ORSZCA updates sent by email

Subject: ORSZCA Update: GFF, WHO, UNICEF and launch latest
Date sent: 26-Oct-21

Colleagues

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.

Reflections

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]

Regards

Leith and Simon

Leith Greenslade and Simon Berry
ORSZCA Start-up catalysts

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