Presentation given by ColaLife's Simon Berry at the Royal Society of Medicine's 11th Medical Innovations Summit 2015 on 12-Sep-15.
This includes a brief history of ColaLife, the learning from the operational trial in Zambia and progress towards national scale-up.
ColaLife presention to C2MTL | 28-May-2014ColaLife
Keynote presentation given at C2MTL on 28-May-2014.
20 mins, fully annotated.
This gives the brief history of ColaLife, describes the ColaLife Trial in Zambia (COTZ), presents our key findings and describes our strategy for impact.
Presentation to PATH (Seattle, Washington DC and San Francisco), 23-May-14ColaLife
Presentation to PATH staff on 23-May-14.
Delivered in Seattle with a video link to Washington and audio link to San Francisco.
Download the presentation for the speech narrative that is contained in the notes to the slides.
Progress update on the Kit Yamoyo scale-up in Zambia for the stakeholders who support public health in Zambia. The meeting was held at the CDC offices in Lusaka.
For on-going updates please see: http://colalife.org/status
ColaLife Presentation to the Janssen Global Public Health Team, 26-Aug-15ColaLife
A 40 minute presentation covering the background to ColaLife, the ColaLife trial and progress towards scale-up. The presentation also covers the impacts and their measurement, the ColaLife Innovation Map and the scale-up version of the voucher system.
ColaLife presention to C2MTL | 28-May-2014ColaLife
Keynote presentation given at C2MTL on 28-May-2014.
20 mins, fully annotated.
This gives the brief history of ColaLife, describes the ColaLife Trial in Zambia (COTZ), presents our key findings and describes our strategy for impact.
Presentation to PATH (Seattle, Washington DC and San Francisco), 23-May-14ColaLife
Presentation to PATH staff on 23-May-14.
Delivered in Seattle with a video link to Washington and audio link to San Francisco.
Download the presentation for the speech narrative that is contained in the notes to the slides.
Progress update on the Kit Yamoyo scale-up in Zambia for the stakeholders who support public health in Zambia. The meeting was held at the CDC offices in Lusaka.
For on-going updates please see: http://colalife.org/status
ColaLife Presentation to the Janssen Global Public Health Team, 26-Aug-15ColaLife
A 40 minute presentation covering the background to ColaLife, the ColaLife trial and progress towards scale-up. The presentation also covers the impacts and their measurement, the ColaLife Innovation Map and the scale-up version of the voucher system.
Presentation to University of Michigan | 19-May-14ColaLife
Presentation to the University of Michigan, 19-May-14, Ann Arbor, Michigan at the invitation of the William Davidson Institute.
Download the presentation for the speech narrative that is contained in the notes to the slides.
ColaLife presentation to the ANDi Workshop, Addis Ababa, Jan-15ColaLife
ColaLife presentation to the ANDi Workshop, Addis Ababa, Jan-15. The presentation is just 5 minutes long and has six sections:
1. The scope of our work
2. Our starting point
3. What we did
4. What happened
5. The effects
6. recommendations for ANDi
The role of innovation in augmenting healthcare - the ColaLife StoryColaLife
Presentation given by Simon Berry, CEO, ColaLife, at the Africa Health Extension Summit, 27-28 Nov 2019.
Key themes: why we need innovation in healthcare; what is innovation?; how to ensure innovations have an impact; how to move innovations into the mainstream.
Narrative is provided in the notes.
After dinner speech at the 26th DuPont Packaging Awards, 15-May-14, Wilmington, Delaware, USA.
Download the presentation for the speech narrative that is contained in the notes to the slides.
ColaLife - Cross-sector partnerships - new paradigmsColaLife
Presentation to the Stakeholder Engagement Event at Middlesex University outlining how ColaLife had partnered with the academic sector in our work. 6-Jul-16.
In the 2019 fall semester, I was a student in Professor Scott Hamula's advertising class and was given the opportunity to rebrand any less known/advertised brand. The group that I was a part of chose to rebrand The Original Oatly. Attached below is our final project booklet about our new Advertising Campaign plan for Oatly. This project was a lot of fun and extremely thankful I got to have real life experiences in this class.
Considerations in Last Mile Delivery in Access to Medicines – the ColaLife StoryColaLife
Considerations in Last Mile Delivery in Access to Medicines
Out of the box thinking and partnership – the ColaLife Story.
