The Social Innovation
Simon and Jane Berry founded ColaLife with the goal of transforming access to life-saving diarrhoea treatment in Sub-Saharan Africa, starting with Zambia.
ColaLife’s innovation is the Kit Yamoyo: an affordable, aspirational anti-diarrhoea kit containing co-packaged Oral Rehydration Salts (ORS) and Zinc, designed for easy use and distribution through both public and private channels.
The model leverages value chain thinking and human-centered design to overcome barriers to access, with a focus on creating demand and profitability at every step - inspired by the Coco-Cola value chain.
For distribution, given the demand and need, ColaLife was able to leverage existing retail and public sector distribution channels, moving beyond their initial idea of simply “piggybacking” on Coca-Cola crates. Given the high need, the companies and public sector partners were game to include their product in their delivery channels, which helped expand the reach.
During a trial in 2012/13, 26,000 kits were sold in rural Zambia in just one year, raising the correct treatment rate for diarrhoea in the trial areas from less than 1% to 45%. After the trial, ColaLife assisted with a national scale-up until 2018 when all external assistance came to an end.
To help quantify ColaLife’s legacy an analysis was done 4.5 years after withdrawal. This found that during the seven years of ColaLife’s involvement, 760,000 kits were distributed. In the 4.5 years since withdrawal a further 1.1 million kits had left the local manufacturer’s factory. Today, 85% of these kits are distributed free of charge via government clinics.
Magnitude of the Problem, and its Root Causes
Each year, approximately 300,000 children die from diarrhoea in Sub-Saharan Africa, yet less than 1% of these children receive the recommended treatment of Oral Rehydration Salts (ORS) combined with Zinc. Additionally, 40% of children under the age of five in the region are stunted, with diarrhoea being a major contributing factor.
During their participation in the Globalizer co-created by Ashoka and Philips Foundation in 2016, ColaLife highlighted the following key factors contributing to the magnitude of the problem:
- Poor access to ORS and Zinc (distance, cost, supply chain gaps)
- Lack of awareness about the co-packing of ORS-Zinc and hence lesser demand among caregivers
- Public sector systems strained; private sector underutilized
- Product design not suited to local needs (e.g., 1L sachets impractical)
- Policy inertia and lack of local manufacturing
Based on their systems change analysis, the ColaLife team made it their mission to build a sustainable market for a better designed and distributed ORS/Zinc co-pack to tackle the inaccessibility and lack of awareness.
The Globalizer was very valuable because it took us through that detailed thought process and actually made us realise, hang on, we don’t think we can do this or... we don’t think it’s the right approach.
Strategy to Catalyze a Network of Changemakers towards the Targeted Mission
The ColaLife team realized that country-by-country replication would not achieve the desired scale or sustainability and shifted its strategy to influence a global policy within the most influential player in the system - the World Health Organization.
Some of the tactics they deployed towards the mission as a part of the strategy include:
1) Co-created, with the Diarrhoea Innovations Group (DIG), a pitch to the WHO to include ORS-Zinc in their Essential Medicines List
After piloting and scaling Kit Yamoyo in Zambia, ColaLife realized that the most effective way to build the co-pack market to address the inaccessibility and lack of awareness was to change the global standard of care.
We weren’t interested in globalising our organisation. We were interested in globalising our impact.
Our organisation and the methodology that we developed was best applied to trying to change the system at global level. So instead of going, you know, country by country repeating what we’d done in Zambia. We decided that the best way was to try and get co-packaged ORS and zinc on the WHO essential medicines list.
They identified that influencing the WHO Essential Medicines List (EML) as the most impactful strategy, since many countries base their national lists and procurement on the WHO EML.
To pursue this, ColaLife approached the Diarrhoea Innovations Group (DIG), a global network of technical experts, researchers, and practitioners focused on improving diarrhoea treatment and prevention. They made a compelling case to DIG that, beyond technical innovation, there was a critical need to advocate for policy change—specifically, to get co-packaged ORS and Zinc recognized as the global standard for diarrhoea treatment.
DIG, with its broad membership and technical credibility, was well-positioned to support this effort. By pooling expertise and resources, the group prepared a formal application to the WHO to add co-packaged ORS and Zinc to the Essential Medicines List. This process required assembling scientific evidence, demonstrating public health need, and building consensus among global health stakeholders.
The application had 15 named authors and was successful. In 2019: the WHO updated its Essential Medicines List to include co-packaged ORS and Zinc for the treatment of childhood diarrhoea.
This policy change was significant because, although the EML is not legally binding in any way, it strongly influences national health policies and procurement decisions across different countries.
2) Co-created ORSZCA to Involve Players to Accelerate the Uptake of ORS/Zinc by National Governments
Following the inclusion of co-packaged ORS and Zinc in the WHO Essential Medicines List, the ORS/Zinc Co-pack Alliance (ORSZCA) was formed as an informal global network with the aim on accelerating the uptake of the new guidance by national governments and those working in partnership with them.
ORSZCA had a mailing list of 250 members across countries which would support data collection and monitor progress of the uptake.
By the end of 2024 at least 3 governments including Ethiopia, Madagascar and Pakistan have added co-packaged ORS-Zinc to their national essential medicines lists.
In December 2024, due to resource constraints, ORSZCA was dissolved and its function was moved to the Child Health Task Force.
For more than 40 years, Ashoka has built and nurtured a network of 4000+ leading social entrepreneurs in the world. Read more about the Ashoka Fellowship here.
- 2016,
The Globalizer strategy accelerator supports social entrepreneurs gain clarity on systemic root causes of social and environmental problems and the importance of engaging more changemakers as part of the solutions. It enables them to design effective collaborative systems change strategies (based on respect to all humans and nature).
Refined since 2010, the accelerator is a structured collective thinking and experimenting process between social entrepreneurs, systems thought partners from Ashoka and selected leaders from business and the social sector.
Participated with support from
Elements of the Collaborative Systems Change Strategy
Hover/Click on things to dive deepType of Root Cause identified as a Leverage Point for Systems Change (Donella Meadows)
The first element of crafting a collaborative systems change strategy to address a problem is to define the problem and identify the most strategic change needed to address the root cause(s) of the problem. That becomes the targeted Systems Change Goal or the Mission.
To identify it, analyze the root causes—barriers, factors, dynamics, points or conditions driving the problem—and determine which offers the greatest leverage for change.
According to the FSG, leverage points include:
- Policies
- Practices
- Resource Flows
- Relationships & Roles
- Power Dynamics
- Mental Models
These "leverage points" are derived from the work of Donella Meadows, the pioneer in the field of systems thinking who articulated and conceptualized "Leverage Points: Places to Intervene in a System to Create Effective Change".
Explore Case Studies of different types of "Systems Change Goal(s)" in our Library.
Endgame / Pathway applied towards Activating a Network of Changemakers towards the targeted Systems Change
The second element of crafting a collaborative systems change strategy includes determining how to achieve the systems change goal.
This means choosing a strategy suited to the system’s context. The strategy could be to:
- Work with government
- Create a new field/market
- Build a competitive advantage
- Shift societal narratives
The items on the list are neither mutually exclusive, nor collectively exhaustive.
You can read more about the types of systems change strategies/pathways/endgames/stories we have come across in this article by Odin Muehlenbein.
Explore Case Studies on different "Types of Strategy" in our Library.
Types of stakeholders activated as changemakers towards the systems change
The third element of crafting a collaborative systems change strategy includes identifying the critical stakeholders to activate as partners- those who influence an exponential number of people in the context of the system.
Irrespective of the type of strategy, systemic change always requires activation of a network of stakeholders for different tactics towards the mission.
Typical stakeholder groups for systemic change include:
- government agencies
- universities (e.g. education schools for the empathy paradigm, public health and med schools for the health paradigm, etc.)
- publishers (e.g. education publishers for empathy, medical journals for health, etc.)
- informal & formal communities / unions (e.g. AARP for longevity, teachers' unions for empathy, families, etc.)
- media companies
- industry-specific companies / organizations (e.g. tech companies and financial institutions for the technology paradigm, insurance and healthcare companies for longevity, relevant civil society organizations etc.).
Explore Case Studies on different "Types of Partners Engaged" in our Library.
The depths of engagements in play for the different stakeholders (CoCreative)
The fourth and final element of crafting a collaborative systems change strategy includes reflecting on what depth to engage with each stakeholder.
Activating a broad network is essential, but so is clarifying their role: Are they simply informed, consulted, or co-creating the strategy?
CoCreative's Five Levels of Engagement Framework guides how one may engage with each stakeholder. Are you:
- co-creating?
- collaborating?
- involving?
- consulting?
- informing?
Explore Case Studies on different "Levels of Stakeholder Engagement" in our Library.
Their work contributes towards
The 2030 Agenda for Sustainable Development, adopted by all United Nations Member States in 2015, provides a shared blueprint for peace and prosperity for people and the planet, now and into the future. At its heart are the 17 Sustainable Development Goals (SDGs), which are an urgent call for action by all countries - developed and developing - in a global partnership.
Explore Case Studies on strategies contributing to addressing different "SDGs" in our Library.
The root causes of global socio-ecological unsustainability their work is addressing (FSSD)
According to the Framework for Strategic Sustainable Development (FSSD) co-created by Ashoka Fellow Dr. Karl-Henrik Robèrt and Dr. Göran Broman and Dr. Merlina Missimer of the Blekinge Institute of Technology, Sweden, there are 8 root causes of all socio-ecological unsustainability problems (also referred to as Sustainability Principles):
- extraction from Earth's crust
- chemical pollution
- physical destruction
- barriers to health
- barriers to competence
- barriers to influence/participation
- barriers to impartiality
- barriers to meaning-making
To get a deeper feel, here are videos on the ecological and social sustainability principles.
You can see case studies of changemakers contributing to addressing different root causes ("Sustainability Principles") in our Library.
