This is the 800th and final ColaLife blog post.

We have been telling our story here for nearly 16 years! The website will stay for historic interest and the full blog archive – a blow-by-blow account of the ups and downs, by month, is here: ColaLife Blog Archive. ColaLife may be gone… but we are still here with a few things still to do! We have a few more papers to publish and networks to chivvy. We’ll be doing this work on a voluntary and personal basis.

So, as first announced on 5-Sep-2023, ColaLife is closing today (31-Mar-2024). We’ve achieved far more than we ever anticipated. Both we and our innovative and supportive board of trustees have always been determined, from the outset, that the charity would not outlive its usefulness. Our trustees have been a pleasure to work with over the years – and they deserve our fulsome thanks! You can read about them here.

We are proud of WHAT has been achieved but also HOW we’ve operated. Taking a radically different approach to most development actors, we stayed small, acting as a catalyst with the objective of ensuring that the change we’ve helped create is self-sustaining. This has been noted by others and is the subject of a recent paper in the Journal of Management Science (see Social Entrepreneurs as Ecosystem Catalysts: The Dynamics of Forming and Withdrawing from a Self-Sustaining Ecosystem) and documented in books. We’ve also written about this catalytic approach ourselves, on this blog, in our Playbook and in a published case study (see Institutionalizing Innovation: From Pilot to Scale for Co-Packaged Oral Rehydration Salts and Zinc—A Case Study in Zambia).

Our approach has been academically rigorous; our public health advisor, principal investigator and surrogate ‘son’ Dr Rohit Ramchandani, who first reached out to us in 2010 as a post graduate student, has stayed the course! Rohit built his Doctorate in Public Health thesis on our work; our approach also featured in Professor Paulo Savaget‘s PhD and in film maker Claire Ward’s MA. Our latest young expert, statistician Dario Domingo, has done an amazing job on our soon-to-be published work on how co-packaged ORS and Zinc improved dispensing behaviour in Zambian health centres.

We do hope that others will adopt and adapt these catalytic ways of working, which are ‘lean’, impactful and empowering for local partners. The legacy we left in Zambia continues without us – the award winning ORS/Zinc co-pack we embedded, to stop kids dying from diarrhoea, is locally and profitably manufactured and distributed by the Ministry of Health, NGOs, supermarkets and shops –  managed by colleagues we have had the pleasure of working with, over the last 15 years. The changes we’ve brought about are now lodged within the appropriate, local mainstream organisations – much more powerful and long-lasting than we could ever be.

As we sign off, we’d like to highlight a few things:

1. If you’ve enjoyed this blog please sign up to the ORSZCA Mailing List – this is where the story continues. We would love to remain in contact.
2. We’d like to thank everyone who has supported us on this amazing journey. Without our supporters – and there are thousands of you – we would have got nowhere. You gave us the soft power we needed to get going; initially engaging the BBC and then, through the BBC, The Coca-Cola Company. You’ve gone on to provide encouragement and technical support and many of you have provided donations. Thank you very much.
3. We thank all our funders over the years and would like to give a special mention to Diane Isenberg and Greg Neichin of the impact investors Ceniarth and the Isenberg Family Charitable Foundation. They have entrusted us with their money ever since Diane heard Peter Day’s feature – The Kit of Life (listen again) – on BBC Radio 4 and have helped us keep going through thick and thin and the vagaries of project funding.
4. And finally, we’d like to thank the people of Zambia and our friends – both Zambian and ex-patriot – who live there. You have shown us such kindness and respect over the 10 years we were privileged to live in your beautiful country – and since. The ColaLife impact is your impact.

So, what do we leave behind?

