In 1980, diarrhea and dehydration were killing 4.6 million children worldwide. You would probably guess that when a simple, inexpensive solution came along, it would be quickly and widely adopted. Unfortunately, eight years after introduction, Oral Rehydration Therapy was only being used in 35% of diarrhea episodes. While there are numerous reasons for the slow adoption for ORT, I want to discuss the case in the context of the ORT marketing strategy. I acknowledge that businesses have the luxury of knowing that the financial benefits of marketing will far outweigh the upfront costs. While the same is true in healthcare, justifying the short-term marketing costs can be far more difficult than in business.
A central pillar of marketing is that you must “meet your customers where they are.” Meaning, your product must be distributed through the channels your customers want to use, not necessary those that are the easiest or cheapest for the distributor. To put this in context: Amazon is opening brick and mortar stores because some customers do not want to shop via the internet, and would prefer to visit a store location. Arguably, BRAC succeeded because its oral rehydration workers were visiting millions of houses, meeting care providers in their preferred locations, which removed hurdles to adoption for ORT. Admittedly, this door-to-door strategy is time intensive, expensive and difficult to coordinate. Nevertheless, it was working, and intensifying the strategy could have eliminated some of the confusion that hindered the use of ORT.
The question of bundling zinc and ORT together, or distributing them separately, is easy to answer from a branding and marketing perspective: together. Setting aside all the other challenges with zinc, customers are more willing to buy complimentary products when offered together. Moreover, not bundling products is simply a missed opportunity for a second sale, or in this case, an improved health outcome. While a costly and logistically difficult, clean water should also have been part of the bundle. How many times have you bought a toy, couldn’t use it because you didn’t have batteries? In this scenario, water is the batteries.
Finally, officials expected a viral marketing campaign based on the quality of ORT alone. Unfortunately, viral marketing requires identifying influencers and targeting them for early adoption, and dissemination. Given this, pharmacists should have been a key target in the early stages of ORT outreach. The same workers conducting in home trainings should also have been training pharmacists, religious leaders, community heads and schoolteachers.
Despite common lure, even great products do not sell themselves. ORT adoption could have been significantly improved with a more traditional approach to marketing.