrated One Health surveillance of antibiotic resistance: the Tricycle protocol, which was published in 2021. It represents a genuine One Health effort, as it enables comparing the prevalence of ESBL-producing E. coli in humans, animals and the environment between different countries.

This year, the theme of WAAW is “Preventing Antimicrobial Resistance Together.” The global AMR community calls on all sectors to encourage the careful use of antimicrobials and to strengthen preventive measures addressing AMR, working together collaboratively through a One Health approach.

The following actions can help reduce the need for antimicrobials and minimise the emergence of AMR:

• strengthen infection prevention and control in health facilities, farms and food industry premises;
• ensure access to clean water, sanitation and hygiene, and vaccines;
•  implement best practices in food and agricultural production;
•  minimise pollution and ensure proper waste and sanitation management.

19 November 2022: World Toilet Day

World Toilet Day 2022 focuses on the impact of the sanitation crisis on groundwater. Inadequate sanitation systems spread human waste into rivers, lakes and soil, polluting the water resources under our feet. However, this problem seems invisible because it happens underground and in the poorest and most marginalised communities. Groundwater is our most abundant source of freshwater. It supports drinking water supplies, sanitation systems, farming, industry and ecosystems. As climate change worsens and populations grow, groundwater becomes vital for our well-being, security and survival. Safely managed sanitation protects groundwater from human waste pollution. Sustainable Development Goal 6.2 is the world’s promise to ensure safe toilets for all by 2030. This means everyone has access to a toilet connected to a sanitation system that effectively removes and treats human waste. Unfortunately, we are seriously off track to ensure safe toilets for all by 2030. With only 8 years left, the world needs to work 4 times faster to meet our promise.

We must make the invisible visible. Through the WHO CC, RIVM contributes to progress on these targets. Most notably, the iWSSP project contributes to improved access to sanitation and also clean water in rural Serbia. Our team is also co-led with Bosnia & Herzegovina (BiH) under Work Area 5 of the Protocol on Water and Health (PoWH). Work Area 5 is focused on Safe and Efficient Management of Water Supply and Sanitation Systems and collaborates in other Work Areas of the PoWH: Work Area 2, Prevention and reduction of Water-related diseases; Work Area 4, Small water supplies and sanitation; and Work Area 7, Increasing resilience to climate change.

More information on major updates to WHO's technical offerings on sanitation. 

24- 28 October 2022: UNC Water and Health 2022 conference, North Carolina, USA

The WHO CC contributed to the UNC Water and Health conference hosted by the Water Institute in Chapel Hill North Carolina, USA during the week of 24-28 October. More than one thousand water and health professionals from around the world attended the conference. Policymakers, practitioners and researchers came together to review the evidence, interrogate the science and improve old and develop new approaches to expand drinking water, sanitation and hygiene (WaSH) access and services globally.

Two staff members from RIVM participated in this important conference to engage with global stakeholders on critical and emerging WaSH issues. Jerome Lock-Wah-Hoon presented ongoing work on environmental surveillance for pathogens that are important for public health and Jesse Limaheluw presented work on the impact of climate change on waterborne infections. Both talks were well attended and stimulated thoughtful discussion among attendees.

The 2022 Conference was held in an in-person format after two years of virtual conferences. Several RIVM partners and collaborating partners, including staff from WHO, were in attendance. Jerome reported that the conference “provided a good opportunity for us to interact in-person with sister institutions and the WHO teams to discuss topics from water quality, risk assessment methodology, guideline development and future priorities. Participants who attended were all committed to improving public health by achieving universal access to WaSH services that are safe, affordable and sustainable”.

Representatives from many countries that the WHO CC had worked with were also present and shared the current state of WASH, new innovations, and future plans from their national and sub-national settings. During the conference, new reports were endorsed including the Sanitation Policy Brief that the WHO CC contributed to, and a new report on the state of the world’s drinking water.

More information about the annual Water and Health conference and recordings of all sessions.

October 2022: Article on the Occurrence of waterborne pathogens and antibiotic resistance in Mozambique published

Harold van den Berg of the WHO CC and colleagues from Mozambique, Italy and the Netherlands are happy to announce the publication of their recent manuscript on Microbiological quality of drinking water supplied in Moamba, a small town in southern Mozambique.

The team collected and analysed over 90 water samples from various sources for the presence of a series of bacterial pathogens. They found that contamination was evident in many types of water samples indicating the presence of faecal contamination and resistant pathogens in the water treatment system and household taps in Moamba. This implies a health risk for the population.

More information

Taviani, E., van den Berg, H., Nhassengo, F. et al. Occurrence of waterborne pathogens and antibiotic resistance in water supply systems in a small town in Mozambique. BMC Microbiol 22, 243 (2022).

September 2022: Re-designation WHO Collaborating Centre for Risk Assessment of Pathogens in Food and Water

In 2022, RIVM’s WHO Collaborating Centre for Risk assessment of Pathogens in Food and Water (WHO CC-NET 42) has been undergoing the re-designation process by the WHO.

We are delighted to announce that WHO CC-NET 42 is now officially re-designated as a WHO collaborating centre to support the WHO in its programmes for the next four-year period. 

The main role of a WHO collaborating centre is to provide strategic support to the WHO with the purpose of meeting two main needs:

• Implementing WHO's mandated work and programme objectives
• Developing and strengthening institutional capacity in countries and regions

Re-designation allows RIVM to maintain its role in carrying out activities as a member of WHO’s international collaborative network. This network supports WHO programmes at the country, intercountry, regional, interregional, and global levels through technical cooperation strategies.

