HEALTH OF A NATION

Economic constraints force Zambia to enlist aid from Unicef and corporate sponsors in its fight against fatal diseases, such as polio. But there is a fine balance between genuine aid and corporate promotional exploitation. Natalie Cheary repor

One man cycled 15km dragging a tin bath with two small children behind him. One woman, with a baby strapped to her back, walked for six hours. A young child had been sent, two toddlers in tow, by a neighbour who was unable to attend. And the local mayor declared it “a very special occasion”, adding that it is a “mammoth task which cannot be undertaken by the Ministry of Health alone”.

The “occasion”, described by Roy Chulumanda, was last Friday’s National Immunisation Day (NID) in Zambia. The objective was to immunise 1.6 million children aged under five – 22 per cent of Zambia’s 9.4 million population – against polio. The bill for the immunisation works out at about 1 per child. But the government in the West African state can only afford to contribute 50,000 out of its annual 100m health budget to eradicating one of the world’s six biggest child killers, although it did prepare the strategy for the NID.

As a result it has to look to aid agencies and corporate sponsors to meet the 1.3m shortfall – 500,000 comes from the United Nations Children’s Fund (Unicef). It in turn raises money from the likes of the ITT Sheraton hotel chain, which is committed to raising at least 1.2m for immunisation programmes through its “Check out for children” (COFC) scheme by the end of 1997. The remaining support, in cash and kind, comes from the likes of the World Health Organisation, Rotary International and the Centre for Disease Control.

Unicef contributes a comparatively small amount when placed alongside other donors in the annual 75m global drive to eradicate polio, but its capacity to deliver expertise has a huge impact on an underdeveloped country. While Rotary International provides the vaccines, Unicef transports and distributes them throughout the country, and funds the training of health workers and the promotion of the NIDs.

What happened in Zambia last Friday and Saturday was cause-related marketing writ large. “[Corporate sponsors] make a very important contribution to Unicef’s work, without which the group could not do what it does,” says Christiane Rudert, assistant project officer for child health at Unicef in Zambia, highlighting the role of the corporates.

“The government is trying its best but it is a lack of resources which is to blame,” says Dr Julie Lamsis, a private GP in the town of Luanshya. “The poverty here is indescribable but we are confident [about eradicating polio] because every organisation is trying to help.”

Polio has now been eradicated in more than 150 countries but it is still a major problem in Africa. In Zambia, where 86 per cent of children are regularly immunised, there has not been a recorded case since 1995. Yet extra measures, including the NIDs which are carried out in two rounds, one month apart, for three consecutive years, are needed to completely wipe it out.

Robert Scott, general counsel for the European, African and Middle Eastern divisions of Sheraton and founder of COFC, was also in Luanshya last week. But Sheraton does not mention the scheme in any of its through-the-line advertising.

Instead guests are made aware of the programme through literature and a video placed in hotel rooms. “We want to promote the programme in Unicef’s interest but we are sensitive not to promote it in our own,” says Scott. “That’s not Sheraton’s style. It would be wonderful if someone chose to come to a Sheraton hotel to support the programme but we do not expect that.”

However, at the back of the corporate minds will be statistics like those provided by the UK’s Business in the Community, showing that 86 per cent of people have a more positive image of a company if it supports a good cause.

A scheme like COFC, which has raised more than 750,000 since its European launch in November 1995, can be a valuable way of encouraging customer loyalty, motivating staff and ensuring positive recommendations.

The scheme means that the local equivalent of $1 (60p) is automatically added to each room bill in 300 of the 435 Sheraton hotels globally. Sheraton then asks Unicef to spend the money on immunisation against the six biggest fatal diseases which strike in childhood – polio, measles, tetanus, tuberculosis, whooping cough and diphtheria – in developing countries.

Over 8,000 immunisation posts were specially created in Zambia for the campaign, from bustling town clinics to straw huts hidden in rural villages. The facilities in many cases consist of merely a table, an ice box, a nurse and two volunteers, yet the people of Zambia are confident the task will be successfully completed. Dr Dean Phiri, head of Zambia’s Ministry of Health Family Health Unit, says: “If we continue at the current rate, we will eradicate polio.”

The pace last week was dramatic, with immunisation centres looking more like production lines. However, the main threat to Zambia comes from its nine neighbours.

The virus is easily transmitted by children crossing the border, as many do from Zaire, now the Democratic Republic of the Congo, for the use of Zambia’s health service. However, political instability and economic constraints currently prevent NIDs being carried out in some of the bordering countries.

Unicef ensures widespread promotion of the NID, including a 25,000 TV, radio and press campaign and millions of posters, flyers and bumper stickers. Rural mothers and children broke into smiles of recognition when we mentioned the campaign strapline “bye bye polio”. Even remote fruit kiosks tucked away down dirt tracks are decorated with advertising posters.

Zambia is one of many African countries suffering mass poverty. The country has a 90 per cent unemployment rate and an average wage of 35,000 kwacha (19) per month. Children are particularly vulnerable, with the under-five infant mortality rate standing at 202 in every 1,000 live births, compared with about seven in every 1,000 in the UK. Moreover, young disabled people, including earlier victims of polio, face a bleaker future, with special education and employment largely unavailable.

But Unicef is acutely aware of being “used” by corporate sponsors. In April, it introduced new guidelines for corporate deals, a recognition that the dynamics of charity/ corporate relationships are changing. “This change in Unicef’s fundraising strategy occurs at a time when companies are coming under increasing pressure… to become “good corporate citizens”. A growing number of companies are “exploiting their ethical stands to win contracts or investors and increase their market share”, claims a statement from the charity.

The change also coincided with the arrival of Rudolf Deutekom, the former vice-president of marketing for Levi-Strauss, who is now responsible for trading and private sector fundraising at Unicef. Ironically, this tougher line on corporate partners comes as the charity’s global income has fallen from $1bn (625m) to $829m (518m). Static funding from governments is forcing it to seek more than twice the current amount of commercial support.

Unicef estimates that it will need to raise annually 550m from private sources by the year 2005 to meet its aid commitments, compared with the current 220m received from its trading, donations and corporate partnerships – accounting for 30 per cent of its total voluntary income.

Without that money, Unicef’s work and the future immunisation of millions of people are at risk.

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