[e-drug] Coca-Cola and Global Fund to bring medicines to remote areas

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Coca-cola and the Global Fund Announce Partnership to Help Bring Critical Medicines to Remote Regions

http://www.theglobalfund.org/en/mediacenter/newsreleases/2012-09-25_Coca-cola_and_the_Global_Fund_Announce_Partnership_to_Help_Bring_Critical_Medicines_to_Remote_Regions/

Partners Expand Work in Africa to Bring Medicines “The Last Mile” in Tanzania, Ghana and Mozambique

Nearly 20 Million Africans Have Benefitted From Partnership Since 2010

New York – The Coca-Cola Company and the Global Fund to Fight AIDS, Tuberculosis and Malaria today announced they will expand a project leveraging the Company’s expansive global distribution system and core business expertise to help government and non-governmental organizations deliver critical medicines to remote parts of the world, beginning in rural Africa.

As part of their participation in the Clinton Global Initiative’s (CGI) Annual Meeting, the Company and the Global Fund outlined their plans to expand the reach of “Project Last Mile," a public-private partnership established in 2010 to help Tanzania’s government-run medicine distribution network, Medical Stores Department (MSD), build a more efficient supply chain by using Coca-Cola’s proven logistics models for delivering beverages most anywhere in the world. The newest phases of the partnership will increase the availability of critical medicines to 75 percent of Tanzania and expand the initiative to Ghana and Mozambique. Opportunities to expand into additional countries are being explored...

Please visit the web site to read the full news release:
http://www.theglobalfund.org/en/mediacenter/newsreleases/2012-09-25_Coca-cola_and_the_Global_Fund_Announce_Partnership_to_Help_Bring_Critical_Medicines_to_Remote_Regions/

regards

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E-DRUG: Coca-Cola and Global Fund to bring medicines to remote areas (2)
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Dear All,

Access to essential medicines for people residing in remote areas is a
perennial problem particularly in resource-constrained countries. Its a
great idea to leverage on the strong outreach network of corporate
organisations towards finding solution to this problem. A big commercial
organisation can take such projects as part fulfilment of its CSR
obligation. The Global Fund should lead this and expand such programmes in
other countries like India too. There is a huge unmet need here.

regards

Dr Santanu K Tripathi
Professor & Head
Department of Clinical & Experimental Pharmacology
Calcutta School of Tropical Medicine
108 C R Avenue, Kolkata 700073
Phone +91-9230566771
tripathi.santanu@gmail.com

Coca-Cola and Global Fund to bring medicines to remote areas (3)
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Dear E-Druggers

I found it interesting that some days after the original posting of the
story about Coca-Cola helping to distribute medicines through/with the
Global Fund that no-one has written in to either congratulate or condemn
the partnership.

Are there any lessons we should learn from this
public-private partnership? Are there moral/ethical concerns in
partnering with a company that could linked (be it rather indirectly) to
the obesity epidemic and disease burden or does the greater good of
making medicines accessible to patients outweigh any other issues?

However, perhaps the press release does not provide adequate information
other than some mutual appreciation between two benefiting parties.
Yale's Global Health Leadership Institute is also a partner (that
benefits from Coca-Cola Company funding) and provides a little more
insight on the web at http://nexus.som.yale.edu/ph-tanzania/.

Here are some snippets to add to the story for those with limited internet access:

Note: TCCC = The Coca-Cola Company; MSD = Tanzania's Medical Stores
Department

"Together with the Global Fund to Fight AIDS, Tuberculosis and Malaria,
the Bill & Melinda Gates Foundation, and Accenture Development
Partnerships (ADP), TCCC and MSD launched the 'Supply Chain
Transformation Project' in 2010, establishing a novel partnership model
that leveraged the global brand recognition of Coca-Cola and focused on
the transfer of core business expertise to improve the distribution of
pharmaceuticals and medical supplies in Tanzania."

“Phase '0': Rapid Assessment
... The assessment confirmed that instead of having TCCC actually
deliver or store MSD products, there were several opportunities for a
knowledge transfer partnership focused on last mile logistics, route
scheduling, development of key performance indicators, and the creation
of systems to enable the MSD to monitor customer needs and service
requirements.”

