How private distribution companies can help reduce diarrheal disease on Astini News
Everyone reading this article has suffered from diarrhea at some point, but did you know that it kills nearly 4,000 children a day? The World Health Organization estimates that diarrhea – simple, annoying diarrhea – is the second leading cause of death in children under five, after pneumonia. It may even be responsible for taking more children's lives than AIDS, malaria, and tuberculosis combined. Not surprisingly, nearly all diarrhea-related deaths occur in the developing world, and are especially prevalent in areas with endemic poverty and poor nutrition.
The perplexing thing about diarrheal disease is that unlike many other global health epidemics, cheap diarrhea treatments exist. Since the 1970s, the WHO has been recommending oral rehydration therapy (ORT) and continued feeding as the "gold standard" for treatment. It is very effective in helping children regain vital nutrients they lose during diarrhea, and crucially, it costs pennies. The medical journal The Lancet even once said ORT may "potentially [be] the most important medical advance of the twentieth century." Other treatments for diarrhea, including zinc therapy and rotavirus vaccination, are also inexpensive and quite effective.
Given this, we must ask ourselves: why are 1.3 million children still dying of diarrhea every year?
I believe there are two primary reasons. First, diarrhea treatments have yet to reach everyone who needs them. In the case of ORT, only 39 percent of children with diarrhea actually receive it. Between stock-out problems in shops that sell the mixture, confusion of how and when to make the solution, and health workers' mixed levels of adherence to treatment guidelines, there are several formidable barriers in getting this WHO recommended treatment to sick children.
Second, universal access to diarrhea treatment does not guarantee an end to the epidemic. Improving ORT availability is not a silver bullet; rather, stopping diarrheal deaths requires an integrated approach that addresses both treatment and prevention of disease. In this case, we must prevent children from contracting diarrhea by improving drinking water quality, hygiene standards, and childhood nutrition levels. Realistically, the epidemic will persist until and unless these broader social ills are addressed.
This does not mean, however, that markets should wait for issues like malnutrition to be "solved" before helping make treatments more readily available. While improving access to treatment will not result in an ultimate end to diarrhea, it is a vital piece of the puzzle. It is also probably the most tangible way the private sector can get involved.
Within the private sector, logistics and consumer goods companies can probably make the biggest difference to the epidemic, by helping streamline distribution of treatments to communities that need it. A recent study by Johns Hopkins University found that in sub-Saharan Africa, out-of-stock rates for ORS were as high as 38 percent – in contrast to consumer goods like mobile phone cards, which boast out-of-stock rates of 6 percent in the same geographies. Consumer goods and logistics companies could significantly help ORS manufacturers with improving their datasets, sharing knowledge of best practices, and even potentially sharing distribution infrastructure. The Johns Hopkins team believes such partnerships could be constructed not as donations or CSR activities but in ways that would benefit both parties.
Improving distribution logistics may seem like an odd and un-sexy way to stop a global health epidemic. When faced with a disease as un-sexy as diarrhea, however, it may be just what the doctor ordered.
