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ColaLife – can Coca-Cola save children’s lives? 28-May-14

Rohit Ramchandani

Jane Berry

The other members of the ColaLife team

Slash & Burn Agriculture | NE Zambia, 1985

Wherever I went I could get a Coca-Cola

Diarrhoea

17%

Malaria

12%

AIDS

3%

Diarrhoea kills more children than Malaria and AIDS combined

In Zambia 46% of children are stunted (up to 70% in some areas)

Remote rural retail shop, Kalomo District, Zambia

Drug store room, Tiriri Health Centre, Katine, Uganda

Empty clinics – full shops

Why not put ORS & Zinc Kit in Coca-Cola crates?

The humble telex machine, 1985

May 2008 | Gordon Brown’s Business Call to Action

The mighty Facebook, May 2008

Strengthened distribution systems and new delivery strategies

Diarrhoea treatment kits for all new mothers… combining ORS and Zinc

Market-based solutions are often the most effective way to deliver key diarrhoea control commodities

We know what to do… but access and availability are barriers“

”2009 | WHO/UNICEF report on the problem of diarrhoea

Jun 2010 | Gave up jobs to try and get a trial started

Jun 2010 | Gave up jobs to try and get a trial started

Our kitchen tableUK

Jun 2010 | Gave up jobs to try and get a trial started

Rohit on SkypeCanada

Our kitchen tableUK

Jun 2010 | Gave up jobs to try and get a trial started

Rohit on SkypeCanada

Our kitchen tableUK

Harvard & UNICEF on speaker phoneUSA

Sep 2010 | Cycle route - Boulogne to Biarritz

Sep 2010 | Cycle ride across France raised £6,000

Oct 2010 | First of three trips to Zambia

Jun 2011 | Partnership and trial plan in place

Nov 2011 | Funding partnership in place

Dec 2011 | Trial gets underway

The trial timeline

Trial (12 months)

Wind-up(3 months)

Set-up (9 months)

Data Collection and analysis

Distribution of kits Distribution of vouchers

Community-based marketing

BaselineTrial runKit assemblyTraining

Focus groupsPackagingRecruitment

Dec 2011

Sep 2012

Mar 2013

Aug 2013

Nov 2013

impact Mothers in underserved rural communities increase use of ORS and Zinc in home treatment of diarrhoea

purposeTarget communities in two under-served rural districts have improved access to ORS and Zinc

outputsProfit-driven supply chains improve availability of ADKs (anti-diarrhoea kits) in targeted communities in two underserved rural districts

Mothers/care-givers demonstrate awareness of ADKs and the benefits of the contents (ORS, Zinc and Soap)

access = ADK in the hand of an aware mother/care-giver

Availability = ADK in stock in retail outlets at community level

Generating robust evidence - the trial results framework

What we learnt

Litre sachets are too big

Measuring water was an issue

Willingness to pay

Preferred branding

Early 2012 | Pre-trial focus group work

Kit Yamoyo• Attractive

Mar 2012 | Finalised the Kit Yamoyo design

Kit Yamoyo• Attractive• ORS sachets are 200ml

Mar 2012 | Finalised the Kit Yamoyo design

Kit Yamoyo• Attractive• ORS sachets are 200ml• Packaging is also:

• A measuring device for the water

Mar 2012 | Finalised the Kit Yamoyo design

Kit Yamoyo• Attractive• ORS sachets are 200ml• Packaging is also:

• A measuring device for the water• A mixing device

Mar 2012 | Finalised the Kit Yamoyo design

Kit Yamoyo• Attractive• ORS sachets are 200ml• Packaging is also:

• A measuring device for the water• A mixing device• A storage device (the soap tray is a lid)• A cup

Mar 2012 | Finalised the Kit Yamoyo design

0Nobody sold ORS or Zinc in the private sector.

Stock-outs in the public sector were common.

Sep 2012

Our starting point

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

Sep 2012

Our starting point

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

7.3kmWas the average distrance to ORS.

Sep 2012

Our starting point

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

7.3kmWas the average distrance to ORS.

Sep 2012

Our starting point

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

7.3kmWas the average distrance to ORS.

Sep 2012

Our starting point

>26kkits sold into the two remote rural trial areas in 12 months.

Aug 2013

After 12 months

>26kkits 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%.

Aug 2013

After 12 months

>26kkits 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%.

2.4kmThe distance to ORS/Zinc in the trial areas was reduced by two-thirds from 7.3km to 2.4km.

Aug 2013

After 12 months

>26kkits 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%.

2.4kmThe 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.

Aug 2013

After 12 months

14The perception of ORS as an effective treatment for diarrhoea increased by 14 percentage points.

>26kkits 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%.

2.4kmThe 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.

Aug 2013

After 12 months

14The perception of ORS as an effective treatment for diarrhoea increased by 14 percentage points.

>26kkits 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%.

2.4kmThe 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.

4%Only 4% of kits went into Coca-Cola crates. It was the space in the market not the space in the crates that was important.

Aug 2013

After 12 months

Our award-winning idea…… this is what happened in practice

14 Jan via

You can get any commodity/service to anywhere in the world by creating & sustaining demand & making it profitable to fulfill that demand

TweetDeck

@51m0nSimon Berry

What we learnt from Coca-Cola – the value chain

14The perception of ORS as an effective treatment for diarrhoea increased by 14 percentage points.

>26kkits 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%.

2.4kmThe 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.

4%Only 4% of kits went into Coca-Cola crates. It was the space in the market not the space in the crates that was important.

...Request access to our findingscolalife.org/openaccess

Aug 2013

After 12 months

14The perception of ORS as an effective treatment for diarrhoea increased by 14 percentage points.

>26kkits 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%.

2.4kmThe 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.

4%Only 4% of kits went into Coca-Cola crates. It was the space in the market not the space in the crates that was important.

...Request access to our findingscolalife.org/openaccess

Aug 2013

After 12 months

The screw-top The flexi-pack

facebook.com/colalife

Feb-14 | Chimtende, Katete

>26kkits 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%.

2.4kmThe 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.

A note on the data contained within this presentation

The data contained in this presentation are unpublished and based on preliminary analysis of data from the ColaLife Operational Trial in Zambia (COTZ). Final calculations may vary and will be published in peer reviewed literature in due course.

In the interim, the following citation may be used: Ramchandani, R. et al. (2014). ColaLife Operational Trial Zambia (COTZ) Evaluation. Johns Hopkins Bloomberg School of Public Health, Baltimore.

Related correspondence should be sent to Rohit Ramchandani (roramcha@jhsph.edu) and copied to Simon Berry (simon@colalife.org).