“Re-designation means we are able to continue our efforts to aid other countries. Through the WHO, we learn about requests that come from other countries and are aware of the right questions. This, in turn, focuses on our development of tools and the implementation of those tools. Moreover, our redesignation aligns with the strategic priorities of RIVM, bringing local knowledge to international, and RIVM at the heart of society”, said Ana Maria de Roda Husman, WHO-CC-NET 42 focal point.

The work and contribution of our WHO CC to microbial food and water safety worldwide are made possible by the RIVM Department of Environmental Microbiology. This department consists of experts in the fields of water, food, and antimicrobial resistance. The WHO CC relies on this expertise to provide successful collaboration in line with the centre's terms of reference and work plans, which are validated and agreed upon together with the WHO.

May 2022: 13th meeting of the Working Group on Water and Health

The thirteenth meeting of the Working Group on Water and Health, under the Protocol of Water and health, took place in Geneva on 19 and 20 May.  More than 100 participants were present from across the European region, including three RIVM experts: Ana Maria de Roda Husman, Harold van den Berg and Jerome Lock-Wah-Hoon. The Working Group on Water and Health is an open-ended subsidiary body responsible for the overall implementation of the Protocol’s work programme.

The joint secretariat of the United Nations Economic Commission for Europe (UNECE) and WHO regional office for Europe (WHO Euro) organised and chaired the meeting. Decisions were made on priority areas for implementing the programme of work 2020–2022 and the upcoming programme of work for 2023–2025. The Working Group also made preparations for the upcoming Meeting of the Parties that will take place in November 2022 and also deliberated on how to raise resources for implementing the programme of work.

A special thematic discussion session on “the Protocol on Water and Health and increasing resilience to climate change” was held on Thursday, 19 May in the afternoon. The joint secretariat invited Ana Maria de Roda Husman to moderate this session. She guided the dialogue on how to use the platform and tools provided by the Protocol to increase resilience to climate change. Moreover, Harold van den Berg provided interventions on the work performed by RIVM in the sessions on “Small-scale water supplies and sanitation” and “Safe and efficient management of water supply and sanitation systems”. More information about the 13th meeting, including presentations and supporting documents, can be found on the UNECE website.   

April 2022: WHO publishes two documents on surveillance of SARS-CoV-2 in wastewater

The COVID-19 pandemic has shown that wastewater surveillance for a new pathogen can be set up relatively quickly. On 19 April 2022, the WHO published the document Wastewater surveillance of SARS-CoV-2: questions and answers (‎Q&A)‎ for a general audience and an Interim Guidance Environmental surveillance for SARS-COV-2 to complement public health surveillance targeted at public health officials who want to understand and integrate complementary environmental surveillance into COVID-19 control strategies. Both of these documents relied upon the technical contributions of experts from the WHO CC.

The Q&As aim to provide a first point of access to knowledge and information around wastewater surveillance of SARS-CoV-2. The WHO CC took the lead in the preparation of this document following a request by the WHO Regional Office for Europe to develop a document of this type. The Interim Guidance led by WHO headquarters updates the scientific brief Status of environmental surveillance for SARS-CoV-2 virus: scientific brief, 5 August 2020. The guidance provides advice on situations where environmental surveillance can add value to public health decision making, requirements to plan and coordinate an effective programme, and how to carry out data collection and communication of results. Experts of the WHO CC were selected to join the external review group of the interim guidance. The two documents (Q&A and interim guidance) complement each other in representing globally relevant advice for a varied audience on:

• Why, or in what situations, does environmental surveillance add value to public health decision making at different stages of the pandemic, and in different settings and contexts.
• What are the minimum requirements for planning and coordinating an effective SARS-COV-2 environmental surveillance programme in different resource settings?
• How should data collection, analysis and interpretation and communication of results be carried out?

Jerome Lock-Wah-Hoon, Harold van den Berg, Joris Sprokholt, and Ana Maria de Roda Husman collaborated with the WHO Regional Office for Europe and WHO's headquarters team in the development of these documents.

March 2022: Updated Guidelines for Drinking-water Quality now available to mark World Water Day

Today is World Water Day, a celebration for water with a focus on the importance of groundwater. It raises awareness of the 2 billion people living without access to safe water, advocating for the sustainable management of freshwater resources worldwide.

To mark World Water Day 2022, the WHO announces the updated Guidelines for Drinking-water Quality (GDWQ): 4th edition, incorporating the 1st and 2nd addenda is published. Key updates include new and revised sections on potable reuse, climate change, emergencies, and food production and processing. Also, fact sheets on chemicals and cyanobacteria were updated, and for this year updates on microbial fact sheets are planned for the next edition.

 The GDWQ builds on over 60 years of guidance by the WHO on drinking water quality, which has formed an authoritative basis for the setting of national regulations and standards for water safety in support of public health. More information on the updates is available in the  Guidelines on recreational water quality.  The preparation of the 4^th edition and new updates to the guidance have covered a period of more than 10 years and involved the participation of hundreds of experts from a wide range of developing and developed countries. The WHO CC has contributed by providing scientific and technical expertise on hazard identification and risk management. 

November 2021: JEMRA report - Safety and quality of water used with fresh fruits and vegetables

 The FAO and WHO report ‘Safety and quality of water used with fresh fruits and vegetables' has been published. It is a publication by the Joint FAO/WHO Expert Meeting on Microbiological Risk Assessment (JEMRA), an international scientific expert group that the RIVM’s WHO CC is a member of. Dr Doctor (Doctor ) Rob de Jonge and Prof. Ana Maria de Roda Husman chaired the panel and contributed to the JEMRA report with their time and expert advice on water quality and risk assessment in food and water. 