1. Zambia
   1. Changed systems in Zambia, to manufacture ORS/Zinc co-packs and distribute them through the public and private sectors.
   2. An increase in ORS/Zinc coverage rates from <1% in 2012 (our own baseline survey) to 34% in 2018 (Demographic Health Survey, DHS 2018), taking Zambia from a non-runner to the Top Three in Africa.
   3. Increasing levels of production, which have continued to expand in the years after we left Zambia in 2018. Close to a million co-packs left the factory in 2023 alone. This should have increased coverage rates even further and we await publication of the 2024 DHS for confirmation of this.
   4. The institutionalisation of free distribution of ORS/Zinc co-packs in Zambia by the government.
   5. These changes will have led to reduced morbidity and mortality in children in Zambia.
2. Globally
   1. We instigated and secured a change to the 2019 WHO Essential Medicines List to recommend that ORS and Zinc should be ‘co-packaged’ for the treatment of diarrhoea. First suggested by UNICEF in 2009, our Kit Yamoyo was one of the first to do this.
   2. Since the above change, three countries so far have so far added co-packaged ORS/Zinc to their national Essential Medicines Lists.
   3. We drove the foundation of the ORS/Zinc Co-pack Alliance (ORSZCA) – an informal global network seeking to accelerate the uptake of the 2019 WHO recommendation that ORS and Zinc should be co-packaged for the treatment of diarrhoea. We acted as its secretariat and will continue to support its website and curate its online resources on a voluntary basis.
   4. We leave the ColaLife Playbook (now renamed the Co-packaged ORS/Zinc Playbook) as a resource for local champions.
   5. Many aspects of our work are now in the peer reviewed, open access academic press:
      1. Emulating value-chains of fast-moving consumer goods to improve uptake of co-packaged ORS and zinc for childhood diarrhoea: evaluation of the ColaLife trial – BMJ Innovations.
      2. Design thinking to improve rational use of oral rehydration salts: lessons from an innovative co-packaged diarrhoea treatment kit – BMJ Innovations.
      3. Institutionalizing Innovation: From Pilot to Scale for Co-Packaged Oral Rehydration Salts and Zinc—A Case Study in Zambia – Global Health: Science and Practice.
      4. Social Entrepreneurs as Ecosystem Catalysts: The Dynamics of Forming and Withdrawing from a Self-Sustaining Ecosystem – Journal of Management Science.
      5.  Impact of co-packaging oral rehydration salts and zinc on diarrhoea treatment dispensing behaviour in selected rural health facilities in Zambia PLOS Global Public Health [Addendum 11-Apr-2025]

Thank you again for your support. It’s been an exhilarating and impactful journey.

Simon and Jane Berry

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It was a great pleasure for Jane and me to meet up with our friends from PI Global yesterday (14-Mar-2024) for a coffee and a long chat at the Young V&A. Since it opened last year the Young V&A has been exhibiting the original Kit Yamoyo nestling in a Coca-Cola crate.

ColaLife’s relationship with PI Global started in December 2010. I was at a Christmas event organised by UnLtd for grantees and UnLtd supporters. As the event got underway a smart person clinked a glass and said “We have a very interesting group of people gathered here, are any grantees facing challenges they need help with?”

I stood up and said “We had an idea to co-distribute medicine in Coca-Cola crates. We’ve been to Zambia and there is a lot of interest but we’ve no idea how to implement this practically. We need help designing the packaging.” Then I sat down feeling slightly ridiculous.

Half an hour later Chris Griffin (third from right) came up to me and said “I think we can help.” And the rest is history. The relationship between PI Global and ColaLife was managed by Eric Connolly (far left) and Tim Llewellyn (far right) led the design.

As we moved away from the original co-distribution idea, PI Global stuck with us and supported the transition to scale with Amcor.

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Based on analysis of interviews with key stakeholders in Zambia between May-2017 and Jan-2023, as well as with us, the paper describes the ColaLife Approach: acting in a catalytic way to gather local stakeholders around a new value proposition while gradually making ourselves redundant to create something bigger than ourselves that will go on without us.

The paper concludes that key requirements for success of this approach are that the catalyst organisation and any other external agents (eg donors) are invisible locally and that local systems are respected and strengthened where necessary. These are ideas we have tried to explain and promote for many years; this paper does an excellent job of explaining and framing our approaches and supplying an impressive academic framework.

We hope, in particular, that international donors and international NGOs can find more ways of supporting this approach. It may be challenging but is worth striving for to achieve sustainable system change.

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I’m excited to pass on Clear Solutions‘ first newsletter. They’ve only been going for 4 months and they’ve got lots to report. If you’d like to receive your own copy in future (as we will not be re-publishing them here), please subscribe by going to their website and clicking on the Newsletter link.

