ColaLife Presentation to the Janssen Global Public Health Team, 26-Aug-15
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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.
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ColaLife Presentation to the Janssen Global Public Health Team, 26-Aug-15
- 1. Global Public Health Team, Janssen, Beerse, Belgium ColaLife learning and opportunities in emerging markets 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. Our starting point Global Public Health Team, Janssen, Beerse, Belgium ColaLife learning and opportunities in emerging markets 26-Aug-15 What we did What we learnt 2 3 How we can support 5 1 Nuggets 4
- 4. Our starting point Global Public Health Team, Janssen, Beerse, Belgium ColaLife learning and opportunities in emerging markets 26-Aug-15 What we did What we learnt How we can support 2 3 5 1 Nuggets 4
- 5. Coca-Cola gets to most places, life-saving medicines don’t
- 6. Under 5 mortality is unacceptably high…
- 7. …when compared with more developed countries
- 8. Diarrhoea is the second biggest killer Diarrhoea
- 9. Sep 2010 | Enrolled into the J&J Innovation Bootcamp Kris Pintens Michelle Akande Johan Offermans Jane Berry Alexander Bielders Simon Berry
- 10. Some of the ColaLife funders Isenberg Family Charitable Foundation
- 11. Awards | The Kit Yamoyo has won many global awards
- 12. Our starting point Global Public Health Team, Janssen, Beerse, Belgium ColaLife learning and opportunities in emerging markets 26-Aug-15 What we did What we learnt How we can support 2 3 5 1 Nuggets 4
- 13. impac t 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
- 14. Dec 2011 The trial timeline
- 15. 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
- 20. Kit Yamoyo
- 30. 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
- 31. Mimicking Coca-Cola – Community-based marketing
- 32. Our starting point Global Public Health Team, Janssen, Beerse, Belgium ColaLife learning and opportunities in emerging markets 26-Aug-15 What we did What we learnt How we can support 2 3 5 1 Nuggets 4
- 33. 0Nobody sold ORS or Zinc in the private sector. Stock-outs in the public sector were common.
- 34. 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
- 35. 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.
- 36. 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.
- 37. 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.
- 38. 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.
- 39. 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%.
- 40. 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.
- 41. 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.
- 42. 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.
- 43. Manufacture Assembly Distribution Wholesale K3.10 Retail K3.70 Customer K5.00 Demand PULLED the Kit Yamoyo into rural communities
- 44. What we learned (1) 1. Value chain • Affordable • Profitable for all • Perceived value • Delivers to expectations (use of standards) • Product design • Attractive • Aspirational 2. Sensible use of subsidy • Top-end subsidy (non-corruption of the value chain) • Use of vouchers
- 45. What we learned (2) 3. Behavior change works better with a product 4. Organisations already exist but may need: • Bringing together in new ways • Capacity building 5. Partnership and shared risk • Donor support for trials and start-up • Donor support for awareness raising and training • Private sector for sustainable production 6. Think about multi-channels to market • Are the private sector needs different from the public sector needs?
- 46. We continue to learn – use of tablets in the scale-up
- 47. We continue to learn – use of tablets in the scale-up
- 48. Our starting point Global Public Health Team, Janssen, Beerse, Belgium ColaLife learning and opportunities in emerging markets 26-Aug-15 Nuggets What we did What we learnt How we can support 2 3 5 1 4
- 49. Network diagram – the trial http://www.colalife.org/2013/11/05/the-cotz-network-diagram/
- 50. Network diagram – the scale-up
- 51. Network diagram – sustainability
- 52. Voucher system – scale-up version
- 53. Voucher system – mark 2
- 54. Voucher system – scale-up version
- 55. Voucher system – scale-up version
- 56. Voucher system – scale-up version
- 57. Voucher system – scale-up version
- 58. Voucher system – scale-up version
- 59. Voucher system – scale-up version
- 60. Voucher system – scale-up version
- 61. Insights for Janssen? - A wider view of Access? Access considerations might usefully be expanded: 1. Asking the customer • Review products destined for African market • Find out what people WANT not on what you think they NEED 2. Adapting better to the African context • Insights from working more closely with NGOs, local private sector 3. Advocacy with government, regulators, pharmacists 4. Deliver Advantage • All along the value chain – ‘price minus costing’ not ‘cost plus pricing’ 5. Awareness-raising • Not just advertising • Invest in customer education, retailer or wholesaler training 6. Aspiration • Produce products that people aspire to use • The poor are as brand and quality aware as anybody else
- 62. Our starting point Global Public Health Team, Janssen, Beerse, Belgium ColaLife learning and opportunities in emerging markets 26-Aug-15 What we did What we learnt How we can support 2 3 5 1 Nuggets 4
- 63. Our partnership – possible next steps 1. It’s about partnership for global impact (not funding) 2. Sharing our learning to impact on the way Janssen does business in Africa (open access with support from ColaLife) 3. Use ColaLife as a catalyst for change • The grain in the oyster / the yeast in the bread 4. For this to work ColaLife would need a point of contact with the Management Board and Global Public Health team
Notas do Editor
- 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.
- This short presentation is structured as 6 sections
- This short presentation is structured as 6 sections
- ColaLife was born from the question: Coca-Cola get everywhere but life-saving medicines don’t. Why?
- Together with the fact that 1 in 8 children in developing countries die before their 5th birthday.
- This is 20 to 30 times higher that the mortality rate in more developed countries. 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.
- Started with our recruitment into the Johnson & Johnson Innovation Boot Camp programme
- 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.
- J&J/Janssen are already a big part of what the World sees as a break-through innovation and there is an opportunity for us to build on this and do more together. I will present some ideas on what form this might take at the end of the presentation.
- This short presentation is structured as 6 sections
- The outline of the results framework…
- 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.
- 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.
- This short presentation is structured as 6 sections
- 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.
- 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).
- This short presentation is structured as 6 sections
- The Access to Medicines Index and other similar models usually concentrate on 4 or 5 facets of Access – eg Availability, Accesibiity, Acceptability, Affordability, Adherence Our experience indicates that it may be worth considering and INVESTING in additional access considerations, for example: - ASKING customers what they want, exploring what their real issues/problems are – NOT just assuming you know what they need. Could be as simple as a smaller pack size or better usage instructions. ADAPTING better to the African context; obtaining insights from working more closely (eg learning projects) with NGOs, local manufacturers distributors or wholesalers Improving ADVANTAGE associated with your products in the local context. Considering both better design of products AND how they are distributed. ‘Reverse engineering’ pricing to achieve maximum costs to hit the target acceptable retail price – whilst maintaining acceptable margins. Also consider working with government to help them hit particular priority targets AWARENESS – Invest in CSR programmes – wider/deeper than just advertising – eg customer education (eg radio features); training for wholesalers and or retailers of your products in enterprise skills/product care/ benefits (NOTE – SABMILLER did this in S Africa)
- This short presentation is structured as 6 sections
- 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).
- 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).