NB Health Care
Life Without Cola: ColaLife founder Berry says anti-diarrhea effort didn’t need Coca-Cola’s distribution system, after all
Editor’s note: This post has been updated to include Simon Berry’s on-camera interview by WDI Health Care Research Specialist Lisa Smith. It can be found at the bottom of the page.
Simon Berry was among the many who marveled at the prevalence of Coca-Cola in even the most remote corners of the globe, and for 20 years he dreamed of delivering life-saving medicine through the Coca-Cola system. The idea was a nonstarter, however, until social media flexed its muscles. In 2008, Berry launched a Facebook page for his dream, ColaLife, to prevent children’s deaths from diarrhea. Two years later the group had 8,000 supporters, and that caught the attention of the mainstream media and Coca-Cola. Next came funding partners and a “locally-determined” ColaLife trial in Zambia that continues today. There’s even a decorated documentary, “The Cola Road,” by Claire Ward (see the trailer below.)
Berry’s team developed Kit Yamoyo, “kit of life,” which contains oral rehydration solutions, zinc, soap and educational material, and designed award-winning packaging to piggyback the meds inside Coke crates. The innovation won Simon and his partner, Jane Berry, plenty of news media attention and coverage. (See past NextBillion posts on ColaLife and the concept here, here and here.) However, on-the-ground feedback quickly determined that the piggyback method actually constrained ColaLife; people were buying more kits, priced at roughly U.S. $1, than Coke.
“The supply chain is not really the problem,” Berry said in a May 19 speech at the William Davidson Institute (the parent organization of NextBillion). “The issue is generating demand … and then making it profitable for people to fill that demand. It’s about awareness and affordability, not capacity.”
These days, with proven demand, ColaLife is working on less expensive packaging options and tinkering with profit margins at various distribution levels. Berry said ColaLife learned a lot from Coke – including the need to create value with customers – but no longer uses cola crates to get diarrhea medicine to children. After his presentation at WDI, Berry answered a few questions via email about the future of his organization.
Kyle Poplin: You’ve overcome so many hurdles to get ColaLife to its present state. What was the highest hurdle you’ve overcome so far, and which approaching hurdle (or potential hurdle) keeps you awake at night?
Simon Berry: It has actually been pretty straightforward; we haven’t really had to “force” anything. It’s felt like we walked into a vacuum.
• We know what treatment children need and have known this for more than a decade. It’s ORS (oral rehydration salts) and zinc.
• The treatment is safe and stable at ambient temperatures and “over the counter” in most places.
• We found all the pieces to improve access to ORS/zinc already in place, including distribution systems to remote rural areas; a pharmaceutical manufacturer; wholesalers; retailers; communication channels to mothers, and so on. It’s just that they were spread across different sectors that didn’t work together very often (if at all). It was just a case of bringing these together in a new way.
• We are talking about saving children’s lives and so people engage. The key engagement for ideas is with mothers themselves. They gave us the key insights we needed. And so this list goes on.
We do have a looming barrier, though. One of our trial funding partners did not follow through to support our three-year scale-up plan, which was a big shock as they had been so supportive of our work. This has left a $1 million hole.
We have responded to this by compressing funding we received from our other donors (the UK’s Department for International Development and Johnson & Johnson Corporate Citizen Trust) into the first six months of the scale-up plan and have gone flat out on the original plan with no let-up in pace. There is now activity in eight districts (up from two) and in most of the townships around Lusaka (Zambia). In parallel with this we’ve been working hard to fill the funding gap. We have several irons in the fire but the funding runs out at the end of June.
KP: What’s your ultimate dream for ColaLife? Would you like to hand it off to a huge commercial enterprise, or keep it small and nimble … or is it somewhere in between?
SB: There are two parts to this: ColaLife the organization and ColaLife the dream.
ColaLife, the organization, will stay as it is. Our strategy is to be the yeast in the bread: to make the ideas behind ColaLife grow; to innovate and share; to design and give away; to generate robust evidence that even the most cautious child health strategist can trust. We want to influence the strategies of existing organizations which already have the scale, the capacity and the responsibility to take our findings forward.
And the dream is that mothers all over the world can buy an anti-diarrhea kit in their local shop wherever they live.
KP: You make it seem so simple: create value, generate demand, listen to potential users. Do most organizations involved in health care in emerging markets make it too complicated?
SB: But it is simple when you are talking about the treatment of diarrhea. I think that by “medical-izing” the response to diarrhea, e.g., having a policy that all mothers/carers should go the clinic, has, in fact, reduced access to ORS and zinc.
The recommendation should be “start ORS treatment as soon as possible,” not “go to the health center.”
Of course, in a small minority of cases, if the child is showing one of the six danger signs, then they should be taken to the clinic as well. But these danger signs can be taught to mothers and retailers and if a visit to the clinic is necessary it’s better that the child arrives hydrated and not severely dehydrated.
KP: How many units have you sold to date?
SB: About 42,000. We estimate that one life is saved for every 330 kits sold.
KP: How many of those were delivered through Coca-Cola?
SB: 26,000 have gone through Coca-Cola wholesalers but only 4 percent of these went into crates. It was the space in the market not the space in the crates that was important.
KP: Are ANY still delivered through Coca-Cola?
KP: I think it’s interesting that you dreamed for two decades about using Coke’s delivery system to get medicine to children who need it. That idea won all kinds of awards and recognition. But you quickly went in another direction when you made on-the-ground discoveries. Was it a difficult decision to de-emphasize the Coke piggyback plan?
SB: It was VERY difficult. People love that image of the kits in the crate. And the awards have been fantastic in raising our profile, which is crucial to our impact strategy. However, you have to go with what your evidence is telling you. And at the end of the day we are not here to generate cool images or win awards!
KP: Have there been any negative implications?
SB: I think there are only positive implications, really. Many health people had “in principle” problems with the kits in Coca-Cola crates. It’s interesting to reflect, though. If we’d had an “in principle” problem we would not have learned what we know today. The kits in the crates will always be where we came from and will always be a metaphor for our approach.
A trailer for “The Cola Road” documentary:
KP: Do you hope to expand to other countries besides Zambia? If so, what criteria will you use to make that decision?
SB: We will not lead an expansion into any other countries but we will help those who wish to adopt our approach to their own circumstances – if they want us to. Hopefully, most people will just get on with it.
KP: There seem to be lots of people – young people, especially – who would love to do what you’ve done, and help make the planet healthier using the efficiency of markets. What advice would you give them?
SB: Think the unthinkable. Don’t do anything that undermines existing systems or processes. Do things that strengthen them and, perhaps, bring them together in new ways to address a challenge. Don’t make solutions dependent on you. Try to reduce the number of “in principle” objections you have to things – we all have a few but having too many will restrict your thinking. And so on!
Simon Berry tells WDI’s Lisa Smith about ColaLife’s beginnings …
… and discusses the Zambia pilot project and the organization’s future:
Kyle Poplin is the editor of NextBillion Health Care.