Zambia Diary | Day 8, Visit 3 | From lowlight to highlight

On Tuesday night (17/5/11) I was worried when a potential problem was revealed to me that I hadn’t even thought about. Fortunately, we don’t get a lot of unpleasant surprises in ColaLife because we have been kicking the concept around our thousands of supporters for three years and this has meant that a lot of the issues we are likely to face have been raised and we’ve had time to think and consult on how we might deal with them.

So what was the potential problem?

Every country has some sort of Pharmaceutical Regulatory Authority (PRA). This authority registers medicines and medicines need to the registered before they can be sold. In Zambia medicines are classified as: GS (General Sales); P (Sales under the supervision of a Pharmacist), POM (Prescription Only Medicines) and Narcotic (I’m not sure what this means but it sounds pretty serious).

The components of the ADK (Anti-Diarrhoea Kit) we are proposing all fall under the GS category with things like Aspirin. This means they can be sold in any retail outlet – just like Coca-Cola. So far so good.

What I hadn’t thought about was package size. The potential problem arose when we went to MSL on Tuesday. There we saw precisely the product we wanted: Zinc?? but it was packaged in small boxes of 10 blister packs, each containing one course of treatment (ie 10 tablets). So each box contained 10 treatments. The boxes were labelled and contained the necessary instruction leaflet but the individual blister packs were white and had no markings on them at all.

I’m no expert but I would bet my house on the fact that the Zambia PRA (or any other PRA for that matter) would NOT allow us to break up a box of ten blister packs and put individual, unmarked blister packs into and ADK even if we did write our own instructions!

This whole experience is a real eye opener for me. What it means is that a medicine can be available in a country but can be inaccessible to the end user because of the way it is packaged. Obviously, it is much more cost-effective to put 10 blister packs in one box with a single set of instructions but this makes the medicine less accessible to an individual mother with a child with diarrhoea. She wants, and can only afford, one treatment not 10.

At this point I am in minor panic mode but trying not to let it show.

Time to ignite the ColaLife supporters network to see if we can find a solution.


  1. Hi Simon. So the crux of the problem is that the blister packs need to have all of the information printed on them, is that right? Could the instruction be printed on to address labels and attached to the blisters or is that too labour intensive?

  2. That is right Ian. The sticky label solution would work from a practical point of view for the pilot – it’s all going to be pretty labour intensive and we will be applying ‘anti-tamper’ labels by hand as well. The problem is regulatory. It will add a whole new level of complication doing it this way as we would have to get permission from the PRA. And it may take several months to hear that we CAN’T do this.

    So we need to use items that are already on the PRA list. The trouble is the PRA list (at least the publicly available one) doesn’t specify package sizes. It just specifies the supplier, medicine name, active ingredients and format (ie tablet, syrup etc).

    We’ve got our feelers out one of the suppliers on the list and have asked about their package sixes.


  1. Lucy Gower says:

    Can you help problem solve for ColaLife? #colalife