Cola model improves global health

ROHIT RAMCHANDANI (BSc ’04)

RohitHealth innovation goes beyond the creation of new medicines and technologies. It also demands new systems to deliver care. As the founder & CEO of Antara Global Health Advisors, Rohit Ramchandani (BSc ’04) advises organizations and governments on global health interventions. He and the organization ColaLife radically improved the treatment of childhood diarrhea in rural Zambia by adopting the value-chain principles used by Coca-Cola: creating demand for a product and making it profitable to fulfill that demand.

Ramchandani is an adjunct professor in Waterloo’s School of Public Health and Health Systems, and a co-lead of the University’s alumni chapter in Toronto. Recently, he answered questions about his work in health innovation.

How did you identify childhood diarrhea as a problem you wanted to solve?

The problem was actually identified locally, by the Government of Zambia, as a key health priority. In Zambia, and globally, diarrhea is one of the leading causes of death in children under five. Yet it is treatable with two simple, low-cost, life-saving medicines – oral rehydration salts (ORS) and zinc. The problem is that these medicines often don’t get to the people that need them, in the way that they need them.

Principles of aid effectiveness stress that developing countries set their own priorities for poverty reduction and have more say over their development processes. Donor countries like Canada and the UK should align with these objectives and use local systems. Zambia’s Ministry of Health was a key partner from day one; it chaired the steering committee, made up of a wide range of partners, which we established early in our innovation journey.

What is human-centred design, and how have you used it in your work?

Human centred-design is an approach to problem solving that develops solutions by involving the perspectives of those affected by the problem. While it seems somewhat obvious, it’s surprising how often this approach is not taken. By applying a design thinking mindset and approach, we are able to create products, services and systems that address the core needs of our end users. In our case, after speaking with caregivers of children under five living in rural Zambia, we learned a lot about the challenges they faced when trying to treat diarrhea. We were able to design an innovative product that addressed all of these issues and redefined the concept of a diarrhea treatment kit. Our product, the Kit Yamoyo, is now owned and manufactured 100% locally in Zambia.

Why are cross-sector partnerships so important to public health?

Years of development experience have shown us that siloed, top-down approaches tend not to lead to true systems-level change. More holistic models can be much more effective.

Health systems typically consist of players from public, private, NGO, civil society and academic arenas. While the strength of these various players will vary from country to country, their full participation and perspective is critical in understanding how to optimize the health system to maximize the quality and reach of interventions, products and services for the population.

Our world is constantly evolving. How is this rapid change shaping your field?

We have made incredible progress as a species and the world, for all its troubles, has gotten better over time. For all our differences, people largely agree on what goes into human well-being. Examples include life, health, sustenance, prosperity, peace, freedom, safety, knowledge, leisure and happiness. All of these things can be measured, and have improved over time based on related indicators. However, while progress and advances in other areas of science and technology have developed at a rate the world has never seen before, the rate of progress in evolving people’s health hasn’t kept pace.

Today, there is a shift taking place. We are more focused on evidence-based design and decision making. With better data, better engagement of our end users, democratization of technologies, more interdisciplinary collaboration and a stronger sense of our inextricable linkages and dependencies, we are regularly gaining new capabilities and more rapidly making strides in global health and sustainable development. Our responses to some of the grandest challenges in the world, as a result, are becoming more precise and more measured, and our rate of progress is improving.