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We’ve had 10 years of Top Tens: an exciting decade when ColaLife achieved much more than we ever expected. 2019 marked the start of a new phase: with our work on the ground in Zambia complete, we moved on to forge partnerships that will globalise our work: to make ORS and Zinc for childhood diarrhoea easily accessible to all who need it. As our achievements become the successes of others,  we’re recording Five Top Achievements for 2019.

1. Co-packaged ORS and Zinc on WHO’s Essential Medicines List.

This is probably our biggest single achievement to date. ColaLife instigated a drive to persuade the World Health Organisation (WHO) – which has recommended ORS and Zinc for diarrhoea for more than a decade – to actually list the co-packaged treatment on its Model Essential Medicines Lists. Why is this apparently small change a big deal? Both medicines were listed separately – but because of this, they were all too often procured separately by governments and aid agencies, distributed separately and very rarely prescribed together. That meant that the global recommendation for a sick child to get both medicines was rarely achieved on the ground. Our work in Zambia, and partners’ work elsewhere, helped us to realise that this small, obvious change could make a big impact.

Things move slowly in global health and the process took more than 2 years (see timeline). It needed a truly global effort. ColaLife recruited the Diarrhoea Innovations Group (DIG) to the cause in Nov-17 and we were then the driving force behind a formal application, written by us and fellow DIG members. This was submitted in Nov-18.

Both the core WHO Essential Medicines List (EML) and the WHO EML for children now read like this:

The updated WHO EMLs were published in Jul-19.  This is a huge achievement as it effectively moves our work out of the “innovation box” and into the mainstream of child health. >>more

2. The millionth co-pack left the factory in Zambia.

The Kit Yamoyo production line at Pharmanova

On 16-Jul-19, nine months after our last trip to Zambia, the millionth ORS/Zinc co-pack left Pharmanova’s manufacturing plant in Lusaka. This kit was part of an order for just 100 kits from a small Lusaka wholesaler, continuing the private sector distribution ColaLife helped establish from 2011-2018. Much larger orders are now coming in from government – see below – but we are delighted that our work in developing private sector value chains continues to underpin commercial endeavour across the country. We estimate that at least one life is saved and a million lives improved for every million kits used.  >>more

3. Zambian Government orders 1 million co-packs.

On 2-Oct-19 the Zambian government placed a single order for 1 million ORS/Zinc co-packs with the Kit Yamoyo manufacturer in Lusaka. By the end of the year, this order was fulfilled. It brings the total number of co-packs procured and distributed by the government, to be given out free in health centres, to a total of just over 1.8 million since we first designed and trialled the Kit Yamoyo co-pack in Zambia in 2011. Government policy is now to ‘flush out’ packets of ORS alone and replace it with co-packs of ORS and Zinc – ensuring that this becomes the ‘go to’ treatment for diarrhoea.  >>more.

We see the on-going production of the co-pack (Achievement 2) and the engagement of the Zambian government, as very strong evidence that the change we helped create in Zambia will be self-sustaining. >>more on self-sustaining development.

4. Ceniarth agree to support ColaLife until 2021.

Ceniarth – a single-family office focused on funding market-based solutions that benefit underserved communities – have supported ColaLife since 2014. Ceniarth see the listing of co-packaged ORS and zinc in the new WHO Essential Medicines list as a huge opportunity to globalise our impact. If all cases of diarrhoea were treated promptly with both ORS and zinc, 90% of child deaths would be avoided. Cascading the co-packaging recommendation from the WHO EML to national EMLs will greatly increase the number of diarrhoea cases treated with both ORS and Zinc. The graphic below shows the present situation. Currently, only 5 countries have co-packaged ORS and Zinc on their national EML.

Ceniarth’s support will fund Jane and Simon part-time until the end of 2021 to enable them to participate fully with other DIG members to get national governments to adopt the new WHO recommendation and incorporate co-packaged ORS and Zinc into their own Essential Medicines Lists. The funding also includes support to publish the different aspects of ColaLife’s work in academic journals. This work will be led by Rohit and Beth. We are particularly pleased to be working again with Beth. >> more

5. Taking the message global.

In Nov/Dec-19 Simon contributed to two conferences run within a week of each other in Nairobi, Kenya. At the first – the Africa Health Extension Summit (#AHES19) – he gave a keynote presentation on the role of innovation in augmenting healthcare. In the second – Impact!Africa – run by the British Council and Ashoka, he participated in a panel session on innovation, policy and regulation.

These were both great events and Simon met some inspiring people. However, this could well be Simon’s last trip to Africa, as we reassess our use of air travel in the light of the climate emergency. We don’t completely rule out future air travel but trips to Europe will be done by train and we will be trying to do as much as possible over video links and through the creative use of social media.

Finally, as we say every year . . . a big thank you to everyone who has supported ColaLife throughout 2019. We continue to have a significant impact and we couldn’t do this without our supporters. 

Onwards and upwards.