The slide deck used for the ColaLife / UNICEF workshop on 21 Jan 2011 in Lusaka. An overview of the workshop can be found here: http://www.colalife.org/2011/01/21/zambia-diary-day-5-visit-2-the-workshop/
2. ” “ Strengthened distribution systems and new delivery strategies Diarrhoea treatment kits for all new mothers New communication strategies Market-based solutions are often the most effective way to deliver key diarrhoea control commodities UNICEF call to action - October 2009
3. Diarrhea-Related Dehydration Still a Top-Killer of Children in Developing World Over 1 million children still dying from diarrhea-related death each year More children die from diarrhea related illness than Malaria, HIV/AIDS and Measles combined
4. Why the Emphasis on ORS? MDG # 4 - Time is Running Out! Millenium Development Goal #4: Reduce by two-thirds, between 1990 and 2015, the mortality rate of children under 5 innovation needed incremental improvement Mortality dropped 1.8% per year (1990-2008) Mortality must decrease 10.5% per year 2008-2015 to reach goal 1990 2008 2015 100 72 33
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6. The heart of the idea: Coca-Cola gets everywhere - why not simple medicines?
7. Key challenges Low affordability levels ‘ Last mile’ distribution challenges Public supply challenges Education, Information and Communication Water!
8. Water! SODIS Key innovations Low affordability levels ‘ Last mile’ distribution challenges Public supply challenges Education, Information and Communication Water! Retail supply chain Piggybacking and empowerment of local entrepreneurs. Business Innovation for corporates - beyond CSR Affordable Mother’s Kit New technology for EIC and tracking
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11. Who is interested in a pilot of the ColaLife concept? Funders and foundations we have spoken to, who are interested 2 years of stakeholder idea/development Global level expert support and advice Possible sustainability models Prof Prashant Yadav Prof Don Nutbeam Rohit Ramchan-dani Dr Ian Goldman
20. Implementation phase The Pilot SODIS research and development Social marketing Packing Distribution Monitoring and evaluation Dissemination Replication planning ColaLife Pilot | Pilot Structure | Zambia Initial research AidPod Mother’s Kit prototyping Set-up phase Design and test EIC materials Baseline study Governance & project management
21. Initial research Assess what mothers/carers would consider to be attractive in an AidPod Mother’s Kit Set-up phase Confirm the margins that would be expected in the distribution chain Confirm the transport premium to remote rural communities Assess the financing/credit requirements of wholesalers/retailers (if any) If required: Look at options for the management of a voucher system Assess the willingness and ability of mothers/carers to pay Assess the need for vouchers to pump-prime the ‘pull’ of AidPods into communities (if any) Determine the level of subsidy required ColaLife Pilot | Pilot Structure | Zambia
22. AidPod Mother’s Kit prototyping Draw up a specification for the AidPod to be used in the pilot Set-up phase Carry out field tests Modify as required Assess options for manufacture Manufacture Produce ‘fit for purpose’ AidPods in the quantities required for pilot ColaLife Pilot | Pilot Structure | Zambia
23. Design and test EIC materials Develop prototype EIC materials Set-up phase Test with sample communities within the pilot area(s) Refine as required Produce the EIC materials in the formats and quantities required for the pilot ColaLife Pilot | Pilot Structure | Zambia
24. Baseline study Collect baseline data in control and pilot districts Set-up phase Design data collection methods in control and pilot districts for implementation phase Baseline report plus methodology for the collection of baseline/control data during pilot ColaLife Pilot | Pilot Structure | Zambia
25. Parallel study If possible, draw up specification and research manufacturing options Assess other options for the promotion and uptake of SODIS in remote rural areas A report on the SODIS options for the post-pilot roll-out phases SODIS research and development Assess the feasibility of producing a SODIS enabled AidPod for post pilot roll-out phases If not possible, look at other options including refining the SODIS bag ColaLife Pilot | Pilot Structure | Zambia
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28. ColaLife Pilot | Organisational Structure | Zambia Funders Governance Project management Accountable Body ‘ Last mile’ Distribution Packing Distribution To District Social Marketing M & E Dissemination Partner 3 Partner 2 Partner 1 Partner 4
Many consider diarrhoea as ‘the forgotten killer’. There is very little money to be made from the production and delivery of ORS to low income households but it is just these very simple medicines that would save lives. From time to time a campaign is launched to remind us of the ‘diarrhoea issue’ and the latest significant report was from UNICEF and was entitled: ‘Diarrhoea: Why children are STILL dying and what can be done’. It was published in October 2009. The report called for: [click} Strengthened distribution systems and new delivery strategies [click] New communication strategies [click] Diarrhoea treatment kits for all new mothers [click] Market-based solutions are often the most effective way to deliver key diarrhoea control commodities Health 2 Wealth builds on the UNICEF recommendations
So what is it that kills these young children? These are UNICEF figures and as we can see diarrhoea is a significant killer and kills more under fives than Malaria, HIV/AIDS and Measles combined.