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Implementation science is a new field. In this article, we refer to recommendations that we discovered only recently, part of the WHO/ExpandNet framework, and we use them to help analyse and describe how we worked. We would have found such a road map invaluable in 2010, but at the time, we were feeling our way forward – towards building a resilient partnership that would take the lead in future as we bowed out. This was always our intention. We were excited to find the framework and wanted to share how the ExpandNet recommendations worked in the Zambian case.  Co-packaged Oral Rehydration Salts and zinc for diarrhoea is now institutionalised in Zambia and local production is self-sustaining. What aspects of our implementation partnership and our wider approach led to this transformation in Zambia? There are lessons in here for everyone, particularly donors. We hope you enjoy the read!

Institutionalizing Innovation: From Pilot to Scale for Co-Packaged Oral Rehydration Salts and Zinc—A Case Study in Zambia

We wish to thank the editors, peer reviewers and copy editors at the journal Global Health: Science and Practice for their support in getting this into the public domain.

Related peer-reviewed publications

Emulating value-chains of fast-moving consumer goods to improve uptake of co-packaged ORS and zinc for childhood diarrhoea: evaluation of the ColaLife trial (2022)
Rohit Ramchandani, Simon Berry, Jane Berry, Stephen Tembo, Robert E Black. BMJ Innovations 2022;8:169-182.

Design thinking to improve rational use of oral rehydration salts: lessons from an innovative co-packaged diarrhoea treatment kit (2023)
Rohit Ramchandani, Simon Berry, Jane Berry, Beth Anne Pratt, Albert Saka, Robert E Black. BMJ Innovations 2023;9:132-143.

BMJ debate

Should we welcome multinational companies’ involvement in programmes to improve child health? (2015)
S Berry, J Berry, R Ramchandani, N Spencer. BMJ 2015;350:h3046

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This is the fifteenth and final annual round-up of highlights. As we announced earlier this year, ColaLife will be closing down on 31-Mar-2024 having achieved what it set out to do and more. We’d like to thank everyone who has been a part of this journey. It’s been quite a ride. >>more

Here are this year’s highlights.

1. Publications in the academic press

Last year (2022) we got our first paper in the peer-reviewed academic press when BMJ Innovations published: Emulating value-chains of fast-moving consumer goods to improve uptake of co-packaged ORS and zinc for childhood diarrhoea: evaluation of the ColaLife trial. This paper covered the results of the original, co-distribution and co-packaging trial.

This year (2023) BMJ Innovations published a second paper: Design thinking to improve rational use of oral rehydration salts: lessons from an innovative co-packaged diarrhoea treatment kit. This covered the design aspects of the ORS and Zinc Co-pack (Kit Yamoyo). The most important features, as regular readers will know, are the choice of 200 mL ORS sachets and the measuring functionality of the packaging. The paper highlights the processes we used to arrive at this improved design for consumers.

This month we had a third paper accepted for publication this time by the Johns Hopkins journal, Global Health: Science and Practice. This paper is entitled  Institutionalizing Innovation: From Pilot to Scale for Co-Packaged Oral Rehydration Salts and Zinc—A Case Study in Zambia and describes how we went about the scale-up to ensure that our work is self-sustaining beyond our involvement. [Addendum 22-Jan-2024: now published see Institutionalising Innovation – 3rd Peer-reviewed paper published]

And finally, we have just submitted a follow-up paper to Global Health: Science and Practice entitled: Institutionalizing innovation: Toward global scale-up of co-packaged oral rehydration salts and zinc for treating childhood diarrhea – a case study. This covers the process of getting co-packaged ORS and Zinc on the WHO Essential Medicines List. If accepted, this will be our fourth academic paper and will mean that the key areas of our work over the last fifteen years are recorded in the academic press and not just on this blog.

2. Our final visit to Zambia

This was our first trip in five years. A key objective was to use it make some noise around Kit Yamoyo, to celebrate its legacy and reaffirm the commitment of the government and private sector to the product.