“Phase I: Defining Targeted Work Streams
... the partners decided to undertake a more comprehensive assessment to
identify the root causes of stock outs across the supply chain ... The
assessment was also designed to identify TCCC practices that could be
transferred to the MSD, including the use of supplier scorecards and key
performance indicators, and the manual distribution center model ... The
partners chose three work streams and initial pilot projects:
* ‘Last Mile’ Logistics: to develop an optimized last mile logistics
methodology in Chamwino district
* Core Planning: to develop a sales and operational meeting structure
and inputs
* Talent Management: to provide online training through ADP’s web-based
Supply Chain Academy."

"Phase II: Intensive Collaboration
... The core planning and procurement workstream resulted in the
following improvements:
* Reduced stockouts through proactive planning and communication
* Improved data and analytics to identify root causes of stock-outs
* Demand segmentation and priority routing of the most critical drugs
and supplies
* Improvements in supplier communications and relations through a
web-based feedback tool
* Improved efficiencies in tendering through the introduction of an
electronic process”

"Despite these successes at the central level, challenges remain:
* It is unclear how many of the new attitudes and procedures will be
integrated into MSD’s work processes beyond the end of the project.
* There was limited tracking and reporting of key performance indicators
(KPIs) to quantify improvements ...
* There are rate-limiting factors beyond the scope of this project that
are likely to limit the project’s impact at the health facility level.”

“The Supply Chain Transformation Project Key Performance Indicators
(KPIs) were designed to measure project impact at the central-level of
the MSD ... At this time, however, existing data systems are
insufficient to measure this project’s impact at the facility level."

regards

Douglas Ball
Pharmaceutical consultant
Public Health and Development
E-mail: douglasball[AT]yahoo.co.uk

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dear E-druggers,

It would be really good to have more info on this scheme. For years there
has been a fascination with Coca Cola' ability to penetrate markets in
rural areas almost everywhere. Yet there are obvious and fundamental
differences between a luxury product like coke and an essential life
saving product like medicines.

Best wishes
Mohga
Dr. Mohga M Kamal-Yanni
Senior health & HIV policy advisor
Oxfam GB
John Smith Drive, Oxford, OX4 2 JY
Tel +44 1865 472290
UK Mobile +44 777 62 55 884
Skype Mohga Kamal-Yanni
Follow me @MohgaKamalYanni

Oxfam works with others to overcome poverty and suffering.

Oxfam GB is a member of Oxfam International and a company limited by guarantee registered in England No. 612172.
Registered office: Oxfam House, John Smith Drive, Cowley, Oxford, OX4 2JY.
A registered charity in England and Wales (no 202918) and Scotland (SC 039042)

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Dear colleagues,

I gather most of us do share the observation made by Douglas. It is probably true to state that many developing countries now have a policy in place for inclusion of private sector players in public service agenda. The health sector is no stranger to these partnership policies and therefore the engagements that arise.

However, this private public engagement arena will remain a challenging place to walk into: Should one select to work with a tobacco company (because it may have one of the best logistics strategies), or not (because after all, it is tobacco..); should one work with a drinks company (again, because they apparently run or inspire a great logistics service), or not (because these drinks may equate obesity, and other bad results), etc.

Are some private sector industries better than others, in terms of these partnerships? There is indeed a judgement call to be made by decision- makers, and hopefully using fair and ethical parameters.

One other area of concern is that public sector players are quite often averse to engaging with private sector service providers. The 'Big' companies of these world would be accused of all manner of intentions, if and when they offer to provide their (private sector) expertise to to a public sector agenda that needs to meet a public goal.

This position has become so strongly held in certain quarters of public service (some public institutions, donors, and advocacy groups, etc), that there is no room at the table for (any) private sector players. And yet many governments are opening up to the services of the private sector through public private partnership policies, etc.

There is of course evidence why such strong positions are held; too many times vulnerable public sector institutions have been taken for a ride by self- serving private sector players. Lessons have, hopefully, been learnt by both parties.

I would argue that automatic alienation of private sector from public services (particularly health), is also likely to work against the public sector. I would argue that it is not only drinks companies, etc, that are so affected; this situation is a lot more closer to home when we talk about engaging pharmaceutical companies in public health services.