Water is used for a variety of purposes in all production and processing steps of fresh fruit and vegetables, from the growing stage up to the point of consumption. But even if this water is conventionally treated and disinfected, it may still contain contaminants. At the 48th session of the Codex Committee on Food Hygiene, it was determined that a risk-based approach appropriate to the national or local production context is needed for the assessment of potential risks associated with a specific water source or supply. This would enable the appropriate risk mitigation strategies. 

In response, the FAO, WHO and JEMRA members commenced work on this subject. The panel developed clear and practical guidance on appropriate and fit-for-purpose microbiological criteria and parameters for water when used with fresh fruit and vegetables. Advice and explanations in the report enable sound decision making when applying the concept of fit-for-purpose water for use in the pre-and post-harvest production of fresh fruit and vegetables. The report is an output of several years of progress on the subject. 

September 2021: workshop Integrated Water and Sanitation Safety Planning

On 21-23 September 2021, RIVM held a hybrid training workshop on Integrated Water and Sanitation Safety Planning (iWSSP) in relation to small water and sanitation systems in rural communities in Serbia. The workshop brought together various stakeholders for an in-depth discussion on all aspects of iWSSP. The workshop took place under the project iWSSP in small supplies in Serbia and was delivered to build capacity on iWSSP.  Participants were from water and sanitation sector organisations, including water utility companies, institutes of public health, and government ministries.

The training workshop helps develop a systematic approach to water and sanitation safety planning at pilot sites that will implement iWSSP. The objective of the training workshop was to train participants about the concept of iWSSP and how to implement this approach at the pilot sites. Through roundtable discussions, presentations, practical case studies and exercises, the workshop fostered exchanges on water and sanitation risk analysis, allowing participants to share experiences and best practices. Participants also benefited from a number of tailored documents and forms, which offered an opportunity to interact with trainers to help make resources derived from global WHO expertise relevant for the rural Serbian context.

Presentations, learning materials and additional resources were made available to all participants. These materials will be used to implement iWSSP in the three pilot sites, small systems located in rural Serbia. Participants were very content with the training workshop and eager to start iWSSP implementation at the pilot sites.

This project is funded by the German Federal Environment Ministry’s Advisory Assistance Programme (AAP) for environmental protection in Central and Eastern Europe, the Caucasus and Central Asia and other countries neighbouring the European Union. It is supervised by the German Environment Agency (UBA).

July 2021: Article on microbial water quality in Mozambique

Drinking unsafe water increases exposure to pathogens, which can result in waterborne diseases, such as cholera, gastroenteritis or hepatitis E. Numerous countries in Africa, Asia and Latin America practice intermittent drinking water supply as a normal operational strategy because water supply companies are not able to supply water continuously and sustain a positive operating pressure within the distribution network. This is also due to high levels of leakage in distribution networks that can also contribute to the recontamination of treated water. Improving access to clean drinking water and good sanitation services is the subject of continuing work and research by the RIVM’s WHO Collaborating Centre for Risk Assessment of Pathogens in Food and Water.

In Mozambique, intermittent drinking water supply is mainly practised in cities and small towns and results in frequent microbial contamination of the supplied drinking water posing a health risk to consumers. Increased disinfectant dosage improves compliance with microbial water quality standards preventing possible health risks. This was shown in the study titled “Effect of operational strategies on microbial water quality in small scale intermittent water supply systems: The case of Moamba, Mozambique”, carried out by the RIVM’s WHO Collaborating Centre for Risk Assessment of Pathogens in Food and Water, IHE Delft Institute for Water Education and Collins Ltd in Mozambique. The aim of the study was to understand the effect of increased disinfectant dosage, number and duration of supply cycles, and first-flush on drinking water quality of an intermittent drinking water supply system in Mozambique.

The study showed that enhanced water quality monitoring improves operational strategies and importantly, this helps to safeguard the microbial water quality. It was identified that increasing the chlorine dosage at the water treatment plant ensured good microbiological drinking water quality, but that changing the number of supply cycles had no such effect. It was also found that, contrary to published literature, the effect of first-flush on the microbiological water quality was not statistically significant. Interestingly, the study revealed that despite purification and disinfection of the water at the treatment plant, possible recontamination of supplied water could occur in the distribution system in part due to recontamination along the distribution chain, or unsafe hygienic practices at the household level. It is important to understand the dynamics of Intermittent drinking water supply systems to help reduce preventable health threats.

The study was funded by the Dutch Ministry of Foreign Affairs through the Director-General for International Cooperation IHE Delft Programmatic Cooperation 2016–2020 (DUPC2) through project SMALL: water supply and sanitation in small towns.

7 June 2021: WHO handbook 'Estimating the burden of foodborne diseases'

A new WHO handbook entitled Estimating the burden of foodborne diseases: A practical handbook for countries was published on 7 June. The handbook was developed with assistance from Lucie Vermeulen and Joke van der Giessen, two scientists at RIVM. It provides guidance for countries to assess the causes, magnitude and distribution of foodborne diseases and identify food safety system needs and data gaps to strengthen national infrastructure to protect people’s health. It was part of a WHO effort to step up actions to improve food safety and protect people from foodborne diseases worldwide. RIVM’s contribution to the development of the new handbook highlights our international standing as a WHO Collaborating Center and the expertise of our scientists in food and water safety. 

WHO Director-General Dr Tedros Adhanom Ghebreyesus stated, “WHO’s new handbook will help countries to collect and analyze data to inform sustained investments in food safety. The COVID-19 pandemic has demonstrated the intimate links between the health of humans, animals and the planet that sustains us. WHO will continue to work with partners with a One Health approach to keep communities safe from foodborne disease.”

Read more in this news WHO steps up action to improve food safety and protect people from disease

29 -31 March 2021: Global Workshop on building climate-resilience

A joint global workshop on building climate resilience through improving water management and sanitation at national and transboundary levels was organised by the UNECE-WHO Regional Office for Europe Protocol on Water and Health and the Water Convention serviced by UNECE.  RIVM's Harold van den Berg attended. Presentations, conclusions and decisions from the 3-day workshop are available on the UNECE website. 

22 March 2021: World Water Day

World Water Day, an annual United Nations observance, raises awareness of the 2.2 billion people living globally without access to safe water. The core focus is to support the achievement of Sustainable Development Goal (SDG Sustainable Development Goal (Sustainable Development Goal )) 6: water and sanitation for all by 2030. 

What is the impact of COVID-19 on water resource management? Clean and safe water is essential to containing the spread of COVID-19, as well as other infectious diseases. This was the theme of a broadcast organised in France by its largest public water union SEDIF. RIVM was invited to provide public health perspectives in the live broadcast for the Club for the World's Premier Water Services, which is an international group of water services from all continents across the world. 

Ana Maria de Roda Husman and Jerome Lock-Wah-Hoon joined the broadcast in round-table discussions on the health challenges of the COVID-19 outbreak, such as how public services and water suppliers can organise, manage consumer fears, and prepare for the next pandemic. RIVM’s WHO Collaborating Centre provided a specialist point of view to the broadcast and a global vision that broadened the discussion. Representatives from 14 countries around the world were also present to share their field experience.

3 March 2021: Webinar The Integrated global surveillance on ESBL-producing Escherichia coli using a "One Health" approach.

On 3 March, WHO organised a webinar providing an overview of the Tricycle protocol.  Read the news New WHO protocol for integrated One Health surveillance of antibiotic resistance: the Tricycle protocol.

20 November 2020: Global Health Day Radboud University

On Friday, 20 November, a Global Health Day was virtually hosted by Radboud University Nijmegen in the Netherlands. This event aimed to showcase international health projects taking place in the Netherlands under the theme of global health and international development. 

Jerome Lock-Wah-Hoon, a scientist in infectious diseases and global health at RIVM, participated as one of the speakers. In a 2 hour workshop with 40 participants, Lock-Wah-Hoon highlighted water and health activities in his department. He focused on the frameworks and mechanisms that enable international health projects to take place, current international work of RIVM, including the provision of expert advice internationally on sewage-based epidemiology of SARS-CoV-2, and a number of water and health projects. Lock-Wah-Hoon also shared the relevance and work of the WHO Collaborating Centre and how it contributes to the WHO's capacity building.

26 October 2020: UNC Water and Health Conference

This week the 2020 conference on Water and Health: Science, Policy and Practice takes place virtually and is hosted by the University of North Carolina. The 11th UNC Water and Health Conference aims to interrogate the science to improve global health and achieve universal access to safe drinking water, sanitation, and hygiene. It is free of charge and covers a broad range of topics relevant to water and health scientists and policymakers.  

COVID-19

UNC director Aaron Salzberg led the opening session focused on the issue on everyone’s mind – COVID-19. The plenary concentrated on interrogating the science and the scientists who are working at the frontier of what we know about COVID-19 to get to the bottom of what we know and don’t know about the virus and especially how it intersects with WaSH (Water, Sanitation and Hygiene) issues. The objective of the session was to highlight the latest evidence regarding COVID-19 to inform both policy and practice about WaSH. Prof Ana Maria de Roda Husman, department head at RIVM who leads the Dutch Wastewater Surveillance programme on COVID-19, was one of the six international panellists. The subject of discussion was the origin of SARS-CoV-2, transmission, disease outcomes, persistence in water, and protective measures. 

The conference is held from 26 – 30 October 2020, with over 2,000 registrants from close to 90 countries.

10 June 2020: technical brief on WASH and wastewater management to prevent infections and reduce AMR

A new technical brief released by WHO/FAO/OIE strongly encourages that reducing the spread of antimicrobial resistance (AMR) requires improvements in water, sanitation, hygiene and wastewater management. This is also needed to prevent infections that would otherwise be treated with antimicrobials. The Global Action Plan to combat AMR calls for action on WASH and wastewater. Yet, at present, they are under-represented in AMR stakeholder platforms and national action plans (NAPs). The technical brief, to which Ana Maria de Roda Husman and Heike Schmitt of RIVM contributed, summarises the evidence and presents WASH and wastewater actions to strengthen AMR NAPs and sector policy. Go to the publication 

24 March 2020: Novel coronavirus found in wastewater

The novel coronavirus that causes COVID-19 has been detected in wastewater in the Netherlands, according to RIVM research. A small percentage of patients with COVID-19 have the novel coronavirus in their gastrointestinal tract and thus excrete it in their faeces. Read news novel coronavirus found in wastewater

See also this article in the Lancet SARS-CoV-2 in wastewater: potential health risk and data source by Willemijn Lodder and Ana Maria de Roda Husman.

For more information read RIVM research on COVID-19 in sewage.

22 March World Water Day 2020: Clean safe water for everyone, even in a changing climate

This year, World Water Day takes place under unprecedented circumstances: the novel coronavirus (COVID-19) pandemic. The UN United Nations  (United Nations  ) calls upon everyone to focus on responsibility, safety and solidarity. Everyone has a role to play. This touches the very essence of the work being done at RIVM by Prof. Ana Maria de Roda Husman, Director of the Collaborating Centre for Risk Assessment of Pathogens in Food and Water. Read more in this interview.