A highlight of the the trip was the event – The Kit Yamoyo Story – organised by our manufacturing partner for the last 15 years: Pharmanova. The event celebrated the Kit Yamoyo legacy, discussed how that sustainable legacy was now institutionalised, and looked to the future. The event triggered at least six articles in Zambia’a national press and features on national TV and radio. It cemented relationships with the Ministry of Health and the national supermarket chain Shoprite and others. During the trip this blog went into overdrive and recorded the detail of this event and the activities that went on either side of it:

• Final Visit to Zambia – Week 1
• Quantifying the Kit Yamoyo Legacy
• Final Visit to Zambia – Week 2
• Final Visit to Zambia – Week 3
• So how was the Kit Yamoyo Legacy achieved?
• Event: The Kit Yamoyo Story
• ORS, Zinc and co-pack prices in Lusaka, Zambia
• Final Visit to Zambia – Week 4

3. Proudly Zambian Product of the Year award

From the outset of our work a key objective has been to embed the outcomes of our work in Zambia and over the years we have presented evidence that this has been achieved – for example, see Kit Yamoyo. Proudly Zambia. (2012) and So how was the kit Yamoyo Legacy achieved?. Here is more evidence. On Friday 24-Nov-2024 Kit Yamoyo came second in the Proudly Zambian Product of the Year awards. You don’t get much more embedded than that.

4. Outreach!

Books

Despite the fact that ColaLife is closing down shortly, there is quite a lot of momentum in the system around what we’ve done and how we’ve done it.

The beginning of the year saw us featured in two books: Paulo Savaget’s ‘The Four Workarounds’ and Teresa Chahine’s latest edition of ‘Social Entrepreneurship’. Paulo’s book explores non-traditional problem solving. We are particularly pleased with his sub-title: “Strategies from the world’s scrappiest organisations for tackling complex problems”; it isn’t always big, well-established organisations which effect change. Paulo shadowed us in Zambia when he was a Gates Scholar and PhD candidate at Cambridge University and has written about us before (See: Emulating Value Chains of Consumer Goods to Save Lives). He’s now an Associate Professor at Oxford University. His book describes four workarounds: The Piggyback, The Loophole, The Roundabout, The Next Best. Obviously, we are The Piggyback.

Teresa Chahine is also an academic. She is Senior Lecturer in Social Entrepreneurship at Yale School of Management. We are a much smaller part of this book – a half-page case study (page 150-151). It’s very interesting to retrofit Teresa’s framework to what we actually did. It would have been great to have had her text fifteen years ago.

Both books are available on Amazon. The Four Workarounds, Social Entrepreneurship.

Early next year (on 3-Jan-2024) Carolyn Reily’s book – ‘Leading with Empathy‘ – is published and this features ColaLife as a case study in the section on ‘Legacy’.

Presentation to the Ministry of Justice

Gina Gill, the Chief Digital Innovation Officer (CDIO) at the Ministry of Justice had been given a copy of Paulo’s book and this lead to an invitation to present to the Digital Team at the Ministry of Justice as part of their ‘Transforming with Digital’ programme. The theme was ‘Uniting Around a Common Vision’ and gave us the opportunity to describe how ColaLife has operated (smart networks and all that) and to reflect on the time when we were gearing up for the launch of ColaLife. Then, I was on secondment to the UK Government and had significant contact with members of the Digital Team at the Ministry of Justice. you can view the full presentation and Q&A on YouTube here.

Uniting Around a Common Vision with ColaLife – Transforming with Digital

We thank the Ministry of Justice for their £500 donation to ColaLife.

Exhibitions

The original Kit Yamoyo, nestled in a Coca-Cola crate, has spent most of the year on display in both the Young V&A (London, from July 2023) and the Holon Design Museum in Israel from 22-May to 25-Nov-2023. Here are some pictures from Israel:

Photographer: Dor Kedmi, Courtesy of Design Museum Holon

5. Joint Policy Brief on Co-packaged ORS and Zinc WHO/UNICEF

And we end with something which we’ve spent quite some time on but made very little headway; something that we will take into the New Year with a determination to achieve before ColaLife closes down on 31-Mar-2024.

What WHO and UNICEF say generally has a big impact. Just after we achieved the ORS/Zinc Co-packaging listing in WHO’s Essential Medicines List and before COVID struck at the end of 2019, there was a movement towards WHO/UNICEF making a joint statement on co-packaged ORS and Zinc with the objective of drawing attention to the new recommendation and encouraging national (and, where applicable, state) governments to consider adopting it. We know from decades of evidence that such action would save tens of thousands of young lives, year on year into the future.

