ColaLife presentation to the ANDi Workshop, Addis Ababa, Jan-15
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ColaLife is a UK-based charity that aims to save children's lives by innovating healthcare delivery and increasing access to life-saving medicines. They conducted a trial in Malawi where they packaged oral rehydration salts (ORS) and zinc with soap in an affordable "Kit Yamoyo." This product was distributed through existing private sector supply chains, pulling the kits into remote rural communities. The trial demonstrated that the Kit Yamoyo approach dramatically increased access to ORS/zinc, with 45% of children receiving treatment compared to less than 1% previously. It also improved correct use of ORS from 60% to 93%. ColaLife's experience highlights the importance of private sector distribution and designing products people want to
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ColaLife presentation to the ANDi Workshop, Addis Ababa, Jan-15
- 1. The ColaLife panel contribution Consultation on transforming healthcare delivery ANDi, Addis Ababa, January 2015 Simon Berry
- 2. ColaLife is a charity registered in the UK Charity number: 1142516 • Small, independent and catalytic • Focus on saving children’s lives • Looking for global impact through • Innovation • Generating robust evidence • Sharing findings and learning • Influencing healthcare strategies • No commercial interest 2009 2010 2011 2012 20131985 What is ColaLife and who am I?
- 3. The scope of our work What happened Our starting point 2 4 The effects 5 1 The ColaLife contribution Consultation on transforming healthcare delivery ANDi, Addis Ababa, January 2015 Recommendations 6 What we did 3
- 4. The scope of our work What happened Our starting point The effects 1 The ColaLife contribution Consultation on transforming healthcare delivery ANDi, Addis Ababa, January 2015 Recommendations What we did 2 3 4 5 6
- 5. The scope of our work What happened Our starting point The effects The ColaLife contribution Consultation on transforming healthcare delivery ANDi, Addis Ababa, January 2015 Recommendations What we did 2 3 4 5 6 1
- 6. Coca-Cola gets to most places, life-saving medicines don’t
- 7. Under 5 mortality is unacceptably high…
- 8. …when compared with more developed countries
- 9. Diarrhoea is the second biggest killer 2 Diarrhoea
- 10. The scope of our work What happened Our starting point The effects The ColaLife contribution Consultation on transforming healthcare delivery ANDi, Addis Ababa, January 2015 Recommendations What we did 2 3 4 5 6 1
- 11. Dec 2011 The trial timeline
- 12. Mimicking Coca-Cola – creating a product people WANT What we learnt Litre sachets are too big Measuring water was an issue Willingness to pay Preferred branding 3
- 13. Kit Yamoyo • Attractive • Affordable • Packaging is also: • A measuring device for the water • A mixing device • A storage device (the soap tray is a lid) • A cup • And can be re-used 3
- 14. Mimicking Coca-Cola – Community-based marketing 3
- 15. The scope of our work What happened Our starting point The effects The ColaLife contribution Consultation on transforming healthcare delivery ANDi, Addis Ababa, January 2015 Recommendations What we did 2 3 4 5 6 1
- 16. Customer K5.00 4 Demand PULLED the Kit Yamoyo into rural communities
- 17. Retail K3.70 Customer K5.00 4 Demand PULLED the Kit Yamoyo into rural communities
- 18. Wholesale K3.10 Retail K3.70 Customer K5.00 4 Demand PULLED the Kit Yamoyo into rural communities
- 19. Distribution Wholesale K3.10 Retail K3.70 Customer K5.00 4 Demand PULLED the Kit Yamoyo into rural communities
- 20. Assembly Distribution Wholesale K3.10 Retail K3.70 Customer K5.00 4 Demand PULLED the Kit Yamoyo into rural communities
- 21. Manufacture Assembly Distribution Wholesale K3.10 Retail K3.70 Customer K5.00 4 Demand PULLED the Kit Yamoyo into rural communities
- 22. Manufacture Assembly Distribution Wholesale K3.10 Retail K3.70 Customer K5.00 4 Demand PULLED the Kit Yamoyo into rural communities
- 23. Manufacture Assembly Distribution Wholesale K3.10 Retail K3.70 Customer K5.00 4 Demand PULLED the Kit Yamoyo into rural communities
- 24. The scope of our work What happened Our starting point The effects The ColaLife contribution Consultation on transforming healthcare delivery ANDi, Addis Ababa, January 2015 Recommendations What we did 2 3 4 5 6 1
- 25. 0Nobody sold ORS or Zinc in the private sector. Stock-outs in the public sector were common.