Many developing countries are receiving technical assistance on health programmes, for example, as a part of that company's Corporate Social Responsibility commitment, etc. Quite often, the partnership entering into this arrangement will not shout about it, even when the benefits from that partnership to public health are very clear, and are based on transparent arrangements.

As with most decisions we're making, we need to establish framework of engagement (eg, ethical grounds, etc). In the case where there are lifestyle choices to be made by individuals, should one on that basis, ground the potential contributions of a private sector entity such as Coca Cola, whose expertise, once engaged, could result in a public good?

So, probably this programme in Tanzania (TZ) may still be receiving critical consideration by colleagues around the world. However, for many of us that are now navigating in these arrangements, I would say, on my part, congratulations to the partnership in TZ; the country seems to be building upon the success of its ADDO programme, too.

Hopefully other counties will take a leaf from this experience in TZ and engage the funding institutions (GFATM, Gates, Accenture, etc) for support in similar cases.

Regards,

Bonnie
Bonface Fundafunda PhD., MBA., B.Pharm
Manager and Technical Adviser,
Drug Supply Budget Line
Ministry of Health,
P.O. Box 30205,
Ndeke House,
Lusaka,
Zambia
Tel: +260 211 25 41 83
Fax: +260 211 25 33 44
Mobile: + 260 979 25 29 00
Email: bcfunda@hotmail.com

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[Rollo Manning had a similar comment: look at http://www.colalife.org/
He considers that to be a brilliant example of co-operation between a service provider and Coca Cola Corp. WB]

dear E-druggers,

Those interested in Public Private Partnerships for Health that involve
Coca-Cola may be interested in the ColaLife Trial. With blessing of
Coca-Cola, we are using Coca-Cola wholesalers as the conduit to get
Anti-diarrhoea Kits (ADKs) to remote rural villages in two districts in
Zambia through the private sector.

There is an overall description of the project here: http://colalife.org

The features of our ADKs - called Kit Yamoyo - have been described by
others as innovative. The kit packaging fits into the unused space in
Coca-Cola crates (if it has to) but it also acts as:

   1. A measure for the water needed to make up the ORS solution
   2. A mixing device
   3. A storage device for the ORS solution
   4. A cup

This video brings these features to life by unpacking a kit and using it to
make up 200ml of ORS solution:
http://www.colalife.org/2012/10/17/the-kit-yamoyo-features-video/

Regards

Simon Berry
simon@colalife.org

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[2 responses, combined into 1 message; WB]

Dear E-druggers,

I don't think we are talking 'luxury' here necessarily. I think it's more
about 'desirability'.

Desirability generates demand and if you can make it profitable to fulfil
that demand for remote rural retailers (like Coca-Cola and many others do)
then, my theory goes, the product will get there. That's what we are
testing in the ColaLife trial.

Our hypothesis is:
“You can get a product or service to anywhere in the world if you can
create and sustain a demand for it and make it profitable to fulfil that
demand”

more:
http://www.colalife.org/2012/09/03/demand-driven-distribution-chains-step-1-create-a-desirable-product/

Obviously, this wouldn't work for everything but it might work for a
desirable anti-diarrhoea kit. It works for Panadol in Zambia after all.

regards

Simon Berry
*project manager | ColaLife Operational Trial Zambia (COTZ)*
*founder and ceo | ColaLife*
*+260 (0)9755 72175 | COTZ project office** http://colalife.org/map*
***skype: sxberry | simon@colalife.org | http://colalife.org*

---------
[2nd message]

A great overview by Bonnie on PPPs for health and some of the issues faced.

I would add, from personal experience, that not all PPPs are the same.
There is a tendency, I think, when talking and thinking about PPPs for
health to have the big global players in mind. When we started ColaLife we
thought we were talking about a partnership at global level with the likes
of Coca-Cola, UNICEF and others. Then it looked like a local partnership
with SABMiller (the Coca-Cola bottler in Zambia) would be where the PPP
would lie. Although we do have SABMiller as a formal partner in our work,
it turns out that they have no operational role - just an important
advisory one.