The AidPod makes use of unused space in crated bottles.
Yes - distribution is a key issue and cost - especially in rural areas.. BUT challenges are more complex than this [click] In a recent study WHO and Health Action International found that clinics in sub-Saharan Africa operated on a 38% availability of basic drugs which in practical terms means that if you walk to your nearest health centre, which may not be that near, it may take you several hours to get there, you may NOT find the medicines you need to help your child. [click] There are last mile distribution issues especially to remote, sparsely populated areas; especially in rainy season. [click] Equity issues: The most remote communities can be among the poorest and often living on less than a dollar a day, yet they pay most. [click] There are also issues to do with education levels and awareness [click] and access to clean water.
[click] Although there are distribution issues in the public sector, the private sector does a lot better. There are still challenges; but new public/private supply chain partnerships show significant promise. [click] Health 2 Wealth proposes developing hybrid supply chains combining the legendary reach of Coca-Cola, harnessing the army of local independent entrepreneurs who travel the last mile and incorporating insight and local intelligence of NGOs, and award winning innovation from our partner ColaLife. Coca-Cola reaches the most remote areas because small retailers can make money in the process. We want to embed the same incentives into the delivery of the simple medicines needed to treat a child with diarrhoea. And piggyback on the same system that gets Coca-Cola everywhere by using the unused space in Coca-Cola crates using ColaLife AidPods. [click] A first use for these AidPods, as agreed for a trial in Zambia backed by UNICEF and other key partners, is as affordable AidPod Mother’s Kits; available to every new mother in the areas being serviced by our initiative. We will talk about the contents of the kit later. [click] As well as using traditional Education, Information and Communication methods . . . . [click] . . . we will embrace the use of the mobile phone for this purpose as well. [click] We will also promote the use of the SODIS technique to disinfect water to help prevent diarrhoea in the first place and to clean the water used to mix the ORS, again more about this later. Now let’s look at these innovations in a bit more detail.
This is what we bring to this proposal. This proposal builds on 2.5 years of partnership development and open innovation work undertaken by ColaLife since April 2008. ColaLIfe has already secured buy-in from key partners including: Agreement from Coca-Cola HQ in Atlanta for a pilot to take place with a supportive bottler, allowing AidPods in their crates In principle agreement from SAB Miller HQ in London and SAB Miller Zambia (Zambia Breweries) to support that pilot Backing from UNICEF Zambia to host the pilot and support Monitoring and Evaluation Backing for the concept from UNICEF HQ in New York In principle interest from the Ministry of Health
We met 45 people while in Zambia from 15 different organisations in the public, private and NGO sectors and in week 2 of our visit we pulled key players together to consider what a trial might look like. This is what we came up with.
Explain . . .
We plan to run a pilot of the ColaLife concept in Zambia in 2011 and we have already visited the country to talk to the key stakeholders there. We met with 45 people and 15 organisations and together came up with the following business model. It was agreed that a pilot should focus on getting WHO-recommended diarrhoea treatment kits to new mothers and that we should do this through the ecxisting private sector network. The same network that gets Coca-Cola to the most remote areas of Zambia. It was agreed that we would embed private sector motivations into the distribution of these mother kits. The same motivators that get commodities such as cooking oil, salt, washing powder, talk-time and Coca-Cola to remote areas in Zambia. The Mother’s Kits, or AidPods, would be inserted into Coca-Cola crates at Wholesaler level in the distribution chain thereby increasing the profitability contained within a crate - profit will be made from the Coca-Cola AND the Mother’s Kits. The retail price of the kits will be based on mothers’ ability to pay. Based on this, and the margins that need to be made by the distributors, wholesalers and retailers, the level of subsidy will be determined and injected at the start of the distribution chain. Crucial to success will be a social marketing campaign aimed at turning ‘need’ into ‘demand’ for diarrhoea treatment kits by mothers. This will consist of awareness raising activities by Community Health Workers; communication and education campaigns using radio, community drama, posters and leaflets. Key to this design is that the only new element is the AidPod in the crate. All the other elements already exist in one form or other in other recent activities - it is just a question of putting the elements together in a different way and helping an unlikely alliance of partners work successfully together.