This presentation was given at the 'Access to Medicines' conference hosted by Takeda in Geneva on 25-May-17. It describes how access to diarrhoea treatment was transformed in Zambia.
Diarrhoea is the second biggest infectious killer of under 5 children and yet we know how to treat diarrhoea and the medicine is simple, safe and cheap. The problem is that 99% of diarrhoea cases do not receive the recommended treatment: ORS and Zinc. The last remaining barrier is access.
Since 2005, Rotarians from around the world have packaged
tens of millions of meals with Stop Hunger Now. This
meal-packaging program is a fun, hands-on international
service project that encourages a cooperative effort within
the community. Learn how you can engage your club in this
sustainable global feeding effort that delivers nutrition to
people in more than 70 countries. Additionally, you’ll hear
about Stop Hunger Now’s new sustainable development
project opportunities and possibilities for global grants.
The Footprint Forum went to Fruit Towers to talk about Agriculture Abroad and the positive contribution that Foodservice can make to the global food system and sustainability
KYTS Programme Final Steering & Learning Group meeting 6-Sep-18ColaLife
Slidedeck to support the KYTS Programme Final Steering & Learning Group meeting on 6-Sep-18.
The KYTS Programme increased availability, access and use of ORS and Zinc therapy for home treatment of diarrhoea in children under 5 via private and public-sector development in Lusaka Province, Zambia
Presentation to University of Michigan | 19-May-14ColaLife
Presentation to the University of Michigan, 19-May-14, Ann Arbor, Michigan at the invitation of the William Davidson Institute.
Download the presentation for the speech narrative that is contained in the notes to the slides.
ColaLife presentation to the ANDi Workshop, Addis Ababa, Jan-15ColaLife
ColaLife presentation to the ANDi Workshop, Addis Ababa, Jan-15. The presentation is just 5 minutes long and has six sections:
1. The scope of our work
2. Our starting point
3. What we did
4. What happened
5. The effects
6. recommendations for ANDi
The role of innovation in augmenting healthcare - the ColaLife StoryColaLife
Presentation given by Simon Berry, CEO, ColaLife, at the Africa Health Extension Summit, 27-28 Nov 2019.
Key themes: why we need innovation in healthcare; what is innovation?; how to ensure innovations have an impact; how to move innovations into the mainstream.
Narrative is provided in the notes.
After dinner speech at the 26th DuPont Packaging Awards, 15-May-14, Wilmington, Delaware, USA.
Download the presentation for the speech narrative that is contained in the notes to the slides.
ColaLife - Cross-sector partnerships - new paradigmsColaLife
Presentation to the Stakeholder Engagement Event at Middlesex University outlining how ColaLife had partnered with the academic sector in our work. 6-Jul-16.
In the 2019 fall semester, I was a student in Professor Scott Hamula's advertising class and was given the opportunity to rebrand any less known/advertised brand. The group that I was a part of chose to rebrand The Original Oatly. Attached below is our final project booklet about our new Advertising Campaign plan for Oatly. This project was a lot of fun and extremely thankful I got to have real life experiences in this class.
Considerations in Last Mile Delivery in Access to Medicines – the ColaLife StoryColaLife
Considerations in Last Mile Delivery in Access to Medicines
Out of the box thinking and partnership – the ColaLife Story.
This presentation was given at the 'Access to Medicines' conference hosted by Takeda in Geneva on 25-May-17. It describes how access to diarrhoea treatment was transformed in Zambia.
Diarrhoea is the second biggest infectious killer of under 5 children and yet we know how to treat diarrhoea and the medicine is simple, safe and cheap. The problem is that 99% of diarrhoea cases do not receive the recommended treatment: ORS and Zinc. The last remaining barrier is access.
Since 2005, Rotarians from around the world have packaged
tens of millions of meals with Stop Hunger Now. This
meal-packaging program is a fun, hands-on international
service project that encourages a cooperative effort within
the community. Learn how you can engage your club in this
sustainable global feeding effort that delivers nutrition to
people in more than 70 countries. Additionally, you’ll hear
about Stop Hunger Now’s new sustainable development
project opportunities and possibilities for global grants.
The Footprint Forum went to Fruit Towers to talk about Agriculture Abroad and the positive contribution that Foodservice can make to the global food system and sustainability
KYTS Programme Final Steering & Learning Group meeting 6-Sep-18ColaLife
Slidedeck to support the KYTS Programme Final Steering & Learning Group meeting on 6-Sep-18.
The KYTS Programme increased availability, access and use of ORS and Zinc therapy for home treatment of diarrhoea in children under 5 via private and public-sector development in Lusaka Province, Zambia
Kit Yamoyo design review - how the trial findings influenced the design of the Kit Yamoyo anti-diarrhoea kit used in the subsequent national scale-up in Zambia.
ColaLife | Key milestones - 1985 to Dec-13ColaLife
This timeline highlights some of the key milestones since the birth of the ColaLife idea in 1985 to the end of the trial and move to scale-up in Dec-13.
It focussed on the key people involved and describes how the relationship with The Coca-Cola Company and SABMiller has developed.
Additional milestone:
May 2010
Together, Simon, Jane and Rohit submitted their first proposal to the Clinton Health Access Initiative (CHAI) who were seeking out innovative financing and delivery mechanisms for ACTs under the Affordable Medicines Facility for Malaria (AMFm).
The proposal got to final stages of consideration and reinforced the global interest in and potential of the model.
Correction: Rohit Ramchandani's title at CIDA was Senior Health Advisor, not Public Policy Advisor.
Presentation at the Institution of Mechanical Engineers - Appropriate Healthcare Technologies for Developing Countries - 18 September 2013
This presentation includes the narrative in the notes. Please download it to see these.
Presentation to the International Society for Neglected Tropical Diseases - 1...ColaLife
A description of ColaLife's Operational Trial in Zambia including sales data for the Kit Yamoyo to 25 Jan 2013 and an analysis of the role of private sector partners during the different phases of the project.
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/
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
Struggling with intense fears that disrupt your life? At Renew Life Hypnosis, we offer specialized hypnosis to overcome fear. Phobias are exaggerated fears, often stemming from past traumas or learned behaviors. Hypnotherapy addresses these deep-seated fears by accessing the subconscious mind, helping you change your reactions to phobic triggers. Our expert therapists guide you into a state of deep relaxation, allowing you to transform your responses and reduce anxiety. Experience increased confidence and freedom from phobias with our personalized approach. Ready to live a fear-free life? Visit us at Renew Life Hypnosis..
Welcome to Secret Tantric, London’s finest VIP Massage agency. Since we first opened our doors, we have provided the ultimate erotic massage experience to innumerable clients, each one searching for the very best sensual massage in London. We come by this reputation honestly with a dynamic team of the city’s most beautiful masseuses.
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
Navigating the Health Insurance Market_ Understanding Trends and Options.pdfEnterprise Wired
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CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
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Royal Society of Medicine - Medical Innovations - Kit Yamoyo and its value chain
1. Medical Innovations – Kit Yamoyo and its value chain
11th Medical Innovations Summit 2015, Royal Society of Medicine 12-Sep-15
#medinnov
@colalife
Simon Berry
2.