We were encouraged that WHO met with us (representing ORSZCA) virtually on 22-Feb-2023. At this meeting it was agreed that a Joint Policy Briefing would be the most appropriate format. Following this meeting we produced:

• A Position Paper requested by WHO on: Defining an ORS/Zinc ‘co-pack’ which is available here  – comments on this are welcome.
• A first draft outline for a policy briefing – this available here as a Google Doc and is open for comment.

However, the WHO and UNICEF representatives we had been dealing with have now stopped responding to emails so in the New Year we will escalate this issue, which we believe, given its expected impact, should be given priority by both WHO and UNICEF.

As always we’d like to thank all those who’ve helped us on our way this year.

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We are very proud to announce that Pharmanova’s Kit Yamoyo came second in the Proudly Zambian Product of the Year awards in Lusaka on Friday (24-Nov-2023). This is a highly contested, prestigious award. Congratulations to Pharmanova’s CEO, Mohammed Umar…

… and to the whole Kit Yamoyo team at Pharmanova.

You can read more about the award on the Kit Yamoyo Facebook page.

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The co-founders of this new non-profit organisation are Dr Charlie Jeong and Martyn James and they are on a mission to increase ORS and Zinc use in populations where diarrhoeal diseases are still a leading cause of child death.

The non-profit, Clear Solutions, is incubated by Charity Entrepreneurship, an organisation that supports creation of cost-effectiveness oriented charities. Clear Solutions’ initial focus is strengthening last-mile delivery and caregiver guidance with Community Health Workers, and they are developing their strategy with input from other organisations including ColaLife.

In Charlie and Martyn’s words:

“We recognise the enormous effort that has gone into making ORS and zinc available to so many communities worldwide in the last few decades – including ColaLife and members of the ORSZCA! The diarrheal death toll has fallen significantly, but there remains work to do and we seek to learn from the experience of those before us.

“Though small, we believe that with agility and a focus on collaboration, we can make a meaningful impact on ORS and zinc usage and further reduce diarrheal deaths.

“Your words of advice and support are much appreciated. Please do reach out to us at charlie@clearsolutions.global, martyn@clearsolutions.global. Thank you!”

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This blog post outlines what we need to do to ensure a graceful shut down. It reflects on why ColaLife was set up in the first place, why it’s kept going for 12 years, the legacy it leaves and why it’s right to close it down at the end of this year.

Animation credit: Sam Berry (view video on YouTube)

When we started to globalise the idea of co-distributing simple medicines with Coca-Cola in May-2008 we had no intention of setting up an organisation. As a couple of volunteers, we thought that if we could get enough support behind the idea and get The Coca-Cola Company engaged, we’d be able to handover to a large existing international NGO (non-government organisation). We wondered if Save the Children or UNICEF might work in a distribution partnership. This was naive. In 2008/9 no NGO concerned with the health and wellbeing of children was going to partner with The Coca-Cola Company – even if Coca-Cola knew how do things they desperately needed to do better. So, Jane and I faced a dilemma. We would have to take things forward ourselves or risk being seen as the couple who generated massive support for an exciting idea and then did nothing about it.

It was over a weekend breakfast in Mar-2010 that we decided that it would fall to us to take things forward. We agreed that we would give up our jobs in Jun-2010 and give ourselves a year to get a trial of the idea underway somewhere in Africa. ColaLife was later incorporated and was granted charitable status in 2011.

But still, our focus was on handover. At this point we believed that if we could generate robust evidence that the co-distribution/co-packaging idea worked we would have an attractive proposition for an appropriate NGO to adopt and take forward. We were also advised by a DfID-funded consultant reviewing the ColaLife trial not to proceed to scale-up ourselves. “Running a trial is one thing, scaling up is quite another”, he said.

But again, there was no one in the right place at the required time to whom we might hand over. If scale-up was going to happen, ColaLife was going to have to catalyse it.

Our involvement in the scale-up in Zambia was intense initially as we worked to get funding in place for our existing partnership. In spite of our evidence, this wasn’t easy – or totally successful. With some funded activity in place, we left Zambia in Jun-2014 returning one month per quarter and supporting the local effort remotely until Sep-2018.

