Case Study: Developing Health Systems Resources

ColaLife, Johnson & Johnson


Our objective was to design a holistic antidiarrhea kit and delivery model to supply the product to the BoP (bottom of the pyramid) in rural Zambia with an emphasis on ease of use, affordability, and accessibility. Diarrhea is the second biggest killer of children younger than five in the developing world.

With the Johnson & Johnson Corporate Citizenship Trust and Janssen, U.K.-based charity ColaLife designed a new product, the Kit Yamoyo, or Kit of Life (oral rehydration salts [ORS], zinc, and soap), and a new delivery model, based on lessons learned from the Coca-Cola supply chain.

The product, delivery model, and packaging have been carefully designed to overcome each barrier encountered by customers in accessing ORS treatment. The innovative package design helps mothers measure and administer the medicine correctly, and the original delivery concept to distribute the kit in empty spaces in Coca-Cola crates was developed through customer consultation and testing.

Lessons Learned?

As the Coca-Cola crates were used for delivery less than 10 percent of the time, the cost of producing the kit has been reduced by two-thirds (mainly due to a change in packaging and by matching the contents more closely to users’ needs). The profit along the value chain remains the same and demonstrates that healthcare products can be delivered with margins similar to consumer goods.

A Zambian manufacturer (Pharmanova) has been commissioned to design, produce, and assemble the new kits. Contracting with a local business has stimulated local zinc production and BoP-sized antiseptic soap production in Zambia for the first time. In 2014, Pharmanova will take over operations from ColaLife, thus sustaining the whole ecosystem that has developed around more effective treatment for diarrhea in Zambia.

Results to date?

For the 12 months leading up to September 2013, nearly 45 percent of children who suffered from diarrhea in the previous two weeks had used Kit Yamoyo, thereby ensuring the correct ORS and zinc combination therapy—up from a baseline of less than 1 percent. There is no other copackaged ORS and zinc treatment available in Zambia, and prescribing in the public sector is negligible.

  • Instead of walking less than 7 kilometers (almost 4.5 miles) on average to a clinic (which would often not have it in stock), mothers bought our kit from one of 85 trained village microretailers, within 2.5 kilometers (1.5 miles) of their home.
  • The Kit Yamoyo costs 5 kwacha (approximately US$1). The journey to a clinic could cost in excess of four to five times that much without any guarantee that the product would be available.

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