3. What is ColaLife and who are we?
ColaLife is a charity registered in the UK
Charity number: 1142516
• Two founding executives
• Five voluntary trustees
• Focus on saving children’s lives
• Independent
• Our only project is in Zambia
• Looking for global impact through
• Disruptive innovation
• Generating robust evidence
• Sharing findings and learning
• No personal commercial interest
5. Our starting point
What we did next
1
Next moves
What we did What we learned
2 3
54
Medical Innovations – Kit Yamoyo and its value chain
11th Medical Innovations Summit 2015, Royal Society of Medicine 12-Sep-15
6. Our starting point
What we did next
1
Next moves
What we did What we learned
Medical Innovations – Kit Yamoyo and its value chain
11th Medical Innovations Summit 2015, Royal Society of Medicine 12-Sep-15
2 3
54
18. Why not put ORS & Zinc Kit in Coca-Cola crates?
19. Our starting point
What we did next Next moves
What we did What we learned
Medical Innovations – Kit Yamoyo and its value chain
11th Medical Innovations Summit 2015, Royal Society of Medicine 12-Sep-15
2 3
54
1
20. Jun 2010 | Gave up jobs to try and get a trial started
21. Jun 2010 | Gave up jobs to try and get a trial started
Our kitchen table
UK
22. Jun 2010 | Gave up jobs to try and get a trial started
Rohit on Skype
Canada
Our kitchen table
UK
23. Jun 2010 | Gave up jobs to try and get a trial started
Rohit on Skype
Canada
Harvard & UNICEF
on speaker phone
USA
Our kitchen table
UK
24. Sep 2010 | Cycle ride across France raised £6,000
25. Oct 2010 | First of three consultation trips to Zambia
26. Jun 2011 | Partnership and trial plan in place
27. impact Mothers in underserved rural
communities increase use of ORS and
Zinc in home treatment of diarrhoea
purpose
Target communities in two under-served
rural districts have improved access to
ORS and Zinc
outputs
Profit-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 COTZ results framework
29. Our starting point
What we did next Next moves
What we did What we learned
Medical Innovations – Kit Yamoyo and its value chain
11th Medical Innovations Summit 2015, Royal Society of Medicine 12-Sep-15
2 3
54
1
30. Early 2012 | Pre-trial focus group work
What we learnt
Litre sachets are too big
Measuring water was an issue
Willingness to pay
Preferred branding
32. Mar 2012 | Finalised the Kit Yamoyo design
Kit Yamoyo
• Attractive
33. Mar 2012 | Finalised the Kit Yamoyo design
Kit Yamoyo
• Attractive
• ORS sachets are 200ml
34. Mar 2012 | Finalised the Kit Yamoyo design
Kit Yamoyo
• Attractive
• ORS sachets are 200ml
• Packaging is also:
• A measuring device for
the water
35. 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
36. 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
37.
38. Awards | The Kit Yamoyo has won many global awards
40. 0
Nobody sold
ORS or Zinc
in the
private
sector.
<1%
of children
received the
correct
treatment
for diarrhoea
Sep 2012
Before we started
41. 0
Nobody sold
ORS or Zinc
in the
private
sector.
<1%
of children
received the
correct
treatment
for diarrhoea
7.3km
Was the
average
distance to
ORS.
Sep 2012
Before we started
42. 60%
Only 60% of
mothers
mixed ORS
correctly
when given
litre sachets.
0
Nobody sold
ORS or Zinc
in the
private
sector.
<1%
of children
received the
correct
treatment
for diarrhoea
7.3km
Was the
average
distance to
ORS.
Sep 2012
Before we started
43. 60%
Only 60% of
mothers
mixed ORS
correctly
when given
litre sachets.
0
Nobody sold
ORS or Zinc
in the
private
sector.
<1%
of children
received the
correct
treatment
for diarrhoea
7.3km
Was the
average
distance to
ORS.
Sep 2012
Before we started
44. 60%
Only 60% of
mothers
mixed ORS
correctly
when given
litre sachets.
0
Nobody sold
ORS or Zinc
in the
private
sector.
<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.
Aug 2013
After 12 months
Sep 2012
Before we started
45. 60%
Only 60% of
mothers
mixed ORS
correctly
when given
litre sachets.
0
Nobody sold
ORS or Zinc
in the
private
sector.
<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/from
Zinc. Up a
baseline of
<1%.
Aug 2013
After 12 months
Sep 2012
Before we started
46. 60%
Only 60% of
mothers
mixed ORS
correctly
when given
litre sachets.
0
Nobody sold
ORS or Zinc
in the
private
sector.
<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/from
Zinc. Up a
baseline of
<1%.
2.4km
The distance
to ORS/Zinc in
the trial areas
was reduced
by two-thirds
from 7.3km to
2.4km.
Aug 2013
After 12 months
Sep 2012
Before we started
47. 60%
Only 60% of
mothers
mixed ORS
correctly
when given
litre sachets.
0
Nobody sold
ORS or Zinc
in the
private
sector.
<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/from
Zinc. Up a
baseline of
<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.
Aug 2013
After 12 months
Sep 2012
Before we started
48. 60%
Only 60% of
mothers
mixed ORS
correctly
when given
litre sachets.
0
Nobody sold
ORS or Zinc
in the
private
sector.
<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/from
Zinc. Up a
baseline of
<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.
Aug 2013
After 12 months
Sep 2012
Before we started
50. In Zambia, it’s the space in the market, not the space in the crates that is important.
This means we can revisit the packaging to make it cheaper.
Kit Yamoyo
Washing Powder
Eggs
Biscuits
Cola – but not Coca-Cola
Bread
52. Our starting point
What we did next Next moves
What we did What we learned
Medical Innovations – Kit Yamoyo and its value chain
11th Medical Innovations Summit 2015, Royal Society of Medicine 12-Sep-15
2 3
54
1
55. ORS
Reduce number
of sachets to 4
NOTE: This will
also enhance
adherence
Zinc
Produce locally
Only include
blister pack
Soap
Produce locally
Leaflet Packaging
Remove
constraint of
fitting in Coca-
Cola crate
Produce locally
Produce re-fill
option
Learning – product design
56. ORS
Reduce number
of sachets to 4
NOTE: This will
also enhance
adherence
Zinc
Produce locally
Only include
blister pack
Soap
Produce locally
Leaflet Packaging
Remove
constraint of
fitting in Coca-
Cola crate
Produce locally
Produce re-fill
option
Learning – product design
58. ORS
Reduce number
of sachets to 4
NOTE: This will
also enhance
adherence
Zinc
Produce locally
Only include
blister pack
Soap
Produce locally
Leaflet Packaging
Remove
constraint of
fitting in Coca-
Cola crate
Produce locally
Produce re-fill
option
4Learning – reduce number of ORS sachets to 4
59. ORS
Reduce number
of sachets to 4
NOTE: This will
also enhance
adherence
Zinc
Produce locally
Only include
blister pack
Soap
Produce locally
Leaflet Packaging
Remove
constraint of
fitting in Coca-
Cola crate
Produce locally
Produce re-fill
option
4Learning – zinc
61. ORS
Reduce number
of sachets to 4
NOTE: This will
also enhance
adherence
Zinc
Produce locally
Design the
blister pack to
enhance
adherence to
the 10-day
regime
Blister pack
needs no box
Soap
Produce locally
Leaflet Packaging
Remove
constraint of
fitting in Coca-
Cola crate
Produce locally
Produce re-fill
option
4Learning – zinc packaging design
62. ORS
Reduce number
of sachets to 4
NOTE: This will
also enhance
adherence
Zinc
Produce locally
Design the
blister pack to
enhance
adherence to
the 10-day
regime
Blister pack
needs no box
Soap
Produce locally
Leaflet Packaging
Remove
constraint of
fitting in Coca-
Cola crate
Produce locally
Produce re-fill
option
4Learning – soap
63. ORS
Reduce number
of sachets to 4
NOTE: This will
also enhance
adherence
Zinc
Produce locally
Design the
blister pack to
enhance
adherence to
the 10-day
regime
Blister pack
needs no box
Soap
Produce locally
(still to be achieved)
Leaflet Packaging
Remove
constraint of
fitting in Coca-
Cola crate
Produce locally
Produce re-fill
option
4Learning – soap
64. ORS
Reduce number
of sachets to 4
NOTE: This will
also enhance
adherence
Zinc
Produce locally
Design the
blister pack to
enhance
adherence to
the 10-day
regime
lister pack needs
no box
Soap
Produce locally
Leaflet Packaging
Remove
constraint of
fitting in Coca-
Cola crate
Produce locally
Produce re-fill
option
4Learning – leaflet
66. ORS
Reduce number
of sachets to 4
NOTE: This will
also enhance
adherence
Zinc
Produce locally
Design the
blister pack to
enhance
adherence to
the 10-day
regime
Blister pack
needs no box
Soap
Produce locally
Leaflet
Simplify –
single fold.
Same leaflet
for all formats
Packaging
4Learning – packaging
67. ORS
Reduce number
of sachets to 4
NOTE: This will
also enhance
adherence
Zinc
Produce locally
Design the
blister pack to
enhance
adherence to
the 10-day
regime
Blister pack
needs no box
Soap
Produce locally
Leaflet
Simplify –
single fold.
Same leaflet
for all formats
Packaging
Remove
constraint of
fitting in Coca-
Cola crate. Only
4% of retailers
used this option
Produce locally
Produce re-fill
option
42014 | Incorporating the learning into the scale-up
77. Our starting point
What we did next Next moves
What we did What we learned
Medical Innovations – Kit Yamoyo and its value chain
11th Medical Innovations Summit 2015, Royal Society of Medicine 12-Sep-15
2 3
54
1
78. Scale-up – from 2015
Control
KYTS-LUSAKA
Trial – 2012-13
Transition – from 2013
Transition
Intervention
KYTS-ACE
Progress towards national coverage
80. Campaigning for…
1. 200ml ORS sachets for home use
2. Co-packaging of ORS and Zinc
3. ORS and Zinc as over the counter
medicines
4. People to understand that all our
designs, learning and findings are theirs
to take and use for FREE – we are NOT
promoting a product – we promoting a
game-changing new approach to
diarrhoea treatment in the home
84. 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. (forthcoming). 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).
