Local production of oral rehydration salts.
Control of Diarrheal Disease (CDD) programs need to move more and more toward self-sufficiency. Thus they want a reliable supply of low cost, locally produced oral rehydration salts (ORS). 2 obstacles hinder the process: low demand and an inadequately developed pharmaceutical industry. It takes about US$200,000 to begin ORS production. In 1987, pharmaceutical plants in developing countries made 75% of all ORS produced. In Indonesia, for example, 12 private and parastatal manufacturers can produce ORS, but low demand is forcing some to decrease production. In Bangladesh, however, only 1 parastatal and 1 private company produces all ORS used in the country, but they cannot keep up with demand. Other developing countries producing their own ORS include Costa Rica, Tunisia, Zambia, Mali, Egypt, and Ghana. Any group that considers local ORS production must first examine various factors including an assessment of potential demand, the extent that diarrhea is treated with oral rehydration therapy (ORT), and the government's position on ORS production and distribution. The group should contact the local UNICEF office to gain its support and guidance. It should also work with WHO and Ministry of Health officials and speak with the chief pharmacist or head of the pharmacy board. This group also needs to consider economic factors such as pricing and costs of importing raw materials. It should also see to a detailed cost analysis and market research. The group also needs to determine production capability in the country which includes the ability of companies to adhere to the international Good Manufacturing Practices code. In the beginning of project development, the group must consider ORS promotion with ORS production, e.g., it should scrutinize the potential producer's record for marketing and organize field research. The group can obtain technical assistance from UNICEF, UNIDO, and USAID funded projects such as PRITECH, PATH, HEALTHCOM, and SOMARC.