The Challenges

Although medication to combat life-threatening diseases such as HIV, tuberculosis, and cancer are widely available in Africa, stock-outs of these drugs are endemic to the clinics and pharmacies used by ordinary people. Medicine users travel long distances, often on foot, to public clinics or hospitals to obtain drugs, only to find that they are not in stock, or priced too high. Public pressure to protest this situation is limited due to poor information exchange on the ground and lack of awareness of the role that an activist public can play in ensuring availability of medicines at both the local and national levels. The Stop Stock-Outs campaign (SSO) calls on governments and health departments to eradicate the critical stock-out problem by developing a transparent drug supply and distribution system, granting a health budget able to meet the population’s basic demands, and allowing civil society to be heard at the top level of the medicine supply chain. NZP+ and HAI-Africa are skilled in outreach and advocacy, however lack the technical skills to design tools to coordinate efforts regionally and internationally. Midolo and Ballard worked through the summer of 2009 to address this situation.

The Solutions

PILL CHECK WEEK
The mission of Pill Check Week was to expose that essential medicines are frequently stocking out in Kenya, Malawi, Uganda, Madagascar, and Zambia despite government assertions to the contrary. Conclusive evidence of the problem needed to be presented to the public, government officials, and media outlets. On advice from the Fellows the NGOs approved the introduction of a new automated system to map stock-outs to the SSO web site after receiving reports from medicine users via SMS text. The final product works as follows: a stock-out reporter texts in to a mobile telephone connected to a computer running FrontlineSMS, which then sends the text to the PHP intermediary script, which retrieves latitude and longitude coordinates based on the text’s location information, and implants the data into Ushahidi’s database. Ushahidi then generates a red dot at the location on the SSO web site, which increases in size as the number of stock-out reports for the area increases. Clicking the dot reveals a pop-up bubble displaying reported stock-outs in the region. During Pill Check Week medicine users and data collectors reported on the state of the shelves. The results from four countries were presented at a press conference in downtown Nairobi. The story was covered by every major Kenyan newspaper as well as KTN and K24 TV channels, blogs, and capital FM. The radio audience learned of its fundamental right to receive medical attention in public clinics and hospitals, particularly in the form of essential medicines, which by law are required to be in stock at all times and available for free or at minimal cost. In the broadcasts the Pill Check Week action was described, as well as the data it collected describing widespread stock-outs across the region.

SPECIAL PROJECT: DOCUMENTARY VIDEO
Midolo and Ballard teamed up to create a documentary focusing on testimony from medicine users and health care providers in both Zambia and Kenya. It was featured on stopstockouts.org and social networking channels.