A note on the data contained within this presentation
Editor's Notes
[Presentation description: This presentation describes the progress of UK charity ColaLife from its initial concept to ‘piggyback’ simple medicines, at the ‘last mile’ of distribution in developing countries, through to the results and learning from the 2 year trial in Zambia, to scale-up plans to cover the whole of Zambia and spread designs and learning more widely.]
Good morning everybody. My name is Simon Berry and I’m going to talk to you about innovation and diarrhoea.
I was last here 4.5 years ago when all I had was:
• two observations
• an idea and
• a determination to do something about the high mortality rates among young children in developing countries.
I’d like to thank Paul Summerfield for giving me that opportunity that helped build our credibility at such a crucial time.
Paul obviously had an inkling that something would happen! And it has.
This is me reporting back.
[Omit: There are other supporters here too and I’d like to mention just one, at the risk of upsetting the others. There is a young women here from Tiffin Girls School. My partner in life and ColaLife, Jane, went to Tiffin Girls School a few years ago and my daughter now head the design and technology department there. The school has raised funding for ColaLife. So please can the student here please take our thanks back to the school.]
Before I start though a quick work on ColaLife.
ColaLife is a very small relatively new organisation, founded by Simon and Jane Berry in 2008/9.
Although Coca-Cola and other corporates have helped us with learning and knowledge, we are completely independent.
Our strategy for impact is to stay small, with very low overheads, and openly share findings, learning and IP so that larger organisations can adopt and adapt these for faster impact. The charity has no commercial interest in the product we’ve designed.
I also want to recognise my colleagues.
Jane works with me full-time when she hasn’t got Shingles which is the case at the moment. She is my partner in life and ColaLife.
Rohit is based in Canada and works with us part-time. He is our public health adviser and it completing his Doctoral in Public Health at Johns Hopkins University.
I’ve split this short presentation into 5 parts
Our starting point.
This is the first observation I mentioned
Against this backdrop, 1 in 5 children didn’t make it to their 5th birthday.
– 25 times higher than here in Europe.
ColaLife wants to make this picture for developing countries look like…
… this one.
Just as shocking as this level of mortality is the fact that diarrhoea, an easily treated condition, is the second biggest killer. It was back in 1985 and still now.
Dehydration from diarrhoea kills more children than Malaria and HIV/AIDS combined.
Just as shocking as this level of mortality is the fact that diarrhoea, an easily treated condition, is the second biggest killer. It was back in 1985 and still now.
Dehydration from diarrhoea kills more children than Malaria and HIV/AIDS combined.
Against this backdrop of high mortality and the lack of essential medicines to treat diarrhoea, you can get a Coca-Cola (and other FMCGs) in most places,
While community shops are well stocked with the things people want, the public sector struggles to keep public health centres stocked with essential medicines.
This brings me to the idea…
Coca-Cola get everywhere so if we put medicines in the crates that would get everywhere too.
So what did we do with those two observations and that idea.
We spent two years sharing and promoting the idea and developing support for it online in the hope that a children’s organisation would pick it up. None of them would. So in June 2010, Jane and I gave up our day jobs to try to and get a trial of this idea underway somewhere in Africa.
We were helped with an award from ‘UnLtd’, the UK Foundation for Social Entrepreneurs.
Despite humble resources, our Facebook Group and our blog that had been ongoing for 2 years at this point had generated global interest – even excitement - in what we were trying to do.
This is what our kitchen table looked like on a typical day:
Jane and I were in the UK.
Rohit was on Skype from Canada with his voice coming out of my laptop.
And we had UNICEF and Harvard on the speaker phone from the USA.
Harvard were working on recommendations to UNICEF who realised that MDG #4 (child mortality) was going to be missed. Harvard had found us online.
The Harvard Report to UNICEF recommended that UNICEF support innovations like ours.
The objective was to raise the money needed to travel to Africa to work on a trial plan with local stakeholders. We raised over £6,000.
