Category Archives: Updates


Welcome to the ORSZCA UPDATE for November 2023

In this update we are focussing on our current four calls for action. These are always at the top of the home page of our website. Currently, they are:

1. WHO and UNICEF – encourage and support a joint policy brief by WHO and UNICEF on the new ORS/Zinc co-packaging recommendation >>more

2. UNICEF Co-pack pricing >>more

3. ORS/Zinc Status around the World >>more

4. DHS/USAID – engage with the next review of the DHS Questionnaires to incorporate questions around co-packaging >>more

1. WHO and UNICEF – encourage and support a joint policy briefing by WHO and UNICEF on the new ORS/Zinc co-packaging recommendation

A joint statement was being considered following the introduction of the co-packaging recommendation in the 2019 edition of the WHO Essential Medicines List. However, the COVID-19 pandemic meant it stalled.

ORSZCA was able to convene a meeting with WHO and UNICEF on 22-Feb-2023. Yasir Bin Nisar (WHO) represented both WHO and UNICEF. Anne Detjen (UNICEF) couldn’t make the meeting but had met with Yasir the week before. They had agreed that a “Joint Policy Brief” would be the most appropriate instrument. The objective of such a policy brief, which would go to all WHO and UNICEF Country Offices, would be to raise awareness of the new co-packaging recommendation in the expectation that this would help with the institutionalisation of co-packaging at the country level.

Following the meeting ORSZCA produced the following resources:

  1. A first draft outline for a policy briefing – this is open for comments here.
  2. A Position Paper on: Defining an ORS/Zinc ‘co-pack’ which is available in the ORSZCA Resources Library here: – again, comments on this are welcome. This was requested by WHO at the meeting.
  3. A summary of the meeting and key action points.

Unfortunately, our progress has hit a roadblock as our senior contacts at WHO and UNICEF have become unresponsive due to their busy schedules. Given the urgency of our cause and the impact this simple action could have on the lives of children, we plan to escalate this issue as soon as a new Head of Health is in place at UNICEF.

2. UNICEF Co-pack pricing

In the UNICEF Catalogue, the indicative price of a co-pack containing 1 L sachets of ORS and a blister pack of 10 zinc tablets is more than twice the price of its component parts. This goes against the general market trend. You can see the calculations here: ORS/Zinc product prices in the UNICEF Catalogue (Sep-2023 tab).

ORSZCA members first raised this issue with the then director of UNICEF Supply Division Director (Etleva Kadilli) in January 2022 and were referred to the re-tendering process for ORS/Zinc products that was about to get underway. This process has now finished and the catalogue prices remain virtually unchanged.

The ORSZCA Secretariat (Simon Berry) met with the Chief of the Nutrition & Medicines Unit (Francisco Blanco) and Cynthia Kamtengeni on 25-Oct-23. UNICEF are very reluctant to change the algorithm they use to calculate indicative pricing as this would mean changing it across the whole catalogue. Our concern is that the indicative pricing of co-packs in the UNICEF Catalogue is a barrier to the uptake of co-packaging and we will continue to push for the algorithm to be changed. In the meantime, FB agreed to look into the possibility of adding a note to the indicative pricing of co-packs in the UNICEF Catalogue. We agreed on the following action points and these include a follow-up meeting in Jan-2024:

ORSZCA to share improved understanding from this meeting with ORSZCA members.
ORSZCA to share ORSZCA’s current pricing information with FB.
ORSZCA to look into becoming a source of pricing information – fulfilling a similar role to the MSF Price guide (but just for ORS/Zinc).
FB to investigate putting up an explanatory note against the co-pack indicative price in the UNICEF Catalogue.
FB to look into possibility of analysing tenders received from manufactures to improve knowledge of the current price differentials between co-packs and separates, and get an idea of the number of manufacturers who tendered who produce their own ORS and Zinc (as opposed to those who have to source one or other of the components externally).
FB, CK and SB to meet again in 3 months time (Jan-2024) to review progress.