05 March 2020: contribution to WHO brief water and COVID-19

In December 2019, an outbreak of a novel coronavirus also called coronavirus disease (COVID-19) began in the Wuhan region in China. The novel coronavirus has spread globally and has also emerged in the Netherlands. The primary means of transmission is via droplets that are released into the air when an infected person coughs or sneezes. It has recently been reported that some patients experience diarrhoea and that the novel coronavirus can be found in faeces of some infected people. Whether the COVID-19 virus is also excreted via urine is still unclear.

That is why RIVM’s Centre for Infectious Disease Control, in collaboration with the World Health Organization (WHO) and the Foundation for Applied Water Research (STOWA), has formulated additional advice on working safely with wastewater and surface water (WaSH). With regard to the COVID-19 virus, the advice does not deviate from regular hygiene regulations.

What does RIVM’s WHO collaborating centre for risk assessment of pathogens in food and water do?

As a collaborating centre for the World Health Organization (WHO CC for risk assessment of pathogens in food and water), RIVM has contributed to formulating advice on the COVID-19 virus and safe water, sanitation and hygiene practices, and on Q&A’s for such best practices. Recently it became clear that some patients abroad, mainly in China, experience diarrhoea. The novel coronavirus has been found in the faeces of some patients. This means that the virus could also end up in wastewater.

More information

WHO publication technical brief 'Water, sanitation, hygiene and waste management for COVID-19'.  The technical brief is written in particular for water and sanitation practitioners and providers. It is also for health care providers who want to know more about water, sanitation and hygiene (WASH) risks and practices.

Read more about RIVM research on COVID-19 in sewage

February 2020: Follow-up training on Climate Resilient Water Safety Plan by RIVM for Nakuru County water service providers in Kenya.

From 10-14 February, Fabio Martins Gueth (RIVM) provided a follow-up training on Climate Resilient Water Safety Planning for the water & sanitation service providers of the Nakuru County in Kenya. The training workshop is part of the Nakuru’s WaterWorX Project, led by VEI. After getting acquainted with the water safety plan framework during the first training in October 2019, the participants started gathering the needed information to develop a water safety plan. This training aimed at scrutinizing the gathered information as well as identifying information/knowledge gaps in order to develop a comprehensive water safety plan. In addition, the participants exercised with the risk assessment for the identified risks for the drinking water supply, which highlighted the challenges the urban and rural water service providers face in developing their water safety plan.

January 2020: Workshop drinking water quality from source to tap in Myanmar 

From 13 – 16 January, Ana Maria de Roda Husman and Harold van den Berg provided a training workshop on drinking water quality from source to tap for the water supply of Mandalay City Development Committee (MCDC), Myanmar. The training workshop is part of the Mandalay’s WaterWorX Project, led by VEI. The objective was to sensitise personnel from MCDC for possible risks for the drinking water supply from source to tap, such as sanitation, hygiene and climate change. 

During the training, information was given on global changes, such as climate change, which affects drinking water quality. By giving examples of such effects and introducing exercises the participants receive experiences with the need for assessment to identify current and future risks for the drinking water supply. Local hazards and developments such as climate change and infectious diseases in the country and region broadened the scope of the participants. Two booster pumping stations were visited, and possible risks were discussed in exercises during the training workshop. 

November 2019: Fifth Meeting of the Parties of the Protocol on Water and Health, Belgrade, Serbia; WHO CC and the Dutch delegation delivered extensive contributions

On 19-21 November 2019, the fifth tri-annual meeting of the parties (MoP) of the Protocol on Water and Health (PoWH) to the 1992 Convention on the Protection and Use of Transboundary Watercourses and International Lakes took place in Belgrade, Serbia. Anoek Backx from RIVM was part of the Dutch delegation, together with Jan Busstra (for the high-level session) and Jelka Appelman (Dutch PoWH focal point and member of the Bureau of the PoWH) both from the Ministry of Infrastructure and Water Management (I&W) and Prof. Ana Maria de Roda Husman (RIVM) represented the WHO CC for Risk Assessment of Pathogens from Water and Food. The WHO CC collaborates with I&W on the Dutch contributions under the PoWH.

The Netherlands co-leads with Bosnia & Herzegovina (BiH) Work Area 5 under the Protocol on Safe and Efficient Management of Water Supply and Sanitation Systems and collaborates in other Work Areas (WA2 Prevention and reduction of Water-related diseases; 4 Small water supplies and sanitation; 7 Increasing resilience to climate change). During the MoP the co-leads jointly reported on the work carried out and achieved under working programme 2016-2019 and outlined the future work under working programme 2020-2022. Highlighted were the trainings provided to several countries in Water and Sanitation Safety Planning (WSP and SSP) and the work done to map the scope of sanitation systems in the pan-European region and bring the importance of ameliorating health-improving sanitation under the attention of policymakers. Future work will focus on further integration of climate resilience into WSP and SSP and on advocacy for sanitation improvements throughout the region.

The high-level session addressed the role of the PoWH as an instrument in realizing the United Nations 2030 Agenda for Sustainable Development. The water-related Sustainable Development Goals (SDG6 and SDG3, among others in particular) also help countries that already have sound systems and management in place, to integrate and implement approaches addressing new challenges, f.i. linked to the changing climate and related extreme weather events. The high-level panel members stressed the importance of continuing international (transboundary) and multi- or cross-disciplinary collaborations for the benefit of mutual exchange and the joint initiation of actions.