The cycle ride funded three trips to Zambia where Jane and I worked with local partners on a plan for a trial of the ColaLife idea. We spoke to 16 NGOs, the Ministry of Health and its distribution parastatal – Medical Stores Limited, as well as corporates like SABMiller/Zambian Breweries – the Coca-Cola bottler in Zambia.
We visited zambia three time for two weeks each time and during this time we put together this ‘unlikely alliance’ and we’d co-designed a trial and had a plan.
Putting this partnership together was no mean feat. Not many partnerships involve UNICEF and the world’s biggest brewer (SABMiller), or Coca-Cola and a small, developing-world pharmaceutical manufacturer – Pharmanova.
This is what we set out to do in the trial.
We wanted to see if our idea would increase the USE of ORS and Zinc in the treatment of diarrhoea in the home. We knew, from many other studies done by others, that if we could do this we would save children’s lives.
In order to increase use we need to increase ACCESS to ORS and Zinc. And by access we mean, co-packaged ORS and Zinc in the hand of mother/carer who know what it is and how to use it.
In order to increase ACCESS we need to do two other things:
1. Increase AVAILABILITY of the co-packaged ORS and Zinc in communities, and by AVAILABILITY we mean the co-packaged ORS and Zinc on the shelves in retail shops serving the communities and
2. Increase AWARENESS among mothers/carers of the benefits of ORS and Zinc in the treatment of diarrhoea
This is the trial timeline.
• 9-montn set-up period
• 12-month trial
• 3-month wind-up which never happened
So what did we learn from the trial?
This was perhaps our most important activity in the whole trial – talking to mothers about diarrhoea treatment in the home.
We learned four key things:
Litre sachets are too big
Measuring water is problem
We also got an indication of how much they might pay for an anti-diarrhoea kit
And how they’d like it branded
This is the resulting product – Kit Yamoyo – is:
• attractive – aspirational even
• it contains 200ml sachets of ORS
• the packaging acts as a measure for the water
• it’s also a mixing device for the ORS
• and can be used as a cup
• that fitted in a Coca-Cola crate
The Kit Yamoyo has captured people’s imagination and won many global health, design and innovation awards.
In Sep-13 it was featured at the UN General Assembly as a breakthrough innovation in Child Health.
In Mar-14 it was show-cased by PATH and PSI in their Best Buys for Global Health initiative.
Before the trial started we conducted a baseline survey and this is what we found:
• Nobody in the trial areas sold ORS or Zinc. The only source was the public sector through health centres and stock-outs here were regular
• Less than 1% of children were being treated with ORS and Zinc – the 10-year-old international standard
• the nearest source of ORS (the health centre) was an average of 7.3km away.
• The ORS sachets available were 1 litre sachets and only 60% of carers mixed these correctly
So it’s no wonder that diarrhoea holds its position as the 2nd biggest killer of under 5 children.
So what happened during our 12-month trial?
• From a standing start we sold 26,000 kits to retailers serving the trial communities
So what happened during our 12-month trial?
• We increased treatment rates from <1% to 45%
So what happened during our 12-month trial?
• We reduced the distance mothers had to travel to access treatment – shops are a lot closer to people’s homes that clinics
So what happened during our 12-month trial?
• And through the design of the kit we increased correct measurement of the ORS from 60% to 93%. When using Kit Yamoyo, 93% of mothers got the mixing right
Before and after…
But here’s the shock:
• Only 4% of the 26,000 kits sold travelled to the village in Coca-Cola crates
In practice, this is what happened.
It wasn’t the space in the crates that was important, it was the space in the market. We had designed and marketed an aspirational product (just like Coke) which people wanted and which retailers could make a profit bring to the communities and selling (just like Coke).
We design and product TOGETHER WITH its value chain.
So what have we done since the trial?
We never wound-up after the ColaLife trial as carers in the trial areas had got used being able to access Kit Yamoyo in their local shop in the trial areas.
We began trialing in 2 remote rural districts (see dark blue dots) – Katete and Kalomo – each 5 to 7 hours drive from the capital Lusaka.
With transitional funding we’ve been able to expand the coverage within the trial districts and move into the neighbouring districts including the trial control districts.
This has been done with very little funding from the bases established for the trial while we seek additional funding for full scale-up.
In parallel with this we have done a root and branch review the the Kit Yamoyo design to drive out the subsidy while maintaining as many of the original features as possible.