- 26. 0Nobody sold ORS or Zinc in the private sector. Stock-outs in the public sector were common. <1%of children received the correct treatment for diarrhoea
- 27. 0Nobody sold ORS or Zinc in the private sector. Stock-outs in the public sector were common. <1%of children received the correct treatment for diarrhoea 7.3km Was the average distance to ORS.
- 28. 60%Only 60% of mothers mixed ORS correctly when given 1 litre sachets. 0Nobody sold ORS or Zinc in the private sector. Stock-outs in the public sector were common. <1%of children received the correct treatment for diarrhoea 7.3km Was the average distance to ORS.
- 29. 60%Only 60% of mothers mixed ORS correctly when given 1 litre sachets. 0Nobody sold ORS or Zinc in the private sector. Stock-outs in the public sector were common. <1%of children received the correct treatment for diarrhoea 7.3km Was the average distance to ORS.
- 30. 60%Only 60% of mothers mixed ORS correctly when given 1 litre sachets. 0Nobody sold ORS or Zinc in the private sector. Stock-outs in the public sector were common. <1%of children received the correct treatment for diarrhoea 7.3km Was the average distance to ORS. >26k kits sold into the two remote rural trial areas in 12 months.
- 31. 60%Only 60% of mothers mixed ORS correctly when given 1 litre sachets. 0Nobody sold ORS or Zinc in the private sector. Stock-outs in the public sector were common. <1%of children received the correct treatment for diarrhoea 7.3km Was the average distance to ORS. >26k kits sold into the two remote rural trial areas in 12 months. 45%of children in trial areas received ORS/Zinc. Up from a baseline of <1%. Comparator sites stayed at <1%.
- 32. 60%Only 60% of mothers mixed ORS correctly when given 1 litre sachets. 0Nobody sold ORS or Zinc in the private sector. Stock-outs in the public sector were common. <1%of children received the correct treatment for diarrhoea 7.3km Was the average distance to ORS. >26k kits sold into the two remote rural trial areas in 12 months. 45%of children in trial areas received ORS/Zinc. Up from a baseline of <1%. Comparator sites stayed at <1%. 2.4km The distance to ORS/Zinc in the trial areas was reduced by two- thirds from 7.3km to 2.4km.
- 33. 60%Only 60% of mothers mixed ORS correctly when given 1 litre sachets. 0Nobody sold ORS or Zinc in the private sector. Stock-outs in the public sector were common. <1%of children received the correct treatment for diarrhoea 7.3km Was the average distance to ORS. >26k kits sold into the two remote rural trial areas in 12 months. 45%of children in trial areas received ORS/Zinc. Up from a baseline of <1%. Comparator sites stayed at <1%. 2.4km The distance to ORS/Zinc in the trial areas was reduced by two- thirds from 7.3km to 2.4km. 93%of Kit Yamoyo users mixed ORS correctly. Only 60% do when given 1 litre sachets.
- 34. 60%Only 60% of mothers mixed ORS correctly when given 1 litre sachets. 0Nobody sold ORS or Zinc in the private sector. Stock-outs in the public sector were common. <1%of children received the correct treatment for diarrhoea 7.3km Was the average distance to ORS. >26k kits sold into the two remote rural trial areas in 12 months. 45%of children in trial areas received ORS/Zinc. Up from a baseline of <1%. Comparator sites stayed at <1%. 2.4km The distance to ORS/Zinc in the trial areas was reduced by two- thirds from 7.3km to 2.4km. 93%of Kit Yamoyo users mixed ORS correctly. Only 60% do when given 1 litre sachets.
