EUROPE-AFRICA: Saving lives by SMS

A new study by Professor Donald A Marchand of the Swiss business school IMD explains how the SMS for Life project used text message technology to save lives by dramatically improving the supply chain for anti-malaria drugs in Tanzania.

"Malaria kills around a million people every year - mostly young children in Africa - but almost all of these deaths are preventable," Marchand, an academic adviser on the project, said.

"The problem is that supply chain difficulties within many African countries make it hard to get the drugs to the right place at the right time. The SMS for Life project saw a group of people from different companies work together to solve this problem using SMS technology."

The team had a small number of people with specific skills, said Jim Barrington, an executive with the company Novartis who led the project. "No one company or organisation had all these people skills, so our group brought together the relevant people from a number of different places - a drugs person from Novartis, a communications expert from Vodafone, a mapping person from Google and a project manager from IBM.

"But we were also determined to eliminate the bureaucratic barriers that this sort of project would normally create. We didn't want to have to spend time with lawyers arguing about who was donating what, or the detail of the contracts between us.

"Instead, each partner agreed to provide their services free and cover their own costs. This saved us at least a year of unnecessary discussion. We simply trusted that everyone involved had a genuine commitment to what we were trying to do."

Barrington and a team from Novartis first looked into this issue during an IMD partnership programme. Barrington also drew on Marchand's experience of working with CERN, the International Olympic Committee, and other organisations that run large, complex projects without relying on formal authority.

The SMS for Life initiative is a public-private project that harnesses everyday technology to eliminate stock-outs and improve access to essential medicines in Sub-Saharan Africa. Maintaining adequate supplies of anti-malarial medicines at the health facility level is a major barrier to effective management of the disease.

"It's simple. If there are no malaria treatments, someone will die. It is very likely to be a child. Reducing stock-outs saves lives," said Professor David Mwakyusa, former minister for health and social welfare in Tanzania.

SMS for Life used mobile telephones, SMS messages and electronic mapping technology to facilitate provision of comprehensive and accurate stock counts from all health facilities to each district management team on a weekly basis.

The system covered stocks of the four different dosage packs of artemether-lumefantrine and quinine injectable. The data captured through the SMS stock count was available through a secure reporting website which was then accessed via the internet on a computer or a Blackberry or other smart mobile phone.

The proportion of health facilities with no stock of one or more anti-malarial medicine fell from 78% in the first week to 26% in week 21. In Lindi Rural district, stock-outs were eliminated by week eight with virtually no stock-outs thereafter.

"Overall, the SMS for Life system was built to be a generic and highly scalable solution that can be leveraged to support any medicine or product, and can be implemented in any country with minimal tailoring. Additionally the system could also be utilised for disease surveillance," said a report on the project.