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An Intern's Perspective: Helping Tackle Global Health Challenges

By:  Peter Cook Aug 28, 2013
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Project Last Mile

Medical supplies being unloaded by MSD employees in Tanzania.


I first thought about Coca-Cola availability when I heard Melinda Gates at a TEDTalk in 2010, where she asks the simple question, “if Coca-Cola can get their beverages to remote regions around the world, why can’t governments and NGOs deliver social products such as medicines and condoms with the same degree of success?” This talk was the inspiration for Project Last Mile, in which Coca-Cola has entered into public-private partnerships with ministries of health across Africa, sharing knowledge on their distribution networks and delivery systems. The project was piloted in Tanzania, and is currently expanding into Ghana and Mozambique. Through my internship with The Coca-Cola Company in Johannesburg, South Africa, I was tasked with preparing a concept paper on launching a similar project in South Africa.

Within the public health field, there is a fair amount of skepticism toward the notion of Coca-Cola engaging with the health sector on issues that are admittedly outside of its core competency. After all, medicines are incredibly different products from a bottle of soda—they have to be handled differently and by specially trained people, as they have temperature-sensitive transportation requirements and strict expiration dates. I’ll admit I was skeptical at first that this was nothing more of a naïve proposal, instead of an innovative development solution.

But my skepticism quickly turned to optimism when I had the opportunity to go onsite to Dar es Salaam, Tanzania, and observe the results of the partnership directly. I held meetings with management at Coca-Cola Kwanza (CCK—Coca-Cola’s in-country, Tanzanian-owned bottling company), and the Medical Stores Department (MSD—Tanzania’s government-run department responsible for the warehousing and delivery of essential medicines throughout the country), in an effort to understand the project’s challenges, opportunities, and successes. What I learned is that the project has not involved any medical products being placed on Coca-Cola trucks. Instead, it is strictly about sharing knowledge of CCK’s management processes with MSD. Like many public sector institutions in developing countries, before the intervention MSD suffered from the lack of a clear incentive structure to drive performance. Roles within the organization were not clearly defined, and central management had little control of what went on in district clinics and medical depots, resulting in frequent stock-outs of essential medicines. Meanwhile, just 10 kilometers down the road from MSD, Coca-Cola Kwanza is a tightly run ship. A performance-driven culture is motivated by a system of financial incentives for employees, demand forecasts for product are fed upstream by a meticulous data department, and route optimization is calculated by logistics experts with state-of-the-art mapping software.

Project Last Mile has paired various members of MSD with a member of CCK in a similar function for trainings and mentoring. I think what drives the success of this model is that the mentors at CCK are Tanzanians themselves—local people who know and understand local markets, local roads, and local systems. Route to market optimization experts at CCK give training to MSD personnel on their mapping and supply chain management software; human resources personnel give training on their performance monitoring processes; and planning personnel at MSD receive training from demand forecasters at CCK. One of the most incredible things for me to witness was that MSD had implemented a performance monitoring system modeled after CCK’s in which employees’ salaries will be adjusted according to performance reviews, and incredible innovation for a public sector entity in a developing country.

Meanwhile, back in South Africa, I’ve visited some of the more remote and rural regions where major inefficiencies plague the drug delivery system. In the country with the highest HIV burden per capita in the world, reliable delivery of ARVs is a life and death matter. Yet recent reports have detailed that stock-outs in rural clinics throughout the country are common. In many rural depots, order forms are rarely correctly completed by pharmacists, paper delivery receipts don’t reach the central office to monitor delivery and stock supply, boxes of medicines are left open on the floor and not correctly warehoused, and demand is not forecasted in any meaningful way. In contrast, Coca-Cola’s South African bottler uses mobile technology to feed upstream data back to its central offices on every bottle of Coca-Cola delivered to its endpoint. This data is time- and GPS-stamped, such that a manager in a regional plant can tell you where any bottle of Coca-Cola for his region is at any given moment. The opportunities for collaboration on sharing this knowledge are immense.

Perhaps the most interesting lesson from observing the Last Mile partnership is that this project is not about outsourcing a key responsibility of the public sector to a private company. Rather, it is about sharing knowledge of the strengths of a private sector entity and its efficiencies with the public sector in order to strengthen public systems and professionalize the civil service. If development is primarily about improving systems, then partnerships such as this one just might be the necessary solution.

Peter Cook
Peter Cook is currently pursuing a master's degree in Global Human Development from Georgetown University. Peter just finished up an internship with The Coca-Cola Company in Johannesburg, South Africa, working on a variety of global sustainability projects.

The Coca-Cola Company is an internship partner of Georgetown University’s Global Human Development program.

Find another Georgetown intern's perspective on partnerships here.