- 35. The scope of our work What happened Our starting point The effects The ColaLife contribution Consultation on transforming healthcare delivery ANDi, Addis Ababa, January 2015 Recommendations What we did 2 3 4 5 6 1
- 36. 6 Don’t ignore EXISTING private sector supply chains in your strategy to distribute over the counter medicines
- 37. Focus on what you know people WANT not on what you think they NEED 6
- 38. Get co-packaged ORS and Zinc on the essential medicines list 6
- 39. Under-5 children have died from dehydration caused by diarrhoea in the time it took to give this presentation
Hinweis der Redaktion
- I have no commercial interest in the commercial product I will show you. But are strategy for impact is that others will find it of commercial interest – more of that later.
- Despite the remoteness and sparsity of population I could get a Coca-Cola in most places I went.
- These days it’s 1 in 8 – so it has improved but it is still unacceptably high
- – 25 times higher than here in Canada. And still diarrhoea is killer number two. In the recent review of the Millennium Development Goals, more developed countries which already had low mortality rates have reduced their mortality rates more than less developed countries. So the gulf is growing between rich and poor countries.
- Just as shocking as this level of mortality is that diarrhoea, an easily treated condition, is the second biggest killer. Dehydration from diarrhoea kills more children than Malaria and HIV/AIDS combined.
- This was the trial timeline. We had 9-month set-up phase, a 12-month trial phase and 3-month wrapping up phase – although we haven’t wrapped up as you will learn later. In the set-up phase: Our partners recruited the field staff they needed We finalised the packaging design We undertook baseline surveys to assess the situation before we intervened We then went into a 12-month trial phase
- Despite their humble resources, the Facebook Group and blog had generated global interest in the idea and these were mustered to try and get a trial started.
- We have designed the trial so that we have created a new product and its end to end value chain. Usually, aid projects focus on distribution – and that can involve purchasing and maintaining 4 wheel drive, for example. We have focused on value chain creation, where profits are made at each step, as a trade intervention. In a value chain, value flows BACK from the customer, and we have assured this in the first 6 months of the trial by distributing vouchers. For the second half of the trial we are going to be seeing if there is sufficient ‘value’ to capture in rural areas. Another way of putting that is Willingness to Pay. (The price paid by the wholesaler is USD 0.5741 (approx $60 us cents) meaning that the subsidy per kit during the trial is USD 1.2712. Just over a dollar ($1.20).
- We have designed the trial so that we have created a new product and its end to end value chain. Usually, aid projects focus on distribution – and that can involve purchasing and maintaining 4 wheel drive, for example. We have focused on value chain creation, where profits are made at each step, as a trade intervention. In a value chain, value flows BACK from the customer, and we have assured this in the first 6 months of the trial by distributing vouchers. For the second half of the trial we are going to be seeing if there is sufficient ‘value’ to capture in rural areas. Another way of putting that is Willingness to Pay. (The price paid by the wholesaler is USD 0.5741 (approx $60 us cents) meaning that the subsidy per kit during the trial is USD 1.2712. Just over a dollar ($1.20).
- We have designed the trial so that we have created a new product and its end to end value chain. Usually, aid projects focus on distribution – and that can involve purchasing and maintaining 4 wheel drive, for example. We have focused on value chain creation, where profits are made at each step, as a trade intervention. In a value chain, value flows BACK from the customer, and we have assured this in the first 6 months of the trial by distributing vouchers. For the second half of the trial we are going to be seeing if there is sufficient ‘value’ to capture in rural areas. Another way of putting that is Willingness to Pay. (The price paid by the wholesaler is USD 0.5741 (approx $60 us cents) meaning that the subsidy per kit during the trial is USD 1.2712. Just over a dollar ($1.20).
