I wouldn’t normally put pictures of Jane and me on the blog but this is a special occasion.
Jane and I will be leaving the lovely Zambia on 30-Jun-14 as we have been unsuccessful in raising the funding we need for the Kit Yamoyo 3-year scale-up plan. Ever since the surprise decision of Grand Challenges Canada not to support the scale-up we have been struggling to fill the CAD$1m that their withdrawal left. By pausing our presence in Zambia now, we will leave enough money in the budget to enable the crucial frontline activity to continue until Oct or Nov-14 and by then we hope to have the full scale-up plan funded.
Left: Jane laughs with Joe in his shop in Bbillili, Kalomo
Right: Simon talks to Golden and Joy the first 2 retailers to sell Kit Yamoyo (since this picture was taken, Golden’s wife has died and Joy lost a child in childbirth)
It is sad that despite the remarkable impact our approach has had, and the global recognition of this (oh, and you MUST read this), we cannot get the funding we need to move to a full national scale-up. The money is there but it’s just in pots which have their own criteria and associated timelines and geographies that don’t match with ours.
Already, in Zambia, anybody can buy Kit Yamoyos directly from a local manufacturer (Pharmanova). And they are. But so far we haven’t found the final funder to come with us on the national scale-up.
“Why do we need one?” you may ask, given that the product is already in the market. We need donor support to ensure equality by developing markets – like we did in the trial – which are not (yet) of commercial interest. We also need resources to independently evaluate what we are doing so that others can pick up the learning that we are generating and improve access to ORS and Zinc for their own populations. In the trial we increased the percentage of children who received the recommended treatment for diarrhoea from <1% to 45%. And the recommendation we are talking about – ORS and Zinc – is 10 years old! In Kenya the percentage who get ORS and Zinc is 0.34%. What the health sector is doing at the moment to get ORS and Zinc to children isn’t working. Our approach looks like it might.
We are very grateful to the funders that are supporting us. DfID enabled us to move seamlessly from the trial to the start of the scale-up by extending our trial funding. This was crucial as, by the end of the trial, so many mothers were relying on being able to buy Kit Yamoyo in their local shop. But the Johnson & Johnson Corporate Citizenship Trust /Janssen EMEA stand out as a truly remarkable funding partner. When DfID decided we had to spend all their money by 31-Mar-14 (and not 30-Jun-14 as originally agreed) and then wasn’t able to release that funding until 22-Mar-14, it was the J&JCCT/Janssen EMEA funding that kept us afloat. Now that the DfID money is in, spent, and accounted for, it will be the J&JCCT/Janssen EMEA funds that will keep the frontline work going until the end of the year.
Despite the roller-coaster funding ride, we have achieved an amazing amount since the trial ended. And provided we return to the UK and stop drawing on the budget ourselves, we have enough to keep this frontline work on-going at least until the end of the year. We had an implementation partners’ meeting last week and here’s a summary of progress:
- KZF is now active in 12 of the ‘compounds’ (slums) around Lusaka
- The 32 Clinical Officers in these compounds have been trained in Kit Yamoyo
- 110 Ministry of Health staff have been trained as well
- 3 Lusaka wholesalers are now stocking the kit and have re-stocked since their initial recruitment
- 33 retailers have been trained in the compounds
- recruitment of retailers is continuing in these areas
- Eastern Province (one of the trial areas was Katete which is Eastern Province)
- We are now active in 4 districts (up from 1 in the trial)
- 33 Ministry of Health staff have been trained
- 75 new retailers have been trained
- 12 radio phone-in programmes have been run and 20 adverts
- Southern Province (one of the trial areas was Kalomo which is Southern Province)
- We are now active in 5 districts (up from 1 in the trial)
- 55 Ministry of Health staff have been trained
- 74 new retailers have been trained
- 4 radio phone-in programmes have been run and 84 adverts
- Other Districts
- Marie Stopes have brought the kit into their portfolio of health products which they distribute and are buying direct from Pharmanova
- Another significant NGO distributor has shown an interest in distributing the Kit Yamoyo through their network from Sep-14
- We are in liaison with a national Supermarket chain who are interested in the flexi-pack
We can expect a similar expansion over the next quarter within current districts.
But what about sales you ask? Pharmanova sold 17,000 kits between 17-Mar-14 to 31-May-14.
We have one funding iron left in the fire and we really hope that this will come good and we can return in Oct-14 to crank things up to cover the whole country. In the meantime, we have support from a British Foundation which will enable us to the provide part-time support to our Zambian partners from the UK.
We will get there!