During the MoP, nine side events took place to allow for more in-depth content discussions and explorations. The Netherlands organized and chaired the side-event Climate-resilient water and sanitation safety planning and did this together with Italy, BiH and Romania. Moderator of the session was Ana Maria de Roda Husman, and Anoek Backx facilitated a by RIVM developed serious game to trigger conversation and thought processes.

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​​​Participants of the Meeting of the Party Side Event on Climate-resilient Water and Sanitation Safety Plans discussing while playing the serious game developed by RIVM, and Ana Maria chairing the side-event.

The WHO CC provided major contributions to two other side-events: during the Legionellosis side-event, Ana Maria de Roda Husman presented the RIVM work around risk identification methods including wastewater treatment plants when identifying sources of community-acquired legionellosis, she also presented in the Risk Assessment side-event the by RIVM developed Quantitative Microbial Risk Assessment for water and related case-studies. All the documents and presentations related to the Fifth Meeting of the Parties of the Protocol on Water and Health can be accessed via this link.

In February 2020 the joint WHO EURO/UNECE Secretariat to the PoWH will visit the Netherlands to agree on the Dutch contributions and activities for the years 2020-2022. The WHO CC is providing support to I&W in determining the agenda of this meeting, and initiates exchange with the Ministry of Health Welfare and Sports, since many aspects under the PoWH fall in the Netherlands under their responsibility.

September & December 2019: Follow-up workshops on Climate Resilient Water Safety Plan for Pampanga Water Districts, Philippines

After the first Climate-Resilient Water Safety Planning workshop for the Pampanga Water Districts in July, Fabio Martins Gueth (RIVM) provided a follow-up training in September 2019 and a third an final training in December 2019. From 9-14 September, Fabio Martins Gueth (RIVM) provided a follow-up training on Climate Resilient Water Safety Planning continuing the collaboration between Philippine Association of Water Districts, VEI & RIVM, the training aimed to continue the development and implementation of water safety plans (WSP) by the participating Pampanga water districts. After gaining knowledge on the approach of water safety planning in July, the water districts started gathering information about their water supply system in order to develop or update their WSP. This training focused on discussing and the scrutinizing gathered information. The twelve water districts were divided into four clusters of three water districts in order to have a more focused discussion and concrete input from the participating water districts per cluster. This approach generated lively debates whereby the water districts shared their experiences and the challenges faced in developing/updating their WSP. It was encouraging to see the progress some water districts had made since July, where the participants took each other’s as well as the trainers feedback to heart. In December (2-6) the third and final training on climate-resilient water safety planning for Pampanga Water Districts was held in Angeles City, Pampanga. The training provided by Fabio Martins Gueth (RIVM), carried on from the previous trainings in July & September. Building on the previous knowledge and experience from the trainings in July where the Water Districts got acquainted with the Water Safety Planning approach and September where the water districts focused on reviewing the existing WSPs based on the Local Water Utilities Administration (LWUA) requirements for accreditation. With this third and final training/workshop the aim was to fine-tune the WSPs and support the water districts in tackling the specific challenges they face in developing and implementing the WSP as well as reflect on this process.
 

Based on the progress made since the first training in July and the participation during the workshop, it can be concluded that the water districts now have a better understanding of the WSP approach and that most water districts have been able to develop a WSP and are now able to review and revise their WSP in a structured and logical manner. This has been illustrated by the fact that six from the eleven water districts have submitted their WSP to LWUA for approval. Moreover, after updating their WSP with the feedback provided in July and September and submitting it to LWUA, one water district’s WSP has been approved with an excellent score from LWUA. This highlights the added value of this workshop, the progress made by the water districts and how they have made use of the tools and information provided to them during the workshops.

October 2019: Climate Resilient Water Safety Planning training by RIVM for Water Service Providers in Nakuru, Kenya.

In October 2019, Fabio Martins Gueth (RIVM) provided a customised a four-day Climate Resilient Water Safety Planning training for the water & sanitation service providers of the Nakuru County in Kenya.

As part of the Kenyan Water Services Regulatory Board (WASREB), Kenyan water service providers are required to develop and implement a water safety plan (WSP). As the participating water service providers have yet to develop a water safety plan, this training aimed to help them get acquainted with the water safety plan framework from the World Health Organization. This training focused on what is needed to develop a WSP and the importance of having a clear and comprehensive description of the water supply system as well as identifying the possible hazard and hazardous events that could negatively affect the water supply. The participants were enthusiastic and participated lively during the several exercises presented to them. Moreover, they are eager to gather the needed information and develop a WSP as they see the potential benefits for their operation in delivering quality drinking water as well as a tool to prevent non-revenue water. A follow-up of this training will be held in February 2020, whereby the participants will have developed a system description and the possible hazards/hazardous events of their water supply system.

September 2019: Third Joint FAO/WHO Expert Meeting on Microbial Risk Assessment (JEMRA) 

In September, the third JEMRA Core Expert Meeting on the Safety and Quality of Water Used in Food Production and Processing of 2019 convened in Geneva. The preceding meetings took place in 2017 at RIVM in Bilthoven and in 2018 at FAO in Rome.  Our WHO CC on Risk Assessment of Pathogens from Water and Food is a major driver of and contributor to these meetings. Prof. Ana Maria de Roda Husman, microbiological water safety expert, head of the WHO CC, and liaison person between food- and water experts, chairs this programme. The WHO CC contributed to the organisation of the meeting and was invited to share its expertise. Both Ana Maria de Roda Husman and Rob de Jonge, microbiological food safety expert, contributed to this meeting. 

