Donors fund many projects in less developed countries. This is a good thing. I am proud as a UK tax payer that some of the tax I pay goes to help support less developed countries. The problem is that many projects are established with the best intentions but fail to deliver long term benefits and some even undermine and weaken local systems because of the way they are implemented.
That is one of the reasons why people get quite excited when they see the legacy that the Kit Yamoyo work has generated both nationally in Zambia and worldwide. But what is this legacy and how big is it really?
Jane and I are back in Zambia for the first time in five years so enquire about this legacy and celebrate it with the Zambian organisations and people who created it. This will culminate in an event on 6-Jul-2023 where we will officially hand over the Kit Yamoyo trademark to Pharmanova who we worked with to develop and test Kit Yamoyo and who have been manufacturing it ever since.
While here, we’ve been given access to the up to date ex-factory sales data and with the kind permission of Pharmanova I am publishing a summary here in an attempt to quantify the Kit Yamoyo legacy.
Donors supported the initial trial and partial scale-up of Kit Yamoyo for seven years up until Sep-2018 when donor support ended and ColaLife completed its role in the programme. It has been 4.5 years since donor support ceased.
Since the project began a total of 1.83 million co-packs have left the Pharmanova factory.
42% left during the seven years of donor support. 58% have left in the last 4.5 years since donor support ceased. This is despite the COVID pandemic and difficult local economic conditions – in particular high inflation.
Most would agree that this is a significant legacy. Things certainly haven’t collapsed on the withdrawal of donor support. There are two components to this legacy: the private sector contribution and a public sector contribution. Let’s look at the private sector contribution first.
Private sector contribution – Kit Yamoyo
Today, you will find Kit Yamoyo in most Shoprite stores nationwide and in some other outlets. This picture was taken this week (29-Jun-2023) in the Shoprite store in EastPark Shopping Mall. This is a significant achievement. We believe that Zambia is the only country in the World where you can get this life-saving treatment (ORS co-packaged with Zinc), as recommended by WHO, in a national supermarket.
However, the situation for the commercial format – Kit Yamoyo – has been tough.
Since the start of the project 220,000 Kit Yamoyo co-packs have left the Pharmanova factory. 68% left during the 7-year donor supported period and only 32% in the last 4.5 years since the donor support ceased. There are several reasons for this including:
- High inflation – when Kit Yamoyo first went on sale in Shoprite in 2016 it cost K8.19. It now costs K19.99.
- The lack of social marketing – this could not be sustained on a commercial basis after donor support ceased.
- The availability of the government format free of charge may also have a negative impact on commercial sales.
However, the private sector format is important for a number of reasons:
- The continuous production of Kit Yamoyo for the private sector keeps the knowledge and manufacturing processes ticking over so that they can respond quickly when a large government order comes in.
- Although the purchases of Kit Yamoyo since donor involvement ceased are low, at 70,000, these are 70,000 kits the government didn’t have to buy and distribute representing a saving of an estimated USD 105,000 (assuming a cost of $1.50 per kit to purchase and distribute).
There is still significant scope for increasing private sector sales but this would need a properly funded social marketing campaign. In the absence of this we have to be content with the modest contribution the commercial format contributes to the overall legacy.
The public sector contribution – the GRZ ORS/Zinc Co-pack
The large majority, 1.61 million of a total of 1.83 million, of the co-packs leaving the factory have been the government format of the co-pack – the GRZ ORS/Zinc Co-pack.
38% of these were financed by donors over the 7 years of their involvement but 62% have been bought by the government in the 4.5 years since donor support ceased.
By the end of 2023, the number of kits bought by the government will increase by a further 663,500 as the current government order for 900,000 is fully delivered.
More kits will be bought and distributed by the government in the next six months than were provided during the 7-year donor-supported period (663,500 vs 612,050).
So, quite a legacy in Zambia.
But things didn’t stop there. From 2017 ColaLife worked with colleagues in the now defunct Diarrhoea Innovations Group (DIG) to submit an application to WHO to change the WHO Model Essential Medicines List (EML). This application included the evidence generated in Zambia that convinced the Zambian government to make co-packaged ORS and Zinc the ‘go to’ treatment for childhood diarrhoea. This application was successful. So, the legacy of the Kit Yamoyo work in Zambia will also have a global impact.
In a future blog post I will look at how and why we think this legacy was achieved [see: How was the Kit Yamoyo Legacy achieved published on 5-Jul-2023].