- We have designed the trial so that we have created a new product and its end to end value chain. Usually, aid projects focus on distribution – and that can involve purchasing and maintaining 4 wheel drive, for example. We have focused on value chain creation, where profits are made at each step, as a trade intervention. In a value chain, value flows BACK from the customer, and we have assured this in the first 6 months of the trial by distributing vouchers. For the second half of the trial we are going to be seeing if there is sufficient ‘value’ to capture in rural areas. Another way of putting that is Willingness to Pay. (The price paid by the wholesaler is USD 0.5741 (approx $60 us cents) meaning that the subsidy per kit during the trial is USD 1.2712. Just over a dollar ($1.20).
- We have designed the trial so that we have created a new product and its end to end value chain. Usually, aid projects focus on distribution – and that can involve purchasing and maintaining 4 wheel drive, for example. We have focused on value chain creation, where profits are made at each step, as a trade intervention. In a value chain, value flows BACK from the customer, and we have assured this in the first 6 months of the trial by distributing vouchers. For the second half of the trial we are going to be seeing if there is sufficient ‘value’ to capture in rural areas. Another way of putting that is Willingness to Pay. (The price paid by the wholesaler is USD 0.5741 (approx $60 us cents) meaning that the subsidy per kit during the trial is USD 1.2712. Just over a dollar ($1.20).
- We have designed the trial so that we have created a new product and its end to end value chain. Usually, aid projects focus on distribution – and that can involve purchasing and maintaining 4 wheel drive, for example. We have focused on value chain creation, where profits are made at each step, as a trade intervention. In a value chain, value flows BACK from the customer, and we have assured this in the first 6 months of the trial by distributing vouchers. For the second half of the trial we are going to be seeing if there is sufficient ‘value’ to capture in rural areas. Another way of putting that is Willingness to Pay. (The price paid by the wholesaler is USD 0.5741 (approx $60 us cents) meaning that the subsidy per kit during the trial is USD 1.2712. Just over a dollar ($1.20).
- We have designed the trial so that we have created a new product and its end to end value chain. Usually, aid projects focus on distribution – and that can involve purchasing and maintaining 4 wheel drive, for example. We have focused on value chain creation, where profits are made at each step, as a trade intervention. In a value chain, value flows BACK from the customer, and we have assured this in the first 6 months of the trial by distributing vouchers. For the second half of the trial we are going to be seeing if there is sufficient ‘value’ to capture in rural areas. Another way of putting that is Willingness to Pay. (The price paid by the wholesaler is USD 0.5741 (approx $60 us cents) meaning that the subsidy per kit during the trial is USD 1.2712. Just over a dollar ($1.20).
- We have designed the trial so that we have created a new product and its end to end value chain. Usually, aid projects focus on distribution – and that can involve purchasing and maintaining 4 wheel drive, for example. We have focused on value chain creation, where profits are made at each step, as a trade intervention. In a value chain, value flows BACK from the customer, and we have assured this in the first 6 months of the trial by distributing vouchers. For the second half of the trial we are going to be seeing if there is sufficient ‘value’ to capture in rural areas. Another way of putting that is Willingness to Pay. (The price paid by the wholesaler is USD 0.5741 (approx $60 us cents) meaning that the subsidy per kit during the trial is USD 1.2712. Just over a dollar ($1.20).
- Less than 1% of children received the correct treatment for diarrhoea – ORS and Zinc.
- Less than 1% of children received the correct treatment for diarrhoea – ORS and Zinc.
- Less than 1% of children received the correct treatment for diarrhoea – ORS and Zinc.
- Less than 1% of children received the correct treatment for diarrhoea – ORS and Zinc.
- Less than 1% of children received the correct treatment for diarrhoea – ORS and Zinc.
- Less than 1% of children received the correct treatment for diarrhoea – ORS and Zinc.
- Less than 1% of children received the correct treatment for diarrhoea – ORS and Zinc.
- Less than 1% of children received the correct treatment for diarrhoea – ORS and Zinc.
- Less than 1% of children received the correct treatment for diarrhoea – ORS and Zinc.
- Less than 1% of children received the correct treatment for diarrhoea – ORS and Zinc.