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​​​The focus of this third meeting was on the definition and its indicators of fit-for-purpose water for use in fresh produce (fruits and vegetables), as not each step requires the use of water of drinking water quality. The WHO CC together with its secretariat supported the renewed group of 14 participating experts from 12 countries. The expert group was renewed to enhance the representation of all continents and better balance gender participation. The WHO CC and secretariat took care of formulating the advice regarding the level of water quality needed for microbiologically safe production and processing of food. This comprises advice on the existing different water sources, possible sources of water contamination, and factors that can influence these. Irrigation methods, yield practices and fruit and vegetable species are key factors in implementing safe production systems for fresh produce. Testing methods, microbiological indicators and risk analyses were discussed. The report from this meeting will be discussed in the coming Codex Alimentarius meeting.  The meeting report 'Safety and Quality of Water Used in Food Production and Processing MICROBIOLOGICAL RISK ASSESSMENT is available. 

Similar meetings on the handling and processing of fish and reuse of water will follow. 

August 2019: Publication WHO report 'Microplastics in drinking-water'

On 22 August 2019, the World Health Organization published the report 'Microplastics in drinking-water' as a first effort to examine the potential human health risks associated with exposure to microplastics in the environment.

The WHO Collaborating Center Risk Assessment on Pathogens from Food and Water contributed to this report, specifically to the revision of the WHO Guidelines on Drinking-water Quality: Guidelines for drinking-water quality, 4th edition, incorporating the 1st addendum.  Read more in this news message: WHO calls for more research into microplastics and a crackdown on plastic pollution.

July 2019: WHO CC moderator of side-event Burden of Foodborne Diseases, 42nd Codex Alimentarius Commission meeting (CAC42)

Dr Doctor (Doctor ) Joke van der Giessen of the WHO CC (RIVM) moderated the CAC42 side-event Burden of Foodborne Diseases held 11 July in Geneva. Panellists were Dr Brecht Devleeschhouwer, Dr Peter Hoejskov and Dr Scott Crerar. One hundred participants joined the side event. This event addressed practical questions concerning the prerequisites, requirements and actual methodologies related to estimating the burden at the national level. Foodborne disease is one of the most prevalent, yet underreported classes of illnesses in the world, with annually an estimated 1 in 10 people affected. The global burden of foodborne disease report published by WHO in 2015 was the first of its kind on such an expansive global scale and estimated that up to 33 million healthy life years are lost per year due to foodborne disease. The importance of developing national estimates of foodborne diseases has been highlighted elsewhere, but many questions remain as to how exactly to calculate the burden. 

Click here for Dr Joke van der Giessen presentation.

July 2019: Training on Climate Resilient Water Safety Plans by RIVM for the Pampanga Water Districts in the Philippines

From 1 – 10 July 2019, Harold van den Berg and Fabio Martins Gueth (RIVM) provided a tailor-made training on climate-resilient Water Safety Plans (WSP) for the Pampanga Water Districts. This training was part of the collaboration between VEI and Philippine Association of Water Districts, which stresses that the implementation of WSP is important to improve the water quality in the Pampanga region.

With the implementation of WSP being legally required in the Philippines, this training workshop aimed at:

• sensitising personnel from the Water Districts for WSP issues and motivate them to support and contribute to the process of WSP implementation.
• revising and reviewing existing WSPs of the Water Districts  based on the training, field visits and WSP rating from the Local Water Utility Administration (LWUA)
• learning from each other by sharing experiences.

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​​​In total, 33 participants from 12 Water Districts participated in the training workshop held at Angeles City Water from 1 – 5 July.  

Through interactive lectures and exercises, the WSP training included all the 11 steps described by the WHO.  In addition, a field visit was conducted to highlight the importance of verifying existing data on the system description and identification of risks. This provided a good opportunity for the Water Districts to have a look at a similar water supply system.

After the training workshop, Harold and Fabio visited all 12 Water Districts (8 – 10 July) to discuss the steps to be taken for implementing or modifying the WSP for their water supply.

The presence of the General Managers of the water districts at the training workshop highlighted the commitment and eagerness from the water districts to participate and learn from this training on WSP. The training and visits were very successful as participants have a better understanding of what is needed to design and implement a WSP as well as its importance in the improvement of water quality.

Later this year a follow up with the participating water districts will take place.

May 2019: Water Safety Planning Training Bosnia and Herzegovina

The WHO EURO and WHO Country Office of Bosnia and Herzegovina organised a three-day introductory workshop on Water Safety Planning for policymakers and drinking water production managers and professionals. The WHO invited Harold van den Berg from the WHO CC to give a presentation on the Risk Assessment and Risk Management methods and tools applied in the drinking water production sector in the Netherlands.  In total, 28 participants from the two entities Bosnia and Herzegovina took part in the three-day workshop. The aim of the workshop was to introduce the participants to the concept of progressive continuous management planning for water safety and invite them to think each step through while sharing mutual experiences. RIVM's Anoek Backx was invited to the workshop and recorded the final discussion and conclusions of the participants: they expressed their interest in further training and support and the willingness to set up water safety plans in their sectors. 

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​​​The secretariat of the Protocol on Water and Health will provide support to the governments of both entities to outline a planning for development and implementation of WSP in the relevant sectors in the country, and to indicate needs for further training. Our WHO CC presented a range of related onward training programmes they can provide. The participants agreed on piloting a training of trainers and rolling out further training to individual production plants and producers.

