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Towards universal handwashing with soap: Annual Review 2008/09

The state of Top 10 Changing behaviour handwashing with soap Hygiene Lessons of 1 billion people Dr Val Curtis by 2015 Lifebuoy way of life Annual Review 2008 - 2009

Lifebuoy aims to bring safety, security LIFEBUOY’S and health to five billion people around ON A MISSION the world, through the active promotion { of handwashing with soap.

02 03 Lifebuoy way of life Annual Review 2008 - 2009 Contents

6 Foreword - Opening statements from , CEO, and Ricardo Pimenta, Global Brand VP Unilever Health Brands

8 Our commitment to making a difference every day - Myriam Sidibe, Lifebuoy Global Social Mission Manager, introduces the Lifebuoy Social Mission

10 Lifebuoy - in brief - Some facts about the brand

12 Handwashing state of the world - A summary from Dr Val Curtis, Director of the Hygiene Centre at the London School of Hygiene & Tropical Medicine

14 A brand on a mission - Making a difference around the world

16 Hygiene promotion activations - Putting a spotlight on Lifebuoy country programmes

20 Capacity building and partnerships - How teamwork is shaping the future for handwashing

24 Advocacy - Keeping handwashing on the global and local agendas

28 Lifebuoy Way of Life - Tracking social and business impacts

30 Rewind and Recap - The Lifebuoy Top 10 hygiene and health lessons learned from 2008-2009

32 Our next steps - Anuj Rustagi, Lifebuoy Global Brand Director, outlines the Lifebuoy Way of Life Challenge

33 References

04 05 Lifebuoy way of life Annual Review 2008 - 2009

“I sincerely believe that businesses like Unilever can be a positive force for good Paul Polman, in the world and that such an approach is Unilever Chief in the interests of all our stakeholders – our Executive POSITIVE Officer investors, our consumers, our employees and the communities where we operate.” {

Foreword from Ricardo Pimenta, Global Brand Vice President, Foreword { Unilever Health Brands

Unilever’s mission is to meet the we use, such as water, packaging, growth every year in recent years, everyday needs of people around energy and raw materials, and the demonstrating its ability to offer an the world for nutrition, hygiene social and economic impacts of our invaluable response to the demands and personal care. We do this with brands in the countries where they of consumers in developing and products that help people feel good, are sold. emerging markets. look good and get more out of life – something which Lifebuoy has been Ever since the launch of its first This first Lifebuoy Social Mission doing for the past 114 years. soap products over 100 years ago, Annual Review is evidence of Lifebuoy has helped make a positive how seriously Lifebuoy takes its Every day around 160 million people difference to people’s health and commitments. The report provides in 150 countries choose our Unilever well-being in the developed and a review of our latest activities to brands to feed their families and to developing world. But preventable support the Lifebuoy social mission – clean themselves and their homes. diseases, resulting from poor hygiene a mission that is absolutely integral And every second, 91 families and sanitation, still pose a significant to the brand. choose a Lifebuoy product to deliver health challenge. Every year more on health and hygiene promises. than 3.5 million children still die Unsurprisingly, therefore, the social before the age of five because of and environmental impacts we have diarrhoea and acute respiratory on the world come largely from our infections. Encouraging people to brands, and Lifebuoy is at the centre change their habits – by washing of the positive social impacts that hands with soap before touching Unilever as a corporation can deliver. food and after going to the toilet – is This is why we are embedding essential, and central to all Lifebuoy sustainability thinking into the brand activities. day-to-day activities of our brand management and R&D teams. The What makes doing good sustainable Lifebuoy brand has been at the in the long run is the business forefront of the piloting of tools such benefits that Lifebuoy delivers year as Brand Imprint and social metrics. after year. It is one of the fastest- Both these tools are helping us think growing brands in our skin care more carefully about the resources business, recording double digit

06 07 Lifebuoy way of life Annual Review 2008 - 2009 Our commitment to making a difference every day

By Dr Myriam Sidibe DrPH, Lifebuoy Global Social Mission Manager

THE LIFEBUOY BRAND’S SOCIAL MISSION IS TO BRING SAFETY, SECURITY AND HEALTH TO FIVE BILLION PEOPLE THROUGH THE ACTIVE PROMOTION OF HANDWASHING WITH SOAP. AND WHILE OUR PRODUCTS ALREADY PROVIDE MILLIONS OF PEOPLE WITH ACCESSIBLE AND AFFORDABLE HYGIENE, AS THE WORLD’S LEADING HEALTH SOAP, WE KNOW THERE IS MORE THE BRAND CAN DO.

Through the Lifebuoy brand’s social mission programmes we aim to make a difference in people’s day-to-day lives – spreading positive hygiene messages through hygiene promotion activities. The projects instigated by our country teams are already making a difference and helping to save lives. The resources we provide to complement those supplied by the public sector are vital to ensure that we continue reaching people who need our help the most. Our commitment to the Lifebuoy social mission is evident in the steps we have taken towards making handwashing with soap central to the brand’s marketing efforts. I AM CONFIDENT THAT THE LIFEBUOY TEAMS, TOGETHER WITH OUR PARTNERS, CAN CONTINUE TO BUILD ON OUR WORK IN This report gives an overview of the work THE FUTURE, TO MAKE A LASTING IMPACT ON PUBLIC HEALTH Lifebuoy has done in 2008 and 2009, partnering Lifebuoy together with public and private sector AROUND THE WORLD. partners around the world, who share the brand’s commitment to promoting health and hygiene. Without these important partnerships it would not be possible to share our messages on such a large scale.

Before joining the Lifebuoy team, I worked for non-governmental organisations and in the public sector, and have lived in more than 20 countries around the world. I sought a platform from which I could make a real impact to people’s lives. I believe that Lifebuoy and Unilever as a corporation offers this platform, with , tangible deliverables that are relevant both for business and social benefits. Visiting some of the Lifebuoy brand’s social mission programmes in India, Indonesia and Vietnam has made me realise that we have already achieved so much, thanks to the right support and gives me the confidence that we can achieve a lot more. The commitment of our Key: Lifebuoy teams across the world is exceptional and unique. Countries where Lifebuoy was sold in 2009

08 09 Lifebuoy way of life Annual Review 2008 - 2009

LIFEBUOY -

• LAUNCHED IN THE UK IN 1894, Lifebuoy is one of Unilever’s oldest • The Lifebuoy Clinical Trial in 2007/8 demonstrated that by following brands, and has championed a message of health through hygiene for the Lifebuoy Way (washing hands at 5 key occasions during the day), more than a century episodes of diarrhoea in target children reduced by 25% and target children had 40% less days off school due to illness, compared with the • One of Unilever’s founders, William Lever, launched the Lifebuoy brand control group. to help bring affordable hygiene to Victorian England at a time when epidemics of typhoid, smallpox, cholera and diphtheria were a • Lifebuoy branded hygiene promotion activations, such as Swasthya constant threat. Chetna in India, Berbagi Sehat in Indonesia and Germ Fighters in Sri Lanka have educated over 125 million people about the importance of • Today Lifebuoy products are sold in more than 34 countries in Asia and handwashing with soap. Africa, and every second 91 families buy a Lifebuoy product, trusting

the Lifebuoy brand for their family’s health. * ACNielsen Scantrack and Retail Index Skin Cleansing Brand Volume Sales 12 months to August 2009

• Lifebuoy was the world’s first health soap when it was launched in 1894, and it is still the world’s no.1 selling germ protection soap today*.

10 11 Lifebuoy way of life Annual Review 2008 - 2009 Handwashing state of the World

A report from Dr Val Curtis, Director of the Hygiene Centre at the London School of Hygiene & Tropical Medicine

AVERAGE CHILD DEVELOPMENT THE GRAPH ON THE RIGHT TELLS LAXMI’S DEVELOPMENT A VERY SHORT LIFE STORY. IT BEGINS WITH LAXMI’S BIRTH, IN A VILLAGE IN RURAL ANDHRA PRADESH ON THE SOUTH-EASTERN COAST OF INDIA. A HAPPY CHILD, LAXMI GROWS WELL UNTIL HER FIFTH MONTH WHEN SHE FALLS ILL WITH DIARRHOEA AND A BAD COUGH. SHE RECOVERS BUT AT NINE MONTHS CATCHES A RESPIRATORY INFECTION THAT TURNS INTO PNEUMONIA.

Though it takes her family a while to gather together thought to reduce diarrhoea risk by up to 50%2-4. And in CHANGING BEHAVIOUR the money for medicine, she is eventually cured. But the last few years we have learned that handwashing because of repeated diarrhoea and respiratory illnesses, can do even more. It protects from respiratory infection, Handwashing behaviour is learned early in life, is highly Laxmi is malnourished, leaving her vulnerable to reducing risk by an estimated 23%5 and a study in habitual, and is influenced by local cultural norms16 – so infections. Pakistan saw handwashing halve the risk of pneumonia by what everyone else is doing. Given the difficulty of infections6. It protects against pandemic flu7, SARS8, shifting established habits, we’ve found that we need encourage handwashing in health care facilities trachoma9, and parasitic worm infections10. It keeps BY THE AGE OF THREE SHE IS SO WEAK to use shock tactics to make an impact. around the world, achieving recognition despite children in school11 and it can reduce the deaths of SO WHAT CAN WE DO? AFTER SUFFERING FROM MEASLES THAT One approach that has been shown to work is to modest levels of funding newborn babies, according to a recent study from AN INFECTION THAT IS NEVER EVEN disgust people, making them aware that there • International programmes to promote hygiene in Nepal12. Research has shown AIDS patients also have DIAGNOSED CAUSES HER DEATH. is something nasty on their hands, by using a schools are also ongoing, many supported by UNICEF. The private sector has a key role to play in handwashing. Soap marketers, significantly less diarrhoea when they wash their hands 17-19 demonstration kit or through advertising . Since These can have a major impact on young people’s such as those working on Lifebuoy, know what changes behaviour and Laxmi’s is not an unusual story. Every year in developing regularly13, and a new study published this year in people copy what others do it’s important to promote behaviour, but we still need to do more work to find countries more than 10 million children die before their the Lancet suggests that poor hygiene may be one of 20 understand how to design and deliver campaigns that reach vast and the idea that everybody is doing it . Public pledges to out which approaches work best with children fifth birthday1. But there is some good news. Child the reasons for chronic and intractable malnutrition in handwash are likely to work, as are visible badges on • Agencies that promote safe water and sanitation diverse populations. Marketers are masters at consumer insight, at creative survival has been improving in recent decades due to developing countries14. young people or on houses or public walls. including UNICEF, the UK Department for design and at the rollout and management of big campaigns21. Those of better health care, continued economic development, International Development, WaterAid, Oxfam and improved products and environments, and new cultural A recent review by the World Bank suggests promoting us working in the health sector are depending on soap companies to work WHO’S FIGHTING FOR HANDWASHING? non-governmental organisations all over the world expectations. handwashing with soap may also be the single generally agree that the promotion of hygiene is an with us to help deliver handwashing to the millions that need it. cheapest health intervention there is, coming above After many years working to raise the profile of essential adjunct to their work. However, it is hard However, there’s still a long way to go. While most malaria and HIV control in terms of health benefits handwashing, it’s finally getting global recognition. Key to run effective behaviour-change programmes, people in emerging markets do have soap at home, against expenditure15. initiatives include the following: especially when hygiene is always under-resourced. HANDWASHING CAN HELP PREVENT: more than 80% fail to use it for washing their hands. As • Governments worldwide are taking up the a result, children face an onslaught of pathogens every Yet, even in developed countries with taps and towels, • The Global Public Private Partnership for Handwashing handwashing message, mostly in response to Diarrhoea Trachoma Sickness in AIDS Patients day in their own homes. handwashing isn’t the rule. We monitored a motorway with Soap shows people around the world that pandemics such as SARS, bird flu and swine flu. They service station in the UK and found that of the 330,000+ handwashing with soap is important and that it can still have to learn that handwashing is for life, not just Pneumonia Worm infection Chronic malnutrition HANDWASHING HELPS: people who used the toilets only 32% of men and 64% be promoted in exciting new ways. It has also helped for emergencies. Swine flu Neonatal mortality THE LATEST FINDINGS of women washed their hands with soap. There is a establish Global Handwashing Day, which has had a long way to go until handwashing with soap becomes a huge impact worldwide SARS School absenteeism It is a well known fact that effective handwashing can universal habit. • The Clean Care is Safe Care programme has been prevent diarrhoeal diseases. Handwashing with soap is rolled out by the World Health Organisation to

12 13 Lifebuoy way of life Annual Review 2008 - 2009

HYGIENE PROMOTION ACTIVATIONS Around the world, Lifebuoy handwashing initiatives and hygiene promotion programmes reach people where they live, work and play – in villages, schools, A brand shopping malls and hospitals. >See page 16 To ensure that our messages make a difference, 1 we find ways to engage communities, ensuring that consumers understand the important role that on a mission handwashing with soap plays in keeping people safe and healthy. Central to this is the need for our target THROUGH LIFEBUOY, WE AIM TO MAKE A DIFFERENCE IN PEOPLE’S audience to experience effective handwashing to DAY-TO-DAY LIVES. WORKING WITH PUBLIC AND PRIVATE instil good habits. SECTOR PARTNERS AROUND THE WORLD, OUR CHALLENGE IS TO TRANSFORM HANDWASHING WITH SOAP FROM AN ABSTRACT GOOD IDEA INTO AN AUTOMATIC BEHAVIOURAL PATTERN AT CRITICAL TIMES OF THE DAY.

CAPACITY BUILDING OUR SOCIAL MISSION ACTIVITIES AND PARTNERSHIPS ARE BUILT UPON THE FOLLOWING The Lifebuoy brand team partners public and private THREE BELIEFS: sector organisations around the world which share our commitment to promoting health and hygiene. By sharing our skills and experiences with our partners • THE WORLD HAS MOVED ON FROM 2 through activities and education campaigns, we can PHILANTHROPY. help build expertise in communicating the importance of handwashing with soap – a task which is too big We realise donations alone cannot not provide the for any single organisation to tackle alone. sustained, continuous programme of support that the world’s most intractable problems – such as improving health and hygiene – normally require THE LIFEBUOY >See page 22 SOCIAL MISSION • WE BELIEVE THAT BRANDS CAN BE A ACTIVITIES INVOLVE POSITIVE FORCE FOR GOOD. SPREADING POSITIVE ADVOCACY HYGIENE MESSAGES This is deep-rooted in the Lifebuoy brand history and Unilever’s ongoing commitment to social responsibility. THROUGH EDUCATION. It is important to raise the profile of We seek to invest in changing behaviour sustainably OUR ACTIVITIES handwashing with soap, creating the right FOCUS ON THREE environment for investment in behaviour- CORE AREAS: change activities. Lifebuoy branded advocacy • THE FUTURE LIES WITH PUBLIC AND activities in 2008/2009 included addressing PRIVATE SECTOR PARTNERSHIPS. delegates at events such as the World Health >See page 26 3 Organisation Child Environmental Health The private sector is best placed to provide expertise conferences and the What If! Sustainable on marketing behaviour-change to large audiences, Development Conference. The brand also working with non-governmental organisations became a founding partner of Global and governments to help achieve the Millennium Development Goals. These goals are a set of Handwashing Day in October 2008. internationally-agreed targets designed to alleviate poverty, hunger and ill-health around the world, and improve education, gender equality and environmental sustainability through global partnerships by 2015.

14 15 Lifebuoy way of life Annual Review 2008 - 2009

Lifebuoy’s 1 hygiene promotion GLOW-GERM EXPERIENCE activations A SIMPLE, LOW-COST DEVICE IS HELPING LIFEBUOY DEMONSTRATE THE CLEANSING POWER OF SOAP TO COMMUNITIES ACROSS THE DEVELOPING WORLD. IN LINE WITH THE BRAND’S COMMITMENT TO MAKING ITS ACTIVATIONS INTERACTIVE AND ENGAGING AS WELL AS EDUCATIONAL, WE CAME UP WITH THE GLOW-GERM EXPERIENCE.

ENCOURAGING HANDWASHING BEHAVIOUR CHANGE IS CENTRAL TO It all starts with a basic black box, which we source ALL LIFEBUOY ACTIVATIONS. GENERALLY PEOPLE WASH THEIR HANDS locally in the countries where activations are set to take SPORADICALLY WHEN THEY ARE ABOUT TO COME INTO CONTACT WITH place. The box is then fitted with an ultra-violet (UV) bulb. FOOD OR AFTER USING THE TOILET. SOAP ONLY TENDS TO BE USED WHEN

HANDS ARE VISIBLY DIRTY, SMELLY OR FEEL STICKY OR UNPLEASANT. At Lifebuoy-branded demonstrations, consumers are given a special UV powder to rub into their hands, which they then rinse with nothing but water. Their hands By reviewing existing knowledge and Featured in this report is a selection of case appear clean to the naked eye but when placed under insight, teams working on Lifebuoy have studies highlighting some of the hygiene UV light, traces of the powder are revealed, highlighting identified key behavioural issues which promotion activations initiated by Lifebuoy how germs can remain on the skin despite hands we address in our campaigns to drive and supported by the brand’s advertising looking clean. sustainable handwashing behaviour change and promotion budget. and which have helped us define the tools Consumers are then invited to wash their hands with Lifebuoy soap before placing them inside the box necessary to achieve such change. again. This time, no signs of the UV powder can be seen – providing a powerful emotional reminder that handwashing with soap provides greater protection LIFEBUOY HYGIENE PROMOTION ACTIVITIES ADHERE against germs than washing with water alone. TO THE FOLLOWING GUIDING PRINCIPLES:

• Activities educate through experience, demonstrating the importance of handwashing with soap and how this should be done

• Lifebuoy is a family ally. It’s a vitality brand, helping families to stay healthy and active for life, in line with Unilever’s global vitality mission

• Activities should include parents and children together, to foster lasting good habits in handwashing.

16 17 Lifebuoy way of life Annual Review 2008 - 2009 SPOTLIGHT: Swasthya Chetna, India

THE LIFEBUOY SWASTHYA CHETNA PROGRAMME, TRANSLATED AS HEALTH AWAKENING, LAUNCHED hygiene IN 2002 AS A RURAL HEALTH AND HYGIENE INITIATIVE IN INDIA, A COUNTRY WHERE MORE THAN 1 promotion 600,000 CHILDREN UNDER THE AGE OF FIVE DIE EACH YEAR FROM DIARRHOEA. Activity: Reach: activations In partnership with local government bodies, the By the end of 2008, the Swasthya Chetna Swasthya Chetna programme continues to raise programme had reached more than 120 million awareness about the importance of handwashing people in 50,600 rural villages, making it the Continued with soap to prevent disease, with the central single largest private hygiene education project in message ‘Visibly clean is not really clean’. Lifebuoy the world, with investment of over US$5 million teams visit each village involved in the programme from Ltd. three times, at a total cost of US$30 per village. Activities involve schoolchildren, parents and the wider village community.

SPOTLIGHT: Germ Fighters, Sri Lanka

THE LIFEBUOY GERM FIGHTERS CAMPAIGN STARTED IN SRI LANKA IN 2002, TO EDUCATE CHILDREN AND THEIR PARENTS ABOUT THE IMPORTANCE OF GOOD HYGIENE HABITS.

Activity: Reach: Working with the Sri Lankan Ministry of By the end of 2008, the Germ Fighters Health, schools and local communities, programme had reached over 500,000 school each Germ Fighters school programme children in over 500 schools. In every region involves different activities to raise where the programme has been activated, SPOTLIGHT: awareness of handwashing with soap. Art soap consumption has increased when Mahfooz, Pakistan competitions, essay writing contests and measured 2-3 months following the activity, drama productions, along with hands- indicating that Germ Fighters has had an SPOTLIGHT: Berbagi Sehat, Indonesia on handwashing experiences ensure impact in changing household behaviour with schoolchildren are engaged. Health and regards to washing with soap. THE LIFEBUOY MAHFOOZ hygiene standards in participating schools PROGRAMME LAUNCHED IN A NATIONAL HEALTH SURVEY UNDERTAKEN PRIOR TO THE LAUNCH OF LIFEBUOY BERBAGI SEHAT are upgraded, with new toilets and water PAKISTAN IN 2005, WITH THE HYGIENE EDUCATION PROGRAMME IN 2004 INDICATED THAT A HIGH PROPORTION OF PEOPLE IN pipeline systems, and community clean-up activities organised. GOAL OF PROVIDING HYGIENE INDONESIA NEGLECTED TO WASH THEIR HANDS WITH SOAP AT CRITICAL TIMES. THIS WAS DESPITE EDUCATION TO PEOPLE IN FIGURES REVEALING ALMOST 100% OF HOUSEHOLDS IN THE COUNTRY PURCHASED SOAP. RURAL COMMUNITIES.

Activity: Reach: Working with an extensive network of partners The programme has expanded both geographically Activity: including national and local government and in scope each year since its launch. Growing The Mahfooz programme reaches out to rural departments, non-governmental organisations, numbers of school teachers and community households and schools. As part of the campaign, retailers and the media, the Lifebuoy Berbagi workers have also been used as hygiene groups of women have been invited to houses Sehat programme aims to help with hygiene champions to multiply the impact of the in their neighbourhood and provided with infrastructure improvements and educate programme in communities. By the end of 2008, information about the importance of handwashing school children, and their mothers, to instil Berbagi Sehat had reached more than 1.1 million with soap. In schools, themed Germ Buster healthy hygiene habits. The three strands of people, with investment of over US$600,000 assemblies have taken place, with bandanas and the programme cover access to hardware (ie from Unilever Indonesia (excluding media spend). soap products distributed to help reinforce the handwashing facilities and toilets), enabling Research carried out following one of the Lifebuoy hand hygiene message. hygiene environments and hygiene promotion. brand’s interventions reported that 84% of people who had been involved with the campaign Reach: subsequently washed their hands with soap after By the end of 2008, the Mahfooz programme had using the toilet, compared to 58% in the reached more than 100,000 households directly. control group.

18 19 Lifebuoy way of life Annual Review 2008 - 2009

SPOTLIGHT: Lifebuoy responds to swine flu

ONLY WEEKS AFTER THE FIRST CASES OF THE INFLUENZA A H1N1 VIRUS, COMMONLY KNOWN AS SWINE FLU, WERE DIAGNOSED IN MEXICO IN EARLY 2009, THE VIRUS HAD SPREAD TO MORE THAN 76 COUNTRIES. GIVEN ITS WIDESPREAD GLOBAL REACH, THE WORLD HEALTH ORGANISATION DECLARED H1N1 A GLOBAL PANDEMIC, WITH THE GOAL THAT RECOMMENDED PREVENTATIVE ACTIONS WOULD HELP TO REDUCE THE IMPACT OF THE PANDEMIC ON SOCIETY.

LIFEBUOY IS UNIQUELY POSITIONED TO PLAY A KEY ROLE AT TIMES OF SUCH HEALTH CRISES. THE LIFEBUOY BRAND MISSION STATES ITS COMMITMENT TO IMPROVING HEALTH AND HYGIENE, AND SAVING LIVES THROUGH HANDWASHING. THE RESPONSE BY LIFEBUOY TEAMS DURING THE GLOBAL PANDEMIC HAS PROVIDED THE OPPORTUNITY FOR LIFEBUOY TO LIVE UP TO THIS MISSION.

Activity: Lifebuoy developed a complete hygiene influenza pandemic response package, with resources made freely available promotion through the Lifebuoy.com website. 1 Information was also deployed during the first wave of the pandemic across a variety of media channels, including activations TV, press, radio, instore and schools in all Lifebuoy geographies where swine flu had been detected. The Continued key message during the pandemic’s initial phase was ‘Washing hands frequently with soap is one of the simplest and most effective ways to prevent swine flu – issued in the public interest by Lifebuoy’. To minimise any confusion for the public, and maximise consumer reach, wherever possible Lifebuoy teams worked directly with SPOTLIGHT: Vietnam’s future in millions of clean hands local Ministries of Health, broadcasting combined public service messages. Activity: THE LIFEBUOY BRANDED HYGIENE In partnership with Vietnam’s Women’s Union, the initiative draws on many of the elements from the Lifebuoy Swasthya Chetna programme. The programme Reach: PROMOTION PROGRAMME IN VIETNAM is taken to women’s groups and primary schools educating them, through the During the first wave of the pandemic, STARTED IN 2008, AND AIMS TO CHANGE use of activities such as the glow germ demonstration, that ‘Visibly clean is not the Lifebuoy Swine Flu response really clean’. In a 2007 Ministry of Health survey, while 70% of respondents package was deployed across all THE HANDWASHING HABITS OF 62 MILLION in Vietnam understood the need to wash hands with soap before eating, only key Lifebuoy geographies, including RURAL CONSUMERS TO REDUCE THE NUMBER 6.1% did it in practice. The programme activities seek to change these habits. India, Sri Lanka, Cambodia, Indonesia, Malaysia, Singapore and Vietnam. OF CHILD DEATHS CAUSED BY DIARRHOEA IN Reach: THE COUNTRY EACH YEAR. The programme was piloted in a single province in 2008, and in 2009 was rolled out to the whole of the Mekong Delta region, comprising 13 provinces and covering approximately 1,200 communes and 400,000 people.

20 21 Lifebuoy way of life Annual Review 2008 - 2009

Capacity 2 building and partnerships

REACHING FIVE BILLION PEOPLE EFFECTIVELY WITH Our capacity building initiatives adