Intended for healthcare professionals

Head To Head

Should we welcome multinational companies’ involvement in programmes to improve child health?

BMJ 2015; 350 doi: (Published 17 June 2015) Cite this as: BMJ 2015;350:h3046
  1. Simon Berry, cofounder and chief executive, ColaLife 1,
  2. Jane Berry, cofounder and business development, ColaLife1,
  3. Rohit Ramchandani, doctor of public health candidate and public health adviser, ColaLife2,
  4. Nick Spencer, emeritus professor of child health3
  1. 1ColaLife, c/o Keepers Zambia Foundation, Lusaka, Zambia
  2. 2Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
  3. 3School of Health and Social Studies, University of Warwick, Coventry, UK
  1. Correspondence to: S Berry simon{at}, N Spencer N.J.Spencer{at}

Pragmatic partnerships with industry can work argue Simon Berry and colleagues, but Nick Spencer thinks the conflicts of interest are too great

Yes—Simon Berry, Jane Berry, and Rohit Ramchandani

“Coca-Cola? We won’t talk to them on principle.” This response, from some of the big players in global finance and child health, surfaced immediately when we approached the Coca-Cola Company at the start of our journey. For decades, many have marvelled at Coca-Cola’s distribution abilities, including those working to distribute essential drugs like oral rehydration salts and zinc. It is clear why. Ten years after the World Health Organization and Unicef recommended this treatment, worldwide less than 1% of children under 5 years with diarrhoea get it.1 Our mission with ColaLife was simple: collaborate across sectors to save as many children’s lives as possible in poor countries by enabling access to essential drugs that are often out of stock in clinics, particularly in remote rural areas.

We thought we could learn from talking to multinationals, and three years later, in 2011, the independently funded public-private partnership we’d put together thought so too. It included Zambia’s Ministry of Health, Unicef, pharmaceutical multinational Johnson & Johnson, local drugs company Pharmanova, drinks giant SABMiller, packaging experts PI Global and Amcor, the UK Department for International Development, and 20 non-governmental observers. We brought together global experts in design, market logistics, participatory consultation, public health, and monitoring and evaluation. We’d resolved that rather than condemn poor rural people to wait for free handouts we would offer them what the management professor C K Prahalad calls “the dignity of attention and choice.”2

Collaboration works

Within a year, our project had sold 26 000 kits to retailers serving rural communities in Zambia, and increased treatment rates with oral rehydration salts and zinc combination therapy from less than 1% to 45%, a preliminary analysis of ColaLife …

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