3. ORS/Zinc Status around the World

We are still keen to receive completed questionnaires (in English or French) on the ORS/Zinc status in your country – this is especially true if you have knowledge of the situation in Niger and Chad. We’ve had no completed questionnaires from these two countries. We’ve been adding to the information contained in the questionnaires through our own research and conversations with members. For example, we’ve been able to locate and link to many of the national Essential Medicines Lists from our unique snapshot of the status of ORS and Zinc around the world.

4. DHS/USAID – engage with the next review of the DHS Questionnaires to incorporate questions around co-packaging

ORSZCA wishes to institutionalise the monitoring of the uptake of the ORS/Zinc co-packaging recommendation. One way of doing this would be to update the appropriate DHS template questionnaire. ORSZCA is seeking to engage with the next DHS review process which was due to start in Sep-2023. We now believe this will take place in Mar-2024. We now wish to gather a group of ORSZCA members around this issue with the aim of suggesting a change to DHS Woman’s questionnaire (Question 615) that would capture the extent to which co-packaged ORS and zinc is being used. If you can help by joining this group, please reply to this email.

As always, please let us have any comments you may have on this UPDATE by replying to this email.

Thank you.

Morseda and Samy
ORSZCA Co-chairs

Dr Morseda Chowdhury
Director of Health, Nutrition and Population Programme
BRAC, Bangladesh

Samy Ahmar
Head of Health
Save the Children, UK




ORSZCA UPDATE: 20-Dec-2022

Subject: ORSZCA UPDATE: Global Fund to support improved ORS/Zinc access
Subheading: Global Fund gets more holistic

Welcome to the ORSZCA UPDATE for Dec 2022


We continue to update and share our resource on the ORS and Zinc status around the world – You can help by adding to the resource either by commenting on the ORSZCA website or by completing a questionnaire in English or French.


ORSZCA welcomes a major new policy shift by The Global Fund, to provide co-financing to eligible countries for the provision of ORS and Zinc to children under five years, as part of their support for Integrated Community Case Management (iCCM) programmes. 

A highly informative webinar, run by the Child Health Task Force on 7-Dec-22 can be reviewed here: THE GLOBAL FUND WILL FINANCE ORSZ FOR UNDER-5 DIARRHOEA IN ELIGIBLE ICCM PROGRAMMES (English only). This is an excellent document with detailed advice and methods on how one might make the case for diarrhoea treatment with ORS and Zinc. It also contains background for those new to The Global Fund and links to the key materials.

If you’d like to listen to the webinar again the recording is here:

The recording includes interpretations in different languages.

So, what are the key messages and next steps for those advocating for improved access to co-packaged ORS and Zinc?

  • Until now, The Global Fund has focussed on HIV/AIDS, Malaria and TB. As the Fund expands to support Community Health Worker (CHW) distribution of a wider range of essential medicines for children, we need a proactive effort to make sure ORS and Zinc are included in bids, and specifically in co-pack form. This will require the active engagement of new advocates in LMIC, outside the specialisations of HIV/AIDS, Malaria and TB, who may not have previous experience of The Global Fund.
  • You are encouraged to contact the Country Coordinating Mechanism (CCM) in your country to see how to engage and participate. You would do this through the CCM administrative contact. As well as an administrative contact, there is normally a CCM Chair and Vice Chair. The full CCM details for all countries can be found here:
    As a quick reference, the current CCM Administrators for the Anglophone countries in the  top 10 high burden childhood diarrhoea countries are

Mr. Abayneh  ADMAS

Ms Gitanjali  MOHANTY
India CCM Coordinator
Ms Sandhya  GUPTA
India CCM Coordinator
Dr Shobini  RAJAN

Mrs Ishioma  JOHN
Finance and Admin. Officer

Mr Hafiz Hammad  MURTAZA
CCM Coordinator 

Mr Ahmed  HASSAN
Secretariat Coordinator

Some of the key features of the 2023-2025 Global Fund Strategy are:

