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ColaLife

A textbook case of innovative policy making and effective implementation.

A couple of weeks ago NESTA hosted a screening of a film about a small innovative charity trying to find a low cost solution to a massive public health problem. It was a masterclass in how to make and implement an effective change. Policy makers should watch and learn.

I will declare an interest. Five years ago, when I was working at Defra we recruited Simon Berry to lead our work on the way the department worked with the third sector. We managed to hang onto Simon for 18 months, guiding him through the ways of Whitehall, before he announced that he and his wife were going to go to Africa to try to solve a problem they had identified when they had lived there 20 years before. The problem was why so many young children in remote communities die of diarrhoea when there is a simple, cheap and effective treatment – oral rehydration salts and zinc. Their insight was that these treatments were simply not available either where people lived or, too often, in the health centres they would trek to with their sick child. Result: unnecessary deaths. But their additional insight was that in these very same communities, cola drinks were very widely available. If cola drinks could “go the extra mile”, why couldn’t lifesaving medicines? So if a way could be found to get the cola distributors to distribute medicines too, could they find a solution to that problem. Simon and Jane then organised a multi-pronged assault – on Coca-Cola via social media to get them to talk about opening up their distribution networks and with the Ministry of Health in Zambia, because what they were trying to establish was a real public-private partnership. To make it happen they needed a low-cost product. So they worked with a local Zambian pharmaceutical company to develop Kit Yamoyo – a one-off child-sized treatment for a parent to buy. The company did not have quite the right equipment to seal the sachets – so they had to buy a new machine – and show the workers how to use it. And they developed a brilliant packaging product to allow the kit to slot in between cola bottles. They won design awards for the packaging. But the packaging was always a means, not an end. Simon and Jane realised that they were not the right people to talk to mothers about what they needed – so they recruited someone who was – a social worker called Albert. They followed the coke bottles into remote villages to work out how to use the logistics. They ran focus groups with mothers in remote villages to understand their real concerns and work out what would work for them. They found that the packet can double as a clean cup – with a measure on the side to ensure correct dosage – so a parent can treat a sick child in the dark. They checked whether parents would be prepared to spend $1 for a kit in a local shop. They said they would. They talked to the men who ran the local village shops to explain the product and persuade them up to sell the kits. And a Canadian DrPH student, working with them, did a baseline survey to see how many parents used oral rehydration salts before they started their trial, so they could know whether they were making a difference. Then they started their trial. And it worked. They transported over 26,000 kits into remote villages – and most were used. Their post-trial survey showed treatment rates went up from under 1% in the baseline to around 45%. They have made all their results available as open access. But they also discovered that the initial solution they identified to the problem was wrong. They didn’t need the “gap in the crate” to get the product into villages. Instead they had accidentally addressed “the gap in the market”. What Coca-Cola had, and ColaLife had now created, was a product where local people saw a business opportunity to go the extra mile and transport the product into the village themselves. What is now needed is a way of turning this into a sustainable market, not dependent on donors or subsidy. And that means driving down unit costs. The innovative packaging, needed to fit into crates, was expensive. And it turned out to be unnecessary. They ditched the packaging.
Publisher
Institute for Government

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