Transcript India-based Zinc assessment for ANE

Scaling up Diarrhea Treatment
with Zinc and ORT through
Public-Private Partnership in
different Asian Countries
Camille Saadé, AED/ POUZN Director
[email protected]
Reconvening Bangkok: 2007 to 2010 – Progress
Made and Lessons Learned in Scaling-Up FP-MNCH
Best Practices in the AME Region
7 – 11 March 2010
Diarrhea, still # 2 killer of
children < 5
• Estimated 1.8 million deaths annually,
down from 4 million in 1990
• Improvement in preventative measures
(water, hygiene and sanitation)
• ORT / ORS rates declining
• Introduction of zinc treatment with ORT
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Zinc in the Treatment of Diarrhea
• WHO & UNICEF include Zinc for rational
treatment of diarrhea (2004) with ORT
• Zinc treatment in diarrhea:
– decreases duration of diarrhea by 20-24%
– reduces the severity of diarrhea by 25%
– provides protection for next 2 -3 months and
reduces diarrhea incidence by 34%
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POUZN Partnership Model
Private
Sector
Public
Sector
Development
partners/
Catalyst
NGOs
Health
Providers Community
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Policy and the Public Sector
• Included Zinc in national diarrhea
treatment guidelines along with ORT
• Zinc and ORS in procurement list
• Training of health workers on-going
• FDA approved Zinc as over-the-counter
(OTC) for diarrhea treatment
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Engaging the Pharmaceutical
Industry
• Well developed capabilities and
infrastructure
– Manufacturing, GMP compliance and Quality
Assurance
– Intensive marketing to doctors and
pharmacists but limited direct-to-consumer
marketing experience
– Nationwide distribution
• Initial enthusiasm and expectation of quick
return
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Production/ Supply is not the
Issue
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L-O ORS
Sustained Demand is the Issue
• At multiple levels:
– Health providers
– Drug sellers
– Caregivers
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Harmonized Message:
Rational Management of Diarrhea
= ORT + Zinc + Feeding
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The Phased Marketing Approach
Pharmaceutical
marketing
Health Professionals
Over-the-counter
(OTC) marketing
Drug Sellers
Interpersonal communication,
Mass advertising
General
Public
Time
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Working with Multiple Partners
• Competition and multiple
products keep prices down
• Additional products
increase “noise” and reach
• Competition helps push
product to lower socioeconomic groups
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Phase 1 Strategy: Establish Zinc
Among Health Professionals
• Engage Zinc manufacturers in promoting
rational management of diarrhea
• Enhance partners’ marketing capabilities
• Intensify continuous promotional efforts
and extended distribution
• Target key opinion leaders and top
prescribers
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1. Pouch bag
2. Brochures
3. Ballpoint
4. Notes
5. FAQ
Booklet
6. Clear
Folder
Phase 2: Saturation of Health
Care Providers and Drug Sellers
• Intensify regular Rx of Zinc among top
prescribers of diarrhea treatments
• Focus on drug sellers and 1st line care
providers in rural areas: informal RMPs in
India, midwives in Indonesia
• Target RMPs, midwives and outreach HW
through NGO’s health promoters.
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The Phased Marketing Approach
Pharmaceutical
marketing
Health Professionals
Over-the-counter
(OTC) marketing
Drug Sellers
Interpersonal communication,
Mass advertising
General
Public
Time
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Phase 3: Reach the Caregivers
• Interpersonal communication:
– Direct private sector promotion through NGOs
– Outreach health workers
• Mass Media – most effective when health
workers are on board, nationwide distribution in
public health system is in place, and there is
sufficient penetration in rural market
• Supported by Public sector and
Development partners
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Model Adaptability
Engaging strategically the private sector:
• Applies to FP/ MNCH/ other Public Health
• Reaches national scale rapidly
• “Primes the market” for public sector
• Increases efficacy of USAID investment
• Is sustainable after project life
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