No element of the kit was exempt from this review, not even the award-winning packaging.
First ORS
The small sachets, making up only 200ml, were very successful. We had put 8 in each kit, to mimic the ‘traditional’ prescription of 2*1 litre sachets… however…
So, we reduced the number of ORS sachets in the kit to 4 (from 8).
This will halve the cost of the ORS component while at the same time enhance adherence to the combined ORS and Zinc regime (as there will typically be no left over sachets and mothers/carers will have to buy a new kit).
Looking at the Zinc component…
We want to see if we can improve adherence to the ten day regimen for Zinc by better design.
Our pharmaceutical partner in the trial as been inspired to produce Zinc locally.
This provides the opportunity to design our own Zinc packaging, and Pharmanova has taken this on board.
The Zinc now has local approval to be manufactured in Zambia – reducing costs and avoiding import costs, breaks in supply, delays in customs, short use-by dates, and unlabelled or poorly labelled Zinc strips.
The locally produced Zinc will be cheaper and there will be no need for it to be in its own box which will also reduce costs.
Looking at the soap component…
We are working to persuade the only soap manufacturer in Zambia to produce a small 25g bar of soap.
This will replace the soap imported from India – and will cut costs and import delays.
The manufacturer also plans to sell the soap as a stand-alone product. The economic environment in Zambia and lack of a big anchor client has delayed this.
Looking at the leaflet…
We have simplified the leaflet and reduced costs by making one single fold format that will serve for all product formats.
We found that clear, high quality, graphical instructions were preferred over translations into multiple local languages.
Looking at the packaging…
Because the kit no longer needs to fit in Coca-Cola crates we can move to cheaper packaging options.
In the scale-up we will be using two new packaging formats:
• a screw-top
• a flexible pack
The screw-top jar is 40% cheaper than the trial packaging and can be manufactured locally using a mold developed by our packaging partner PI Global and manufactured in China.
This has all the functionality of the trial packaging but is a better measuring, mixing and storage device and cup.
However, this will retail at around K8.00 with no subsidy which will be too expensive for some of our target group.
The flexi-pack is very cheap to transport – over 150 can fit in one carton.
The much simpler flexi-pack achieves our target price of K5.00 and retails the measuring functionality.
Both products will be available in selected supermarket stores during scale-up. But the flexi-pack will be the primary product in other outlets.
In early 2015 we secured funding for scale-up in peripheral districts of Zambia – KYTS-ACE. These are not the places you would choose to scale-up a commercial product but this is where the funding is!
However, we will be working with a supermarket chain in 4 of these districts. However, most kits will be going out through the public sector.
452,000 Government-branded kits have been ordered and if our ‘Lives saved’ model developed from the trial holds true, these will save 1,350 lives.
While in the private sector the Kit yamoyo version of the product will be promoted using the same techniques that Coca-Cola uses.
Product Branding, Name and photo are based on our original focus group’s preferences.
While in the private sector the Kit yamoyo version of the product will be promoted using the same techniques that Coca-Cola uses.
Product Branding, Name and photo are based on our original focus group’s preferences.
These micro-retailers can then advise their community on product benefits and the wider issues around diarrhoea
Thanks to DfID funding we will start scale-up where most people live - over 2 million of Zambia’s 13 million people live here.
As the final step to national scale-up we will seek support to develop the market in the Copperbelt (green circle) where another 2 milllion live.
And at the same time we are campaigning for:
The production of 200ml ORS sachets for treatment of diarrhoea in the home – we don’t care who produces them – we just want them to be produced and available on the market.
The co-packaging of ORS and Zinc to improve the likelihood that they are dispensed together
ORS and Zinc to be classified as over the counter medicines. They are in many places but not everywhere. This classification will mean that the all pervasive FMCG distribution channels will be open to co-packaged ORS and Zinc
People to understand that ColaLife is not selling anything! We want to give all our designs, learning and findings away for others to exploit for free. We are not selling a product or ideas, we are promoting a game-changing approach to diarrhoea treatment in the home
It was the early commitment of funds to the ColaLife idea that leveraged all the other support for the trial and subsequent to the trial additional funders have come on-board. Notably Ceniarth and the Isenberg Family Charitable Foundation have provided ‘catalytic’ funding and we have always enjoyed support from individual supporters.