Treating childhood diarrhea in India with ORT and zinc : engaging the pharmaceutical industry and private providers -- lessons learned from the POUZN/AED project

To do this effectively required changing both patient and provider treatment patterns, while creating a viable marketplace for the product. This case study recounts the story of zinc introduction in India in the private sector. It provides the context for and goals of the project; the various phases of the project; and strategy adjustments. It looks to the future for next steps and summarizes the principle lessons learned during the project. The following lessons may prove useful for further work in India, as well as be adaptable to other countries: (1) zinc treatment is a new concept and competes with well-entrenched prescription behaviors and traditional treatment practices; (2) key opinion leaders in both the public and the private sector (including top pediatricians) are crucial zinc champions; (3) working with the private pharmaceutical sector is critical to ensure a long-term, competitively priced supply of zinc and sustained demand generation; (4) at the same time, the reach of pharmaceutical marketing (and "detailing") is limited in rural areas; (5) the balance between supply and demand creation is a delicate one; and (6) the public and private sectors have different objectives and time scales. (Author abstract, modified)