The two most significant developments during the scale-up were that the national supermarket chain in Zambia (Shoprite) began stocking Kit Yamoyo and the government adopted the ORS/Zinc co-pack as the preferred treatment for diarrhoea – both providing significant customers for our manufacturing partner, Pharmanova. The government in particular had a huge impact on ORS/Zinc coverage in the country: our baseline surveys in 2012 showed ORS/Zinc coverage rates of <1%. After our scale-up efforts, the 2019 DHS survey found a coverage rate of 34%.

We are very proud of the legacy of the work in Zambia. By the end of 2023, 2.5 million co-packs will have left the local manufacturer’s factory. What’s more, the majority of these (1.7 million) will have left since donor support ceased in Sep-2018. Legacies like this are rare in the international development sector and others are keen to understand how this was achieved. This is our analysis: So how was the Kit Yamoyo Legacy achieved?

With this national impact we saw an opportunity for global impact and started to plan for an application to WHO. We thought that if we could change their Model Essential Medicines List (EML) to recommend co-packaged of ORS and Zinc this would move the co-packaging innovation into the mainstream. Our application was successful. The 2019 edition of the EML was changed to include the co-packaging recommendation.

At this point it was tempting to call it a day even though we realised there was still a job to be done to advocate for this new recommendation, to accelerate its uptake by national governments. However, at what we imagined would be a final, sign-off meeting, in Aug-2019, with our most loyal strategic funder – the Isenberg Family Charitable Foundation – we were encouraged to continue to try and catalyse a global advocacy effort.

With the help of handful of key players, most notably Leith Greenslade (JustActions) and Elena Pantjushenko (PATH), and the support of two co-chairs – Dr Morseda Chowdhury (BRAC) and Samy Ahmar (Save the Children UK) – the ORS/Zinc Co-pack Alliance (ORSZCA) was launched in Jan-2022.

Since mid-2019, most of ColaLife’s resources have been focussed on the launch and establishment of ORSZCA. ORSZCA has already achieved a lot but now we believe that, to achieve its full impact, the administration of the ORSZCA network needs to be taken over by a large NGO with a track record in advocating for child health. We are working to try and make this happen. We are determined that this final handover attempt will be successful – ORSZCA has the potential to be a vibrant and influential network of key players who can promote a simple change, in their own countries and states, to save children’s lives: increasing coverage of co-packaging ORS and Zinc together.

After the closure of ColaLife, this website and blog will remain in place as a reference resource but with no further updates. We will continue to maintain the ColaLife Playbook, now remodelled and renamed as The Co-packaged ORS/Zinc Playbook, on a voluntary basis, and answer questions and requests for case studies of how we worked – which still continue to come in.

We wish to thank the thousands of people that have made this effort possible over the last fifteen years. Special mentions go to the 8,000 members of the Facebook Group in Mar-2010, which made turning back impossible, to all of our partners and supporters, past and present, and to the Isenberg Family Charitable Foundation. We thank them for seeking us out and trusting us with their money. Their funding has tied everything else together and allowed the effort to be continuous and relentless.

And so to the proverbial question. How many lives have we saved? This is very difficult to say although we do know from the evidence that there is a direct link between coverage of ORS and Zinc and child mortality. Increased coverage reduces mortality. But let’s not dodge the question. The case fatality rate from childhood diarrhoea ranges from one per 10,000 infections to more than 20 per 10,000 infections. If we assume that one co-pack treats one case and that the child survives, then we might say we have saved between 250 (2.5m/10000) and 5,000 (2.5m/10000 x 20) lives. This relates to our work in Zambia. It is impossible to say how many more lives will be saved by the global adoption of the co-packaging recommendation.

Also, it’s not just about saving lives. We’ve helped 2.5 million children get better and reduced the morbidity associated with childhood diarrhoea.

Onwards and upwards.

The post ColaLife to close down at the end of 2023 appeared first on ColaLife.

The main focus of this week was the ‘Kit Yamoyo Story’ event with Roma Chilengi, Health Advisor the the President, as guest of honour. This ran on Thursday (6-Jul-2023). It was an energising occasion and great success. It is reported on separately here. However, we were able to get a few other things done.

Handover of the Kit Yamoyo Trademark.
From left to right: Simon Berry (ColaLife), Prof Roma Chilengi (Health Advisor to the President) and Sadik Seedat (Chairman, Pharmanova)

On Sunday (2-Jul-2023) I visited Albert Saka at his home to get an up-to-date video on how to use the Kit Yamoyo Flexi-pack using the scale-up version of the packaging. Albert was a Project Manager at Keepers Zambia Foundation for the COTZ Trial and scale-up in remote rural areas and his wife, Agnes, starred in the current video we have that was filmed several years ago using a prototype of the flexi-pack.

