Enterprise for Development (EfD) series on models of best practice for socially and
environmentally sustainable private enterprise and social enterprise
Case study: ColaLife
Background
Globally, diarrhoea is the second leading cause of mortality in children under 5 years of age,
accounting for approximately 15% of all childhood deaths. Since 2004, the World Health
Organisation (WHO) and the United Nations Children’s Fund (UNICEF) have recommended
the use of low-osmolarity oral-rehydration salts (ORS) and zinc supplementation for the
treatment of diarrhoea, yet less than 1% of children in sub-Saharan Africa receive these lifesaving interventions. Should they do so, it is estimated that 75% of all diarrhoea deaths
would be prevented.
The reason why so many people do not receive treatment for diarrhoea, especially in rural
parts of the developing world, is often a matter of access. For millions of people, ORS and
zinc is often not available locally, either because of distance, cost, or stock-outs. Providing
ORS and zinc solely through public sector clinics has also not proven effective,
comprehensive or sustainable in any country in sub-Saharan Africa.
ColaLife concept and business model
While it has not proven possible to stock highly effective and essential medicines in rural
areas across sub-Saharan Africa, fast moving consumer goods such as Coca-Cola are available
virtually anywhere. In response to this observation, ColaLife developed an ‘AidPod’ package
that fits between the necks of crated Coca-Cola bottles, in unused space, adding no extra
volume and very little weight to a crate (see Figure 1).
Figure 1: ColaLife AidPod package in Coca-Cola crate
ColaLife initially aimed to work with Coca-Cola (and/ or other manufacturers of fast moving
consumer goods) and its independent in-country bottlers to find practical ways to open up
their distribution channels in developing countries to carry simple medicines and social
products the ‘last mile’ to save children's lives, including co-delivery.
The concept was developed through an open innovation process, online and through
conferences and meetings with customers, expert leaders in logistics, global health and
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other supporters over a period of 3 years. ColaLife promotes participative approaches so that
local agencies determine the required interventions and models to trial (e.g. private/ retail
models, public sector models and/ or hybrid models) and items to distribute depending on
their needs and priorities; such items could include ORS, zinc, vitamin A, water purification
methods, and other medicines or social products.
ColaLife past, present and future
Following a 9-month local partnership development and co-design process in Zambia, the
ColaLife Operational Trial Zambia (COTZ) was launched in 2012/13 to test an anti-diarrhoea
kit (called Kit Yamoyo) designed for home use by mothers/ carers in underserved rural
communities. The kits were comprised of ORS, zinc, soap and information, education and
communication (IEC) materials and sold at an affordable, subsidised price by trained local
retailers in target communities, supporting improved livelihoods. Mobile phone technology
was employed to provide voucher redemption, authentication and information services.
The trial showed very positive results: 26,000 anti-diarrhoea kits were sold into two rural
areas over a period of 12 months. This resulted in a dramatic increase in access to ORS and
zinc with 45% of children in the trial areas receiving ORS/ zinc, from a baseline of less than
1%. Average distance to ORS and zinc also reduced from 7.3km to 2.4km, and the perception
of ORS as an effective treatment for diarrhoea increased by 14% among the target
population. Using academic estimates on the efficacy of the anti-diarrhoea kit, it is thought
that over 75 lives were saved through the COTZ, where 3 lives are saved for every 1,000 kits
distributed.
The trial also yielded interesting (and some unexpected) lessons. In particular, the trial
demonstrated that the Kit Yamoyo design was superior to more conventionally packaged
ORS and Zinc, and customers like it.1 It also showed that the use of Coca-Cola crates to
distribute the kits was not the key innovation – only 4% of kits were actually carried back to
the village in Coca-Cola crates. Rather, the kits were carried in cheaper cartons and bags. The
key success factor for the concept was actually in the use of Coca-Cola’s business techniques
– i.e. creating a desirable product, marketing it, and putting the product in a distribution
system at a price where everyone along the value chain can make a profit.
Drawing on these lessons, ColaLife is embarking on the Kit Yamoyo Transition to Scale Project
(KYTS), combining ten key approaches:2
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Revising the product design to better meet customer needs. This included reducing
the number of ORS sachets in the kit, redesigning the Zinc packaging and leaflet with
graphical instructions on usage to support increased adherence, and redesigning the
packaging to include two packaging designs: a screw-top and a flexi-pack.

Reducing the cost of production (through local production, design revision and
economies of scale) and passing this on to other actors in the value chain.
https://www.globalgiving.org/projects/colalife-aidpods-for-african-children/updates/?subid=56539.
http://www.colalife.org/nextsteps/.
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Embedding responsibility for the manufacture, distribution and management of the
product locally. Local partners in Zambia are currently taking over responsibility for
the manufacture and distribution of kits through the public and private sectors,
including supermarkets, as well as for awareness and promotion activities.

Leveraging support for the preparation and development of markets for products.

Building ‘end-to-end’ value chains where an affordable price for customers still
supports profits at every step and for each actor.

Stimulating a range of channels to market, including small community-based
retailers as well as national supermarkets.

Ensuring customer awareness through community level marketing as well as
nationwide campaigns.

Training micro-retailers in health issues around diarrhoea and the benefits of
treatment.

Supporting the poorest customers to access the commodities, such as through the
use of discount vouchers.

Collecting robust monitoring information and using this to support learning.
Most of these approaches need donor support in the short term, but ColaLife’s aim is that
once this investment is made and the market established, distribution of Kit Yamoyo will be
self financing in commercial situations and therefore sustainable in the long run.
ColaLife has won funding to support the dissemination of its innovative concept, using and
adapting the lessons learnt designs and processes from the COTZ, over the next two years to
interested agencies, governments and the private sector – to date, interest has been
received from 6 other countries.
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