The operational PPP has ended up being two-fold:

   1. A partnership with a local Zambian Pharmaceutical manufacturer (to
   produce 4g/200ml ORS sachets and assemble our anti-diarrhoea kits) and
   2. A partnership between retailers in remote rural areas and the public
   health infrastructure/staff in the same areas

So our PPP has moved from the global to the hyper-local.

If our trial is successful and we go for a global roll-out then, once again
the level of the PPP will switch back to global before drilling down again
in each locality.

Regards

Simon

E-DRUG: MSF Holland: vacancy for a Pharmacist
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Effective 1 December 2012 the Public Health Department of Médecins Sans Frontières is looking for a:

Pharmacist (100%)

based in Amsterdam, the Netherlands.

The overall purpose of Médecins Sans Frontières (MSF) is to preserve life and alleviate suffering while protecting human dignity and seeking to restore the ability of people to make their own decisions. MSF accomplishes this through the provision of medical aid and a personal commitment to act as witness to events surrounding populations in danger. This work is essentially performed in periods of crisis, when a situation is no longer held in balance and the very survival of a population may be threatened. The underlying basis for realising its objectives is respect for medical ethics, humanistic ideals, human rights and international humanitarian law.

The Public Health Department (PHD) of the MSF Operational Centre Amsterdam (OCA) supports the overall purpose of MSF, providing medical and public health leadership for the organisation. The department is responsible for providing strategic direction and integrated advice on medical and public health issues to the field and headquarters. The PHD plays a key role in developing and maintaining the medical humanitarian identity and image of MSF-OCA, and in continuing to develop and improve intervention strategies so as to be relevant and effective.

The department is made up of a group of generalist Health Advisors (based in Amsterdam and Berlin) and medical and public health specialists (laboratory, mental health, nutrition, paediatrics, water and sanitation, etc. based in Amsterdam) so as to provide expert support in a range of fields. The Manson Unit, a medical unit based in MSF-UK, focuses on support to tuberculosis and epidemiology, including longer-term direct field support to overcome implementation challenges.

The pharmacist post is situated in the Public Health Department in Amsterdam. The PHD pharmacist works in close collaboration with the MSF-OCA procurement pharmacist in the Logistics department and with fellow pharmacists in other MSF operational centres.

PARAMETERS OF THE POST

Position within the organisation
The pharmacist reports hierarchically directly to the Co-ordinator Medical Specialists, Public Health Department (Amsterdam) and receives functional support from the international pharmacist (Geneva).

Objective of the post
The overall aim of this post is to assure, and continuously improve, the quality and use of pharmaceutical products in MSF-OCA, through definition of and monitoring adherence to MSF and recognized international pharmaceutical policies.

Core responsibilities and tasks:
• Lead implementation in MSF-OCA of relevant new MSF policies and procedures, including quality assurance of medicines, rational drug use, and pharmacy management • Continuously analyse developments in the realm of pharmaceuticals and liaise with counterparts within other MSF sections and other organizations in order to initiate timely updates to MSF standards and policies • Monitor and evaluate the quality of pharmacy management in MSF-OCA programmes • Provide quality and timely advice and support to health advisors and field medical and logistical personnel (especially medical coordinators) concerning pharmaceutical issues • Collaborate with human resources pool manager on development of pharmacist pool, and support development of field pharmacists through briefing, training, and coaching • Support the use of the standard pharmaceutical supply systems and tools • Advise operational and medical decision-makers on the possibilities and risks of local drug purchase in project countries, after evaluation of the safety of such purchases when importation is not possible • Execute field visits to selected missions to assist with addressing implementation difficulties and provide technical support on local procurement of pharmaceuticals where that has become necessary; document findings and recommendations in trip report • Lead and support optimal development of pharmacy management in MSF-OCA, in collaboration with the field support unit (logistics) and other MSF sections
  
CANDIDATE CRITERIA

Education and experience:
• Qualified Pharmacist
• Field experience in low-resource contexts
• Experience with quality assurance of pharmaceuticals
• Field/headquarters experience with MSF or a similar organisation is an advantage