On Monday (3-Jul-2023) we met with John Msimuko who was the Executive Director of Keepers Zambia Foundation when we first partnered with them in 2011 on the Kit Yamoyo trial. John was to play a key role in the ‘Kit Yamoyo Story’ event as a panel member.

On Wednesday (5-Jul-2023) we were hoping to meet with Bonnie Fundafunda. Bonnie has been a key part of the Kit Yamoyo project. Initially, as advisor to the Ministry of Health, he organised our first meeting with the then Director of Public Health, Dr Elizabeth Chizema. He then went on to manage Medical Stores Limited (MSL), the public sector medicines distributor, a key partner in the trial and scale-up. Unfortunately, he was called to travel outside the country but we were in contact regarding his moderation role of the panel session during the ‘Kit Yamoyo Story’ event.

On Wednesday afternoon we gathered with the Pharmanova team at the event venue to check out the technology.

Thursday (6-Jul-2023) was the ‘Kit Yamoyo Story’ event and turned out to be the highlight of our visit. It was so great to see more than 100 people come together to celebrate the legacy of Kit Yamoyo and learn from it. Many of those who attended were a key part of the story. The event was used to officially hand over the Kit Yamoyo trademark to Pharmanova. ColaLife registered the trademark ten years ago as an insurance, in case things took off which they clearly have. Before the event I was interviewed on the Hot FM and several delegates heard the interview as they were driving to the event. You can listen to the Hot FM interview on SoundCloud.

On Friday (7-Jul-23) I went back to BongoHive to meet with Mapalo Lukashi. Mapalo had asked to know more about the dashboards we produced during the Kit Yamoyo scale-up. I was able to explain how we used CommCare to collect data from the dispersed team of frontline staff supporting Kit Yamoyo retailers and how we turned that raw data into KPI dashboards using Excel. I left Mapalo with a copy of the Excel workbook (XLSX file, 1.1 MB) we used to produce the dashboards with an offer to support him, if required, in the implementation of dashboards for future BongoHive projects.

On Saturday (8-Jul-23) we met up with Ruth Mitimingi. Ruth was crucial in establishing our initial partnership with Keepers Zambia Foundation from late 2010 and oversaw the initial Kit Yamoyo trial. It was a great shame that her work (with Habitat for Humanity) called her away so she missed the event. However, she was very well informed when we did meet as she had watched the whole event here. Habitat are about to start a water, sanitation and hygiene effort in communities they work with and are looking to incorporate awareness raising of Kit Yamoyo.

And finally, on Saturday evening, we were able to meet up with Bonnie Fundafunda. As usual he was brimming with ideas and we regretted that we couldn’t meet at the beginning of our trip but when we didn’t have COVID, he was travelling outside the country. However, we are following up this meeting virtually.

Monday (10-Jul-2023) was our last full day in Zambia. We visited Pharmanova in the morning to say our goodbyes. We left their factory where Kit Yamoyo is painted on the roadside wall. We were aware of this as it’s been in place since 2016:

However, as we drove past their second factory, which assembles Kit Yamoyo, we saw this:

It’s very special to have Kit Yamoyo here, front and centre.

In the afternoon we were privileged to visit NRB. NRB is a modern pharmaceutical manufacturing facility which Pharmanova have started leasing. They have just won approval for the manufacture of their flagship product (Panado) there. NRB is a state of the art facility and we hope that, in due course, the manufacture and assembly of Kit Yamoyo will move there too. We are grateful to Mr Vaibhav for showing us around.

While moving between these appointments we called into all the pharmacies we passed to carry out some informal research on ORS, Zinc and ORS/Zinc Co-pack prices and this is reported here. The conclusion was that, in Zambia, as elsewhere, the cheapest way to buy ORS and Zinc to treat diarrhoea is by buying a co-pack.

Tuesday (11-Jul-2023) was spent packing and travelling back overnight to the UK.

We are very thankful for the warm welcome we received and the enthusiastic engagement with our visit. Zambia has always been very kind to us and we are extremely grateful.

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