  • The Global Fund Strategy has CHWs and iCCM at its heart. It will support the provision of ORS and Zinc at the community level. It will NOT support the management of diarrhoea cases in health facilities.  For this reason, co-packaging has huge potential to improve the likelihood that children receive both ORS and Zinc when treated in the home, helping to underpin  the ‘rational use’ requirements of successful bids. 
  • The focus is on children under five years of age.
  • Co-financing is needed.
  • Funding is not just for provision of medicine: applicants will have to identify gaps in their CHW expansion plans, to include Human Resources for Health (HRH) planning and recruitment, training, remuneration etc. Note that HRH may sometimes be abbreviated as HHR (Health Human Resources).
  • Financing is part of The Global Fund’s Resilient and Sustainable Systems for Health (RSSH) grants: successful applications will need strong Health Management Information Systems (HMIS), access to data and alignment with national health strategies.

Key resources:

Please let us know about your experience engaging with this new opportunity, especially in areas where ORSZCA might be able to support.

Thank you.

Morseda and Samy
ORSZCA Co-chairs

Dr Morseda Chowdhury
Director of Health, Nutrition and Population Programme
BRAC, Bangladesh

Samy Ahmar
Head of Health
Save the Children, UK

ORSZCA UPDATE: 14-Nov-2022

Subject: ORSZCA UPDATE: Global ORS/Zinc Status, Child Health Spotlights, DHS, Website now in French

Welcome to the ORSZCA UPDATE


We continue to update and share our resource on the ORS and Zinc status around the world – You can help by adding to the resource either by commenting on the ORSZCA website or by completing a questionnaire in English or French.


UNICEF and Save the Children have collaborated to share 15 “high-burden” country profiles focussed on pneumonia and diarrhoea and in particular how to protect, prevent and diagnose and treat these two diseases – see Our concern is that the resource makes no mention of ORS or Zinc for the treatment of diarrhoea. We are in communication with those behind the site in an attempt to get this corrected. This is particularly important as the site is designed to “help inform policy and decision-making at national and global levels”. We have also suggested that profiles are added for Cameroon and Madagascar which are both in the top 10 high-burden diarrhoea countries.


As a network focussed on accelerating the uptake of co-packaged ORS and Zinc, we are interested in how we monitor the uptake of this 2019 WHO recommendation. With this in mind, we have been in contact with ICF, which has implemented the USAID-supported Demographic and Health Surveys (DHS) Program since 1984, with a view to modifying the questions within the DHS that relate to diarrhoea treatment to gather information on co-pack usage. The DHS questionnaires are reviewed every five years and the next opportunity to engage in this process will be in the last quarter of 2023. Between now and then we will be consulting with the ORSZCA network on how the DHS questionnaire might be usefully modified to collect this data. If you can contribute to this effort please email


We have updated our information on ORS/Zinc Co-pack manufacturers around the world but would like your input in ensuring the list is as complete and correct as possible. Please add any amendments or additions by commenting on our manufacturers page here: ORS/ZINC CO-PACK MANUFACTURERS. Your comments will not be published directly on the website but will be used by our website editor to update the page.


Of the top 10 countries with the highest -burdens of diarrhoea, five are Francophone: Cameroon (8th), Chad (5th), DRC (7th), Madagascar (9th) and Niger (6th). However, engagement with ORSZCA from these countries is very low. As part of a strategy to improve this we have now launched a French version of the ORSZCA website. We have also split our mailing list and in future we will be issuing different versions of this ORSZCA UPDATE for English and French speaking members. If you would like to receive the French version of the ORSZCA UPDATE in future please email If you have contacts in Francophone countries you might benefit from the ORSZCA UPDATE please direct them here: INSCRIVEZ-VOUS ICI

Thank you.

Morseda and Samy
ORSZCA Co-chairs

Dr Morseda Chowdhury
Director of Health, Nutrition and Population Programme
BRAC, Bangladesh

Samy Ahmar
Head of Health
Save the Children, UK



Welcome to the August ORSZCA UPDATE

As announced in our June update, on 15-Jul-22, thirty two experts gathered to share their views on the Enablers & Barriers to increased ORS and Zinc coverage. These included two co-pack manufacturers (Nigeria and Zambia), those with experience delivering ORS/Zinc programmes and academics who had evaluated such activities. These Enablers & Barriers were captured in our Enablers & Barriers table which is still open for additional views and comments here. The columns in this table are based on the framework suggested in the review: Progress over a Decade of Zinc and ORS Scale-up (Feb-2016) – Diarrhoea & Pneumonia Working Group.

We also recorded the key contributions made during the event here. This document is also open for comments.

We will now be encouraging follow-up conversations to dig deeper into some of the key issues.

A resource offered by USAID during the roundtable was the slidedeck from the Dec-2020 USAID Partners meeting: Building on over a decade of progress in ORS/Zinc. This can be downloaded from the ORSZCA website here.


We continue to update and share our resource on the ORS and Zinc status around the world – – you can help by adding to the resource either by commenting on the ORSZCA website or by completing a questionnaire in English or French.

Thank you.

Dr Morseda Chowdhury and Samy Ahmar
ORSZCA Co-chairs
BRAC, Bangladesh and Save the Children, UK 






Welcome to the June ORSZCA UPDATE with opportunities to contribute and help.

We are organising an invitation-only roundtable to improve our understanding of the enablers and barriers to increasing ORS/Zinc coverage particularly in the top 10 high burden countries. We have invited all the people we know with experience implementing or evaluating ORS/Zinc programmes to participate. If you’ve not received an invitation and are able to participate, please email for an invitation. The key output will be the completion of this table of enablers and barriers.
The 90-minute roundtable will take place on 15 July 2022 from 10:00am to 11:30am (EST).

Thanks to all those who responded to our Call to Action in the last ORSZCA UPDATE and completed our an online questionnaire (en Français) to gather information on the ORS/Zinc status around the world. We now have a unique public resource developing here: ORS/Zinc status from around the world. However, we do need a bit more help to obtain questionnaires from Cameroon, Chad, Madagascar and Niger. If you are from one of these countries, or have appropriate contacts, please complete a questionnaire on the link above. The questionnaire will take less than 10 minutes to complete and is designed to quickly collect the information you have at your fingertips.

We will be sharing the outcome of the above enablers and barriers to ORS/Zinc coverage roundtable before the end of July for you to use to help support child health strategy development (local and international), funding bids, research plans, local proposals for action and so on.
We are also sharing back information harvested for the ORS/Zinc status questionnaires as they come in here:

Thanks again for your support.

Dr Morseda Chowdhury and Samy Ahmar
ORSZCA Co-chairs
BRAC, Bangladesh and Save the Children, UK


Faites défiler vers le bas pour lire et remplir le questionnaire en français


With the launch of ORSZCA complete, we have moved on to the ORSZCA work plan. In our discussions so far with UNICEF, would-be donors and partners, the most frequently asked question, that no one can answer, is “What is the current status of ORS and Zinc across LMICs?”:

  • Where does Zinc have “over the counter” status?
  • Which countries are using ORS/Zinc co-packs?
  • Which countries have co-packaged ORS/Zinc on their Essential Medicines List?
  • Co-pack pricing, availability, and so on

Working together, we, the ORSZCA Network, can bring this information together for everyone to see and enable strategic planning to help ensure that the new WHO co-packaging recommendation is implemented on the front line, and save hundreds of thousands of lives.

To enable this, we have developed and piloted an online questionnaire (in French and English) to gather this information from each country. It takes less than 10 minutes to complete. You do not have to know the answer to every question; our aim is to quickly gather insights from the information you have at your fingertips. We hope to receive multiple questionnaires from each country.

Please click on the link below to submit the information for your country:

The information contained in submitted questionnaires will be anonymised and published as country summaries on the ORSZCA website here:

The launch on 19-Jan-22 was a great success and once again we wish to thank the Child Health Task Force for hosting the event. More than 200 people registered for the event and around 75 people attended. All 200 registrants were sent a link to a recording of the launch. The launch was rich in content with six international speakers and panellists. This content has been curated here: – with key points and transcripts in both French and English.

We look forward to receiving your questionnaires and sharing the information back to you.

Dr Morseda Chowdhury and Samy Ahmar
ORSZCA Co-chairs
BRAC, Bangladesh and Save the Children, UK

Please register to join the ORSZCA Launch – 19-Jan-22

Launch of the ORS/Zinc Co-pack Alliance (ORSZCA)

Date: Wednesday, 19 January, 2022
Time: 9am – 10:30am EST [GMT-5]
Zoom: Register here

Photo credit: Kate Holt/MCSP, Nondwe Iganga, Uganda

Please register to join a webinar to launch the ORS/Zinc Co-pack Alliance. We are grateful to the Child Health Task Force for hosting our launch. ORSZCA brings together organisations and individuals to identify and remove barriers to co-packaging to accelerate uptake and save lives. The Child Health Task Force will collaborate closely with ORSZCA towards the common goal of strengthened equitable and comprehensive child health programs. Join the event to hear from a distinguished panel of experts on this topic, meet the ORSZCA leadership, and become a part of this global collaborative effort.
Register here.

Speakers & Panelists

Dr. Alison Morgan
Senior Health Specialist
Global Financing Facility
Audrey Battu
Essential Medicines
Clinton Health Access Initiative
Malia Boggs
Senior Technical Advisor
Child Health
Dr. Om Prakash Singh
Head of Health and Nutrition
Save the Children India
Dr. Robert Black
Global Disease Epidemiology and Control, Johns Hopkins University
Dr. Tahmeed Ahmed
Executive Director, icddr,b


    • Dr. Morseda Chowdhury, Director, Health, Nutrition and Population Programme, BRAC Bangladesh, ORSZCA Co-chair
    • Samy Ahmar, Head of Health, Save the Children UK, ORSZCA Co-chair
    • Dyness Kasungami, Director, Child Health Task Force, Senior Child Health Advisor, JSI Research & Training
    • Simon Berry, ORSZCA Start-up Catalyst, ColaLife

Please register using the link below in order to access the meeting connection information and add the webinar to your personal calendar.


ORSZCA Update: 14-Dec-21

Welcome to the latest *pre-launch* ORSZCA Update. 

UNICEF responds on co-pack prices and invites ORSZCA to join pre-tender consultation
In our last update we explained that discussions with UNICEF on co-pack pricing had stalled. We asked ORSZCA members to consider writing to the Director of UNICEF Supply Division to express concern about the fact that, in the UNICEF catalogue, an ORS/Zinc co-pack is more than twice the price of its component parts.

We’d like to thank all those who used our template letter to help re-start discussions. This approach worked. We received replies from the Director, Ms Etleva Kadilli, and the Chief of the Medicines and Nutrition Centre, Dr Akthem Fourati. These responses explained why the 2020 re-tendering for ORS/Zinc products did not happen – COVID – another example of the way COVID has disrupted health services for children. However, both UNICEF respondents reassured us that they were finalising tender preparations for ORS/Zinc products for issuance early in Quarter 1 of 2022 and have asked the ORSZCA team to be part of our pre-tender consultations with key partners. This is good news.

Various reasons were given as to why the current catalogue co-pack prices (from 2015) are more expensive than their component parts but we believe that these reasons should not apply in 2022. In their response, the ORSZCA Co-chairs welcomed the imminent re-tendering but stated:

…we wish to reiterate our utmost concerns that, going forward, […], attention should be paid to whether ORS/Zinc co-packs appear to be more expensive than the sum of their parts. This would be an active disincentive to the purchase of co-packs and this has a real, concrete impact on child morbidity and survival.

This is the second example of how, by acting together, ORSZCA can remove barriers to the uptake of the 2019 WHO ORS/Zinc co-packaging recommendation. In October this year the GFF changed the publicity around their ‘Reclaim the Gains’ initiative from “oral rehydration treatment” to “oral rehydration solution and zinc treatment”. This will affect how 458 million additional diarrhoea treatments are delivered between now and 2025.

Latest on the ORSZCA launch
Preparations are advancing for the ORSZCA Launch on 19-Jan-22 at 9am EST. This will take the form of an interactive webinar. So far, we have confirmed contributions from Prof Dr Robert Black (Johns Hopkins Bloomberg School of Public Health) and Dr OP Singh (Stop Diarrhoea Initiative/Save the Children India). We will send a full programme shortly, once all elements are confirmed, to all ORSZCA and Child Health Task Force members.In the meantime, please add the launch date to your calendar and forward this email to anyone you think might be interested:

Add the ORSZCA Launch webinar to your calendar:
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Once again, we thank the Child Health Task Force for hosting the launch.

Replies to this email are open; please get back to us with your comments.

Simon and Leith

Simon Berry and Leith Greenslade
ORSZCA Start-up catalysts




ORSZCA Update: 30-Nov-21

Welcome to the latest *pre-launch* ORSZCA Update.

We have two big announcements and one call to action.

1. ORSZCA Co-chairs confirmed
We are pleased to announce the ORSZCA Co-chairs. They are Dr Morseda Chowdhury, Director, Health, Nutrition and Population Programme, BRAC, Bangladesh and Samy Ahmar MSc, Head of Health, Save the Children, UK.

Dr Morseda Chowdhury, BRAC, Bangladesh
As Director of HNPP in BRAC, Dr. Morseda Chowdhury heads the largest non-governmental healthcare network in the world with ~50,000 community health workers (CHWs) serving a 110m population in Bangladesh. Currently, the program reaches around 10m people through CHWs with Essential Health Services (EHS) and Reproductive Healthcare which includes Orsaline and zinc packages for mothers, children and adolescent girls.
With nearly 20 years of work experience and PhD from Sydney School of Public Health, Dr. Morseda brings decades of experience in Public Health from practical project management to strategic research. Her specialty lies in reproductive healthcare, nutrition, communicable and non-communicable diseases through community-based healthcare at national scale.
As ORSCZA co-chair, she brings the insight of practical ground-level realities of a nation-wide program combined with academic research for advocacy with the Government.

Samy Ahmar, Save the Children, UK
Samy Ahmar is Head of Health at Save the Children UK, where he and his team oversee a global portfolio of maternal, newborn, and child health projects in 20 countries with a focus sub-Saharan Africa and South Asia. Samy has 14 years of experience in international development, global health and evidence-based programming. Recent work includes diarrhoea-control in India and Nigeria, adaptive MNCH programming in rural DRC, the development of evidence-based strategies for pneumonia control in nine countries and the development of global health partnerships with a private sector organisations. Samy’s blog page is here.

Leadership like this will ensure that co-packaged ORS and Zinc gets the attention it needs to trigger the step-change in the coverage of ORS and Zinc we are seeking.

2. ORSZCA launch date set
Our Co-chairs will introduce themselves at the ORSZCA Launch webinar which has been set for 19-Jan-22 at 9am EST. Please hold the date – add the event to your calendar using the links below. We thank the Child Health Task Force for their offer to host the launch and a formal invitation will be sent in due course with the details of the interactive agenda and speakers.

Add the ORSZCA Launch webinar to your calendar:
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3. Call to action: A letter to UNICEF on Co-pack pricing – template provided
We are pleased to have started a positive dialogue with UNICEF Supply Division on their co-pack pricing but this has stalled, so we are asking ORSZCA members to consider writing to the Director of UNICEF’s Supply Division, Ms Etleva Kadilli, to ask for her support on this issue. To help with this we have provided a template letter here.

And finally, replies to this email are open, please get back to us with your comments.


Simon and Leith

Simon Berry and Leith Greenslade
ORSZCA Start-up catalysts

ORSZCA Update: 26-Oct-21

ORSZCA updates sent by email

>> GFF, WHO, UNICEF and launch latest

Welcome to the latest *pre-launch* ORSZCA news. This is a summary of what ORSZCA and friends have achieved in recent weeks.

Global Financing Facility (GFF)

ORSZCA applauds the clarification made in mid-October by the GFF to their Reclaim the Gains campaign endorsing the importance of Zinc together with ORS in the treatment of childhood diarrhoea. Reclaim the Gains stands out as being the most significant current global initiative aimed at improving access to diarrhoea treatment. It is essential that such a significant effort is in line with the current WHO and UNICEF treatment recommendations.

Over the last three months ORSZCA has been engaged in a positive and productive dialogue with GFF which has resulted in their reference to an additional 458 million “oral rehydration treatments” being amended to “oral rehydration solution and zinc treatments”. This simple change could save hundreds of thousands more young lives. We thank ORSZCA members who sent letters to the GFF. They made a difference!
See the ORSZCA blog for more details.

WHO Virtual technical meeting on the prevention and management of childhood pneumonia and diarrhoea

Both ORSZCA start-up catalysts (Leith Greenslade and Simon Berry) were invited to this key three-day virtual event aimed at re-energising efforts to combat the two top infectious killers of young children. This was the first time this group had met since the addition of co-packaged ORS and Zinc to the WHO Essential Medicines List (EML) in 2019. Surprisingly, co-packaging was not mentioned in the diarrhoea paper circulated before the event. However, this was addressed very effectively during the meeting and featured in the summary feedback. We await the full report of this meeting.

UNICEF Supply Chain catalogue / Co-pack price

While developing the Data & Evidence section of the ORSZCA website, we included the evidence that the Diarrhoea Innovations Group (DIG) and partners presented in their application to WHO to modify the EML and one subsequent survey in Uganda (Lam et al 2019) on co-pack prices. All of these sources indicate that buying an ORS/Zinc co-pack is cheaper than buying the components separately.

We then checked the prices in the UNICEF Supply Chain catalogue only to find that a co-pack is more than twice as expensive than ORS and Zinc bought separately from the same catalogue. We immediately sought to engage UNICEF on this, and we are pleased to report that a conversation has started. We understand that these prices were last updated in 2015 – four years before the EML recommendation changed (in 2019) and at a time when co-packaging was seen as an innovation, not mainstream. Moving forward ORSZCA will be providing all the support we can to expedite an update to the UNICEF catalogue. We consider this to be an urgent task. We will be sharing a template letter to UNICEF with ORSZCA members next week and we will be encouraging you to share it and create your own version to send to the Director of UNICEF Supply Division.

Clearly, UNICEF customers are unlikely to implement the current WHO co-packaging recommendation if it will cost them more than twice as much to do so. The other concern is that the UNICEF pricing is used as a benchmark by donors, policy makers, and strategists and currently the UNICEF catalogue gives a very misleading picture of what is happening elsewhere in the market where co-packaging is the cheapest way to deliver both ORS and Zinc for diarrhoea treatment.

ORSZCA launch

In parallel with the urgent activities above, we have been planning the launch of ORSZCA and are in the final stages of securing two co-chairs: one from an organisation in the global south and the other from the global north. We anticipate sharing news on this next week.


What recent weeks have underscored is the need for advocacy for co-packaged ORS and Zinc for diarrhoea treatment. Without it, the current global diarrhoea treatment recommendation is too often overlooked. Aligning all the key players should not be difficult to do, as the GFF example shows above, and doing so has the potential to prevent more than 400,000 child diarrhea deaths each year.[1]


Leith and Simon

Leith Greenslade and Simon Berry
ORSZCA Start-up catalysts