22 March 2019: WHO highlights water safety plans Tajikistan on WorldWaterDay

As a health response towards achieving Sustainable Development Goal 6, the World Health Organization (WHO) recommends the introduction of a Water Safety Plan (WSP) for every drinking-water supply. The approach combines established risk-management principles with the prevention-focused operation and monitoring practices. These principles remain the same for large urban suppliers as they do for small rural operators, and they have already been applied in over 80 countries around the world. The national surveillance authorities responsible for drinking-water quality monitoring showed great interest in strengthening their efforts in alignment with WHO recommendations. The staff of the local, regional and national branches of the Sanitary Epidemiological Service were trained in collaboration with the Dutch National Institute for Public Health and the Environment (RIVM) on risk-based surveillance approaches and the prioritisation of water quality parameters to ensure focused and cost-effective monitoring while protecting health. Read more.

October 2018: Training Risk-based Drinking Water Quality Surveillance in Tajikistan

Within the WHO-EURO project Small and safe: scaling-up water safety planning and effective water quality monitoring in rural Tajikistan, Harold van den Berg provided two 2-days training on risk-based drinking water quality surveillance for Sanitary, Epidemiology and Surveillance (SES) in Dushanbe, Tajikistan. In total, 36 participants from 22 district and 3 regional SES, participated in the training. During the training, the participants learned how to set up and conduct risk-based surveillance for water supplies in the districts. As part of the training, field measurements and sanitary inspections were conducted in water supplies of three villages. Based on the results, we discussed what advice and guidance could be given based on the water quality data and sanitary inspections. 

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​​​Six of the participants were identified as a trainer, based on their experiences and participation in previous training on water quality monitoring. The trainers supported the participants with the field measurements and conducting sanitary inspections. In future, the trainers can play an important role in supporting other districts in conducting risk-based surveillance.

July 4th 2018: 41st Codex Alimentarius Commission

RIVM’s Collaborating Centre for Risk Assessment of Pathogens in Food and Water was invited to WHO’s side event during the 41st Codex Alimentarius Commission. The side event highlighted the importance of national capacity-building efforts for conducting foodborne disease burden estimates. Countries can request WHO to support them in calculating disease burden estimations. RIVM’s  WHO CC  will support WHO in providing capacity building workshops.

May  2018: JEMRA on Water Quality in Food Production and Processing at FAO in Rome

14- 18 May  2018, the JEMRA on Water Quality in Food Production and Processing convened for a second time at the FAO in Rome. The first meeting with the RIVM WHO CC was in June 2017 and it was then concluded that further guidance needed to be developed to make the information from the water sector better accessible for the food handling and processing sector, with a focus on fisheries, primary production and reuse and recycling in food processing facilities.

May 2018,  the RIVM WHO CC again played a facilitating role in its interdisciplinary capacity as a bridge-builder between the food and water sector. 

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​​​About 20 experts representing high and lower-income settings took part in this meeting in Rome, which had two main goals:

1. To formulate scientific advice with regard to gaps in current guidance on microbial assessments in relation to fisheries, primary production and reuse/recycling.
2. To develop a decision support tree with regard to water quality and detailing points of contact for these aforementioned sub-categories

The findings will be presented to the Codex Alimentarius Committee for Food Hygiene (CCFH) in November 2018. Dr Doctor (Doctor )   Rob de Jonge,  Ir. Lieke Friederichs, Prof.   Ana Maria de Roda Husman of the RIVM's WHO Collaborating Centre are recurring members of this JEMRA expert group.

April 2018: Revision of WHO GDWQ

A small group of microbial experts including from RIVM, gathered from April 16-20, 2018 to further the revision of the 4th edition of the World Health Organization (WHO) Guidelines for Drinking-water Quality (GDWQ) kindly hosted by Karl Linden and his group at the University of Colorado in Boulder, USA. The experts determined the next steps in developing the fifth edition of the GDWQ related to microbial aspects. Main topics concerned the microbial fact sheets in Chapter 11 and the microbial treatment tables in Chapter 7 of the WHO GDWQ. The content of the microbial fact sheets was reviewed and also the initial findings from the systematic literature review on selected treatment technologies to inform the update of the microbial treatment tables in the GDWQ including the log reduction values were reviewed. The remaining gaps were identified and agreements made upon a way forward towards the launch of the 5th edition of the WHO GDWQ planned for 2020.

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Microbial experts, University of Colorado, Boulder USA

April 2017:  Pan-European Symposium Water and Sanitation Safety Planning and Extreme Weather Events

On April 6 and 7, 2017 the WHO CC on Pathogens in Food and Water hosted a symposium on Water and Sanitation Safety (WSSP) Planning in Extreme Weather Events at RIVM National Institute for Public Health and the Environment   in Bilthoven. The event was co-sponsored by the Netherlands Ministry of Infrastructure and the Environment, WHO Regional Office for Europe and the United Nations Economic Commission for Europe.

Safe management of water and sanitation.

With contributions from over 15 countries, mainly from the pan-European region, the event meant a kick-off from the work on the safe management of water and sanitation systems within the 2017-2019 programme of work of the Protocol on Water and Health.  The symposium included a number of sessions with topics like impacts from flooding and droughts, including health impacts, sanitation safety planning in urban areas, water safety planning in peri-urban and rural areas, and integrated management solutions for climate adaptative water services planning.

The sessions were introduced by keynote presenters, among which were prof. Barbara Evans, prof. Paul Hunter and prof. Pier Vellinga. The WHO Regional Office for Europe supported two workshops: one on Climate-adaptive Water Safety Planning and one on Sanitation Safety Planning. In an interactive session, the potential linkage between the two, and their potential to provide an integrated management strategy for climate adaptive water management was discussed. The presentations from the symposium can be found on the IWC website http://www.iwcconferences.com/wssp-and-extreme-weather/

A symposium summary report is available. For more information please send an e-mail to whocc.micro@rivm.nl