Apologies for all the posts recently about packaging. It is a major focus at the moment but it’ll soon pass!

I thought it would be useful to describe how the packaging and the components have now come together to form the anti-diarrhoea kit (ADK). Until the start of the set-up period of the trial we had talked about the packaging (the AidPod) as something distinct from the contents, but over recent months, with thanks to our packaging partner – PI Global, the packaging has become part of the kit itself.

The production prototype of the AidPod is made from rPET (80% recycled PET) and is transparent. This means that the branding can be carried on the information leaflet which is a component of the kit. This is really helpful because we need to finalise the packaging now, but we still have consumer consultation work to do before finalising the branding. If the branding were an integral part of the packaging, we would have had to finalise it later – after we’d finished asking our target consumers what they find most attractive from a branding point of view.

The second thing to note is the number on the leaflet. This will be carried on a label and will be applied as part of the packing process. This number will be unique for each ADK and will be used for various purposes including authentication and voucher redemption.

The authentication will work like this: anyone at any point in the distribution chain will be able to send this number by SMS text and will get an automatic reply indicating whether the ADK is authentic, or not, and its expiry date.

To redeem a voucher – given them by a mother or care-giver – retailers will enter this same code together with the code on the voucher. This will put cash on the retailer’s phone, to pay for the ADK.

Note that both authentication and voucher redemption can be done without opening the ADK. To open the ADK, the heat-sealed film must be removed. This heat sealed film provides waterproof protection for the content of the ADK while in transit as well as a tamper-evidencing mechanism. Care-givers will be trained not to accept an ADK if this seal has been broken.

Removing the seal and the leaflet reveals the soap sitting in a tray. This tray separates the soap from the medication within the pack. This was a requirement of the Pharmaceutical Regulatory Authority (PRA) of Zambia.

This tray also acts as a removable and replaceable lid. Removing the lid reveals the rest of the contents and these are: a packet containing 10 zinc supplement tablets (PedZinc), eight sachets of oral rehydration salts and a drinking straw.

As mentioned in a previous blog post, these ORS sachets are smaller than those available generally on the market, which make up a litre of solution. In urban areas, litre ORS sachets can be found for sale in some of the very few retail pharmacies in Zambia; in rural areas they are not seen. Our smaller sachets will make up just 200 ml of ORS solution which is much more appropriate for the home treatment of diarrhoea.

The ADK packaging, or AidPod, is much more than a simple container for the ADK components, as the next couple of features will show.

The AidPod is a measuring jug. It has calibration marks on it. Fill the AidPod to these calibration marks and you have exactly the 200 ml of water you need for one of the ORS sachets in the kit.

The AidPod is also a mixer. After filling the ADK to the calibration marks with water and emptying in the entire contents of one of the ORS sachets, stir with straw to dissolve the salts. There is no need to introduce another object such as a spoon, stick or finger which might be dirty.

The AidPod is also a device for administering the ORS solution. Very small babies will ‘suck’ the solution from a corner of the AidPod. Older children can use the straw to drink the ORS. Straws are a novelty in remote rural areas and are likely to act as an incentive to older children to drink sufficient quantities of ORS.

The lid will also keep flies, dust and dirt out of the ORS solution and reduce the likelihood of contamination.

So there you have it. The ADK. Components as recommended by WHO and UNICEF (plus one or two others: soap and straw) in an active package which will help ensure that the kit is used and used properly (engagement and adherence).

I’d like to acknowledge the key role that PI Global, our packaging partner, have played in getting to this point. They have taken a basic concept, a few good ideas and made it real, with a patent pending.

Through the efforts of Rohit Ramchandani (pictured on his last trip to Zambia in April/May this year), ColaLife’s public health adviser, we are being considered for a Grand Challenges Canada Rising Stars in Global Health award and we need your help! The public is being asked to vote on their favorite applications/ideas which can be found here: http://rs.applications.grandchallenges.ca/. To vote for Rohit and ColaLife:

1.  Visit: http://rs.applications.grandchallenges.ca/en/viewVideo/28735E6AA0EB3DA8882E2F
2. Click on the red “Login to like this application” button under the video
3. Click on the create a new account button (registration is free and necessary to vote)
4. You will receive an e-mail from Grand Challenges Canada Account Registration. Click on the link in the e-mail.
5. Log in and click on the red button to like the application

Please help spread the word through your networks and feel free to pass along the instructions on how to vote. Thank you all for your help. We would not have gotten this far without your ongoing support for this idea, which we hope will help improve access to live saving medicines.

The video for the application was only allowed to be 2 minutes. You can see the full (4m) video on YouTube here. It is also embedded below:

Thank you.

As part of this work, we are looking for a consultant to help us develop a financial sustainability plan for ColaLife ‘the organisation’. We are seeking an experienced fund-raiser/social business developer to look at Business Modelling for ColaLife and its core future development.

The task is to research and produce a viable income generation plan – including cash flow. This would build on learning from the COTZ trial but not be part of it; rather, it will inform future options for the charity’s core costs. So, the work will not involve fund-raising for specific in-country trials, or scale-up/roll-out of the current trial (ie ‘project funding’).

We expect the task to cover some research into the viability of a ‘cross-subsidy’ product, based on the AidPod (eg merchandising, licensing*, sponsorship) as well as the usual income streams a small charity/social enterprise might expect to apply for or develop – eg a mix of donations, fund-raising, events, sponsorship, small grants, organisational development grants etc.

The successful consultant will be able to work with one of our UK-based Trustees as well as liaising with Jane and me in Zambia.

The full brief of the assignment can be downloaded here: ColaLife SUSTAINABILITY PROJECT Brief (PDF, 134 KB)

If you’d like to be considered for this work please send an expression of interest including your CV to act@colalife.org by 5pm GMT on 14 May 2012.

Shortlisted candidates will be contacted on 18 May and asked to provide a fully-costed proposal for this work to the same email address by 5pm  28 May 2012.

* We have a UK Patent Pending on the AidPod in anticipation that there may be interest in the commercial use of the AidPod which might cross-subsidise social uses.

 
First exposure to the ADK

Keepers Zambia Foundation are leading on this work and before going to our intervention districts later this week (Kalomo) and next (Katete), they used the contacts they had in peri-urban communities nearby to test the materials and techniques developed by Beth and Jane

How should it be branded?

The project plan demands that this work is completed by 23 May so that we can fix the branding and the recommended retail price of the ADK and Jane can complete the visuals for the training materials.

Initial indications are that our client group like literal, no-nonsense descriptions and pictures and not ‘clever’ abstract logos. Watch this space . . .

In our original plan we said we would use ‘off-the-shelf’, pre-approved, over the counter products to make up our ADKs (anti-diarrhoea kits). So these were going to contain:

1. 2 x 20g sachets of ORS which each make up one litre of ORS solution
2. 1 x blister pack of Zinc supplements
3. 1 x small bar of soap

Items 2 and 3 remain unchanged but there are such compelling reasons NOT to include two of the standard ORS sachets that we are not going to do it. Instead we are going to make up our own 4g ORS sachets which will make up just 200ml of solution each. And we will include eight and not two.

So why stick our necks out and run this risk? As mentioned in a previous post the 20g sachets which are generally available were never designed for home use – they were designed for use in hospitals where it makes sense to make up a litre of solution at a time. In the home it makes no sense at all, given that the average consumption is around 400ml in a day and any solution not used after 24 hours of mixing should be thrown away.

So what are the implications of this change of plan? Well, we’ve had to come up with our own artwork for the new, smaller sachets (see the image to the left). We then have to import the packaging (from India) along with new machine parts to deal with the smaller packet size and weight of contents. We then have to run a three-month stability test on the new product and get approval from Zambia’s Pharmaceutical Regulatory Authority (PRA) before the trial starts. Quite a few risks. However, the artwork has been signed off and the machine parts have been ordered, so we are on our way.

What are the benefits of this new approach? The key benefit is that mothers and care-givers won’t have guess the amounts of ORS and water and risk making up a solution that is either too weak to be effective or too strong and cause osmotic diarrhoea. What tends to happen at the moment is that mothers and care-givers know that they do not need a whole litre of solution, so rather than mix up a whole litre and throw most of it away after 24 hours, they tip a part of a sachet into and indeterminate amount of water resulting in an ORS solution that is either too weak or too strong.

