ColaLife Presentation to the Janssen Global Public Health Team, 26-Aug-15

Global Public Health Team, Janssen, Beerse, Belgium ColaLife learning and opportunities in emerging markets

Simon Berry

ColaLife is a charity registered in the UKCharity 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

2013

1985What is ColaLife and who am I?

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

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

Coca-Cola gets to most places, life-saving medicines don’t

Under 5 mortality is unacceptably high…

…when compared with more developed countries

Diarrhoea is the second biggest killer

Diarrhoea

Sep 2010 | Enrolled into the J&J Innovation Bootcamp

Kris Pintens

Michelle Akande

Johan Offermans

Jane Berry

Alexander Bielders Simon Berry

Some of the ColaLife funders

Isenberg Family Charitable Foundation

Awards | The Kit Yamoyo has won many global awards

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

impact Mothers in underserved rural communities increase use of ORS and Zinc in home treatment of diarrhoea

purposeTarget communities in two under-served rural districts have improved access to ORS and Zinc

outputsProfit-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

Dec 2011

The trial timeline

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

Kit Yamoyo

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

Mimicking Coca-Cola – Community-based marketing

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

0Nobody sold ORS or Zinc in the private sector.

Stock-outs in the public sector were common.

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

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

7.3kmWas the average distance to ORS.

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

7.3kmWas the average distance to ORS.

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

7.3kmWas the average distance to ORS.

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

7.3kmWas the average distance to ORS.

>26kkits sold into the two remote rural trial areas in 12 months.

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

7.3kmWas the average distance to ORS.

>26kkits 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%.

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

7.3kmWas the average distance to ORS.

>26kkits 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%.

2.4kmThe distance to ORS/Zinc in the trial areas was reduced by two-thirds from 7.3km to 2.4km.

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

7.3kmWas the average distance to ORS.

>26kkits 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%.

2.4kmThe 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.

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

7.3kmWas the average distance to ORS.

>26kkits 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%.

2.4kmThe 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.

Manufacture

Assembly

Distribution

WholesaleK3.10

RetailK3.70

CustomerK5.00

Value

Kit Yamoyos

Demand PULLED the Kit Yamoyo into rural communities

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

What we learned (2)

3. Behavior change works better with a product4. 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?

We continue to learn – use of tablets in the scale-up

We continue to learn – use of tablets in the scale-up

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

Network diagram – the trial

http://www.colalife.org/2013/11/05/the-cotz-network-diagram/

Network diagram – the scale-up

Network diagram – sustainability

Voucher system – scale-up version

Voucher system – mark 2

Voucher system – scale-up version

Voucher system – scale-up version

Voucher system – scale-up version

Voucher system – scale-up version

Voucher system – scale-up version

Voucher system – scale-up version

Voucher system – scale-up version

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, pharmacists4. 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

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

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

Questions?Comments?