Capacities and skills:
• Good written and oral communication skills, with the capacity to act as an adviser to colleagues and the field
• Must be able to visit and support projects at short notice, and willing to spend up to 30% of time in the field
• Strong interpersonal skills: innovative, able to mobilise/motivate and coach people
• Able to work under time pressure on various projects at a time
• Fluency in English and preferably French is required; Dutch is not necessary

WE ARE OFFERING

• A full time appointment (based on a 40-hour work week) for a period of (preferably) three years in Amsterdam as of December 1, 2012 • A gross monthly salary of a minimum €2,961 and a maximum of €4,230 depending on relevant professional work experience, for a full-time appointment • A stimulating, professional working environment in an international organisation • Attractive secondary benefits

INFORMATION AND APPLICATION

If you are interested in this post and would like additional information, please contact Debbie Cunningham (Coordinator of Medical Specialists) phone +31 20 5208724.

If you are interested in this position and believe that you fit the profile and meet the requirements, please send your application letter together with your CV before 4 November 2012 to officejobs@amsterdam.msf.org mentioning ‘Pharmacist’ for the attention of Ms Jaline Wijkhuizen (Personnel Officer HQ). Please also mention where you read about this vacancy.

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Dear E-Druggers,

Are we perhaps overstretching the analogy?

Coca cola stores very well under a very broad range of conditions. Most
medicines do not, and require rather restricted conditions of storage.

Building a robust supply chain for a product like coca cola cannot be
anywhere as difficult as building a robust supply chain for medicines,
which has complex regulatory and educational requirements and
pre-requisites.

I never saw anybody have to teach someone how to drink coca
cola. For instance.

Warm regards,

Bright Simons
mPedigree Network
bbsimons@mpedigree.net
www.mPedigree.Net

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Dear Simon, E-druggers,

Making a product desirable means creating demand. So that is fine on
paracetamol or Oral Rehydration Salt packs.

I do hope that it does not extend to creating demand for medicines to
treat diseases that require proper diagnosis by trained health workers.

Also the service has to be affordable for poorest people otherwise they
will be excluded.

Best wishes,

Mohga
Dr. Mohga M Kamal-Yanni
Senior health & HIV policy advisor
Oxfam GB
John Smith Drive, Oxford, OX4 2 JY
Tel +441865 472290
UK Mobile +44 777 62 55 884
Skype Mohga Kamal-Yanni
Follow me @MohgaKamalYanni

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Dear e-druggers,

There is, in my view, some confusion about Coca Cola and their ability to
get their product into every village and rural area. The reason we notice
it, is because it is a strong brand, of course supported consistently over
time by well-executed promotion and advertising - and by their distribution.
It is very well done, both promotion-wise and distribution-wise, and there
is much to learn.

However, if Coca Cola wasn't such a strong, visible, iconic brand we would
not notice it, or notice it much less - just like we do not notice as much
all the other products that reach as far and wide and deep as Coca Cola.

Yes, there are many products like that: soap and detergent, biscuits and
candy, pencils and pens, cigarettes and matches, salt and sugar - in short
all the small items one finds in the typical small town or village store,
including, to some extent, condoms.

The point is that supply chains exist for all these products, although they
are not as visible as for Coca Cola. Many of these can be used to distribute
"our" products as well - wholesalers and distributors are almost always
looking for new products to add to their line. Working with these local and
smaller dealers is a way to get "our" products into the mainstream
distribution channels for all these other products. And if it is profitable
for them, it is sustainable.

So although there is much to learn from Coke, there is not something magic
about Coke that nobody else does. There are many other products with supply
lines that reach 'everywhere". And let's keep in mind that these products
are all consumer products - and all sold through the private sector. Very
useful for that kind of products through that channel - professional
products and products for the public sector is again another thing for
another discussion.

Best regards,

Kim Beer
Kim von O. Beer
USA Office: +1-919-933-6192
USA Cell: +1-919-619-8490
fambeer@mindspring.com

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Dear all

Just to pique minds little more on the conflict of interest with
Coca-Cola, I direct you to an article by Reuters as part of its
investigation into the influence of Big Food on WHO that talks about how
PAHO (WHO in the Americas) is taking funding from food and nutrition
companies.