With our smaller sachets they will only make up 200ml at a time and they can use the AidPod itself as a measure. The production AidPod has a 200ml mark on it to indicate precisely the amount of water needed. We also think that it will be possible to use the AidPod as a mixer. Tests involving shaking an AidPod full of tea look promising in this regard! See the video below:

So, all in all, we think it’s worth risking it and going off-piste at this point in the trial set-up phase as the potential benefits are wonderful.

The ColaLife Packaging Team at PI Global.
Back Row, L-R: Eric, Anna and Tim (PI Global), Jane (ColaLife);
Front Row, L-R: Stuart (Saunders & Dolleymore LLP), Peter (Armcor), Chris (PI Global), Gary (Charpak) and Matt (Packaging Automation)

In this video, Matt from Packaging Automation shows me how to use the machine. The machine that will be put together for us will have jaws made specifically for the AidPod and it will seal two ADKs at a time.

The next steps for this part of the project are:

1. To finalise the type of film to use. It needs to fulfil the tamper evidencing requirement and be strong enough for the conditions in Zambia. Amcor are also looking at a ‘microporous’ option that will allow air, but not contaminants or water, to move in and out of the pack.
2. To manufacture of the jaws for the PA machine and then calibrate it to seal the film to the ADK.
3. To assemble and seal 100 ADKs in the UK for final testing in Zambia – to do this we will need to ship sufficient of the components of the ADKs to the UK – soap, ORS sachets, PedZinc and leaflets. We are waiting for the ORS sachet packaging to arrive from India so that we can produce our new 4g/200ml sachets for stability testing and will need to make 800 additional samples for shipping to the UK.
4. To do a final test of the assembled ADKs in Zambia.
5. To manufacture 41,000 ADKs and lids/trays
6. To ship the packaging machine, the AidPods and film to Lusaka.

Things are staring to feel very real!

We wound up the day with Stuart from Saunders & Dolleymore LLP. Stuart has been guiding us through the process of patenting the AidPod to that we have some control over its use – we wouldn’t it to be used for cigarettes for example – and there may be scope for us to licence its use in the future and raise money to pump back into the ColaLife project.

The AidPod now has a British Patent Pending Number 1201701.8

Thanks go to Eric who had the foresight to bring us all together and to everyone who made time to be there on the one spare day in our short visit to the UK.

Yesterday (28/3/12) was a big day. The highly anticipated Skype meeting with our packaging partner to present what is likely to be the version of the AidPod that will go into production was postponed from 11am to 3pm to allow time for the video below to download so that the we, ColaLife team in Zambia, were properly prepared.

The image above is a screen capture of the Skype meeting. On the UK end (main picture) you have Tim Llewellyn demonstrating the Mark XI AidPod with team members Chris Griffin* and Eric Connolly in the background. To the left (inset) you see the ColaLife team in Zambia – permanent members Jane and me with Rohit who is also with us at the moment as we tie up the recruitment of our monitoring and evaluation partner.

Anyway, the session did not disappoint, the Mark XI looks just perfect. We expect to receive samples of it tomorrow (30/3/12) and hope to sign-off the design so that the production process can start.

Below is the video mentioned above where Tim explains the Mark XI features:

* Just for the record I wanted to describe how I met Chris. Jane and I received an UnLtd Award way back in June 2010 when we decided to give up all other activities and focus on trying to get a trial of ColaLife underway. One of the networking opportunities provided by UnLtd was a pre-Christmas gathering of award winners and supporters of UnLtd from the private sector. And one point in the evening award winners were asked if there was anything we needed. I said that we had this great idea and a huge level of support for it but without an AidPod we couldn’t proceed. Chris came up to me and the rest is history. Frankly, I’m not sure what we would have done without PI Global as a partner. Put frankly, we would have struggled.

It’s taken more than 3 years but we are nearly there. Final prototypes (Mark XI) are expected on site next week. Watch this space.

Mark X	Mark IX	Mark VIII	Mark VII	Mark VIb
Mark V	Mark IV	Mark III	Mark II	Mark I

Consider the two pictures above – both are efforts to save lives – one is supply-driven the other demand-driven. Many would group these types of initiative together as ‘aid’ as opposed to ‘trade’ type activity. However, they are fundamentally different. In the first example a need is identified, in this case a need for food, and it is supplied. It is pushed out to the people who need it. In the second case, the ColaLife case, a demand is created for a commodity. The commodity, in this case an anti-diarrhoea kit, is first given a recommended retail price that people in remote communities can afford. Marketing is undertaken to turn need into demand. The commodity is then fed into the top of the distribution chain at a price that enables everyone along the distribution chain to make a profit fulfilling the demand. The demand for the commodity pulls the commodity into these remote communities.

Note how the word ‘need’ is associated with a ‘push’ system. And the word ‘demand’ is associated with a ‘pull’ system.

Supply-driven assistance is non-personal and is usually time-bound. Everybody in the same area gets the same thing (food, vaccinations, shelter, mosquito nets etc) at the same time.

Demand-driven systems are different. By definition, they are able to provide personal assistance at the time and the place that an individual needs it.

Historically, the majority of development assistance has been supply-driven and, generally speaking, we, the global community, have got pretty good at it. The trouble is that there is a limit to what supply-driven systems can achieve. For example, at the current rate of progress to reduce child mortality (1.8% per year since 1990) it will take more than 185 years for child mortality in less developed countries to fall to the levels in Europe and the USA today. Demand-driven systems like ColaLife may be part of the step-change in progress that we need in this area.

Child mortality rates in sub-Saharan Africa vs those in the UK today. At the current rate of progress it will take more than 185 years for mortality rates in Africa to fall to the mortality rate in the UK today. ColaLife thinks that demand-driven systems might be part of the answer.

Consider this recent quote from Abdulai Tinorgah, who heads the UN Children’s Fund’s Child Survival and Development section in Nairobi:

“The challenge is not what to do [to stop a child dying from dehydration from diarrhoea] but how to deliver [ORS] at very high coverage. Whereas blanket interventions such as measles immunisation, vitamin A supplementation, and bed-net distribution have been scaled up significantly over recent years, those that have to do with case management have shown much less progress.

“Because these require a health system ready and able to respond to individuals when they need care, there are special challenges especially of access, demand generation and logistics.

“Social marketing and private-sector initiatives, coupled with better distribution and public information, are among the ways ORS coverage could be increased.”
Source: Follow the fizz, save a life, IRIN News, NAIROBI, 2 March 2012

The other characteristic of supply-driven assistance – delivered as it usually is – is that it does nothing to strengthen local systems. Indeed it will undermine any local systems that may exist. On the other hand, demand-driven systems, such as ColaLife, have the potential to strengthen existing systems and put money into the pockets of people in the local communities being provided with the product or service.

Related blog posts

• The ColaLife Business Model
• Child survival – why innovation is needed
• Why FREE won’t work for ColaLife

[This blog post was first published through the Business Fights Poverty Network]

Early this morning (15/3/12) we had the privilege of hosting a visit from members of the UK Parliament’s International Development Committee. We’d rearranged the office last night to accommodate quite a crowd: the VIP visitors, our project manager, Silke Seco at DfiD Zambia, our majority funder, as well as the DfID Head of Mission Mike Hammond (far left front and back row, respectively) … and of course our partners on the COTZ project. These were well represented, with Panji Banda from SABMiller, Dirk van Wyk and Chipopa Kazuma from Medical Stores Limited, Hans Hesse from Mobile Transactions, Albert Saka from Keepers Zambia Foundation, and Lusako Sichali from UNICEF – not forgetting our highly informed local volunteer, Beth Anne Pratt.

After introductions, Jane and I presented the project, or at least we tried to amidst the barrage of questions! This is probably one of the most engaged audiences we’ve faced. It really was very stimulating. We were very well prepared with good, well rehearsed answers. One of the benefits of being open with your idea for so long is that there aren’t many questions you haven’t been asked before, or had time to research sound answers for. The meeting could have gone on a lot longer but the committee had a tight schedule to keep. The verdict from those organising the trip was that we got their day off to a highly animated start.

We will see everyone again this evening at a reception at The High Commission which we are looking forward to. It will be an opportunity to pick up those last few questions.