Ethical issues are different when dealing at a policy level
compared to dealing at a more technical level, but they are still
present (non-communicable diseases are on the rise due to unhealthy
diets, including too many sugary drinks, tooth decay contributes to
morbidity, often overlooked (it is the leading cause of school
absenteeism in the Philippines - National Oral Health Survey 2006).

Is it right for health services to partner with companies that contribute
to/cause the problem? Others might argue that this is an appropriate
response - even that they should be taxed for revenue to address
problems they contribute to (so-called 'sin' taxes) rather than being
allowed to gain honours as part of corporate social responsibility
programs that will help them to grow their business and cause more
morbidity. But when one is short of funds....an ethical dilemma can result.

I won't copy the whole article here since it is quite long (my apologies
to colleagues without internet access) but I have pasted the opening
paragraphs below (copied as Fair Use). It makes interesting reading.

Regards

Douglas
--
Douglas Ball
Pharmaceutical consultant
Public Health and Development
E-mail: douglasball[AT]yahoo.co.uk
---------------------------------------------

http://uk.reuters.com/article/2012/10/19/us-obesity-who-industry-idUSBRE89I0K620121019
[Please fix URL in browser if broken]

Special Report: Food, beverage industry pays for seat at health-policy table
By Duff Wilson and Adam Kerlin

Geneva, Switzerland | Sat Oct 20, 2012 12:37am BST

(Reuters) - As the world's foremost health agency, the World Health
Organization bills itself as an impartial advocate working on behalf of
194 member nations.

But to fight those diseases in Mexico, the nation with the world's
highest rate of obese and overweight adults, a Reuters investigation
found that WHO's regional office has turned to the very companies whose
sugary drinks and salty foods are linked to many of the maladies it's
trying to prevent.

The office, the Pan American Health Organization, not only is relying on
the food and beverage industry for advice on how to fight obesity. For
the first time in its 110-year history, it has taken hundreds of
thousands of dollars in money from the industry.

Accepting industry funding goes against WHO's worldwide policies. Its
Geneva headquarters and five other regional offices have been prohibited
from accepting money from the food and soda industries, among others.

"If such conflicts of interest were perceived to exist, or actually
existed, this would jeopardize WHO's ability to set globally recognized
and respected standards and guidelines," said spokesman Gregory Härtl.

But the Pan American office - known as PAHO, based in Washington and
founded 46 years before it was affiliated with WHO in 1948 - had
different standards allowing the business donations.

Even so, not until this February did PAHO begin taking industry money,
Reuters found: $50,000 from Coca-Cola, the world's largest beverage
company; $150,000 from Nestle, the world's largest food company; and
$150,000 from Unilever, a British-Dutch food conglomerate whose brands
include Ben & Jerry's ice cream and Popsicles.

The recent infusion of corporate cash is the most pointed example to
date of how WHO is approaching its battle against chronic disease.

Increasingly, it is relying on what it calls "partnerships" with
industry, opting to enter into alliances with food and beverage
companies rather than maintain strict neutrality. The strategy differs
dramatically from WHO's approach to interacting with the tobacco
industry - companies with which it is unwilling to partner.

The decision appears to stem in part from necessity.

Despite being tasked a year ago by the U.N. to direct the attack on what
both groups now call a "global epidemic," WHO has cut its own funding
for chronic disease programs by 20 percent since 2010 - an even bigger
decline than for the agency as a whole. These diseases cause 63 percent
of premature deaths worldwide, but the WHO department that leads the
effort to fight them receives 6 percent of the agency's budget.

The industry's cash donations, which have not been previously reported,
were described by Irene Klinger, a senior adviser for partnerships in
PAHO, as "a new way of doing business." She compared the closer
cooperation with that of a couple who needs to discuss marital problems.
She said PAHO spends about $30 million a year to fight chronic diseases.
But amid WHO's budget cuts, Klinger said, the organization needed
industry "money to make this happen."

Mexicans drink far more Coke than citizens of any other nation. But even
as Coca-Cola denies that soda causes obesity, it says it is committed to
solving the health crisis. The Atlanta-based company has placed a top
official on the steering board for WHO's Pan American Forum for Action
on Non-Communicable Diseases, a group that helps determine how WHO
fights obesity in Mexico.

Klinger and other WHO officials who work with industry say they are
careful to maintain control of policy making. But on its website, the Pan
American Forum touts the benefits of membership as helping businesses
"avoid regulation" and "influence regulatory environments."

"WHO is getting hijacked," said Boyd Swinburn, an Australian professor
and long-time member of WHO's nutrition advisory committees. "They're
cash-strapped, and they're bringing the private sector in. That's very
dangerous."

Coke sees the situation differently.

"It's about the convergence of the interests," said Jorge Casimiro,
Coca-Cola's director of international government relations and public
affairs. "What we're trying to say is we're ready to take action. We're
companies who want to do this. We're ready to go."

<snip - the article has been truncated here>

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Dear colleagues,

I fully agree with Dr Kamal-Yanni. In most cases so far that this sort of partnership is addressing, one is dealing with those situations were the parents or guardians are trained to address the most basic of illnesses (e.g., common diarrhoea).

Working together with the MOH which in the case of Tanzania and Zambia is the case, the guidance is provided accordingly, and limitations, boundaries, oversight services from government, etc, are all part of the package. There is no intention to bring on board disease such programmes, those disease conditions that require appropriately trained and experienced healthcare officers to carry out diagnosis and treatment.

Regards,

Bonnie
Bonface Fundafunda PhD., MBA., B.Pharm
Manager and Technical Adviser,
Drug Supply Budget Line
Ministry of Health,
P.O. Box 30205,
Ndeke House,
Lusaka,
Zambia
Tel: +260 211 25 41 83
Fax: +260 211 25 33 44
Mobile: + 260 979 25 29 00
Email: bcfunda@hotmail.com

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[discussion closed - WB (moderator)]

Thanks for raising the obvious point that is always forgotten: that all
sorts of products reach remote area.

It seems that global/foreign policy makers can only see foreign brands
like Coca Cola and contemplate its great success in penetrating such
markets.

So thank you Kim Beer for reminding them that people in remote
areas consume other products: essential products like sugar, salt and oil
as well as luxury products like Coke and harmful products like cigarettes.

Best wishes

Mohga
Dr. Mohga M Kamal-Yanni
Senior health & HIV policy advisor
Oxfam GB
John Smith Drive, Oxford, OX4 2 JY
Tel +44(0) 1865 472290
UK Mobile + 44 (0)777 62 55 884
Skype Mohga Kamal-Yanni
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E-DRUG: Coca-Cola and Global Fund to bring medicines to remote areas (15)
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[OK, this was the last response on this topic. Discussion closed. WB]

Dear e-druggers,

Kim's description of how things work, and one's general misconceptions of
how things work, match our experience exactly.

Just because you see Coca-Cola or talk-time signs everywhere doesn't mean
the products are available although to the casual observer the perception
is that they are. As an example, AirTel is one of the mobile phone
companies here and they have a very strong brand. A couple of months ago I
was in Siachetema village (a remote rural village in Kalomo District in
Zambia). It has about 8 small shops and almost without exception they
display an AirTel sign. However, none had any stock of talk-time the last
time I was there. Whereas more mundane items (with higher profit margins)
were available in most shops - cooking oil, washing powder etc

ColaLife's hypothesis is:
*“You can get a product or service to anywhere in the world if you can
create and sustain a demand for it and make it profitable to fulfil that
demand”*

So why are these small retailers not given more attention when it comes to
essential medicine supply to remote rural areas? It's true that they could
not handle 'complicated medicines' (eg cold chain items) but there are a
lot of essential medicines that are 'over the counter' in most places -
like ORS for example. And ORS is not an insignificant treatment. It is the
recommended treatment for diarrhoea and dehydration diarrhoea is one of the
top killers of under 5 children.

This presentation explains - in annotated pictures - the ColaLife business
model . . . note that there is not a Coke bottle in sight!
http://www.colalife.org/2012/11/06/the-colalife-business-model-in-annotated-pictures/

regards

Simon Berry
*project manager | ColaLife Operational Trial Zambia (COTZ)*
*founder and ceo | ColaLife*
*+260 (0)9755 72175 | COTZ project office** http://colalife.org/map*
***skype: sxberry | simon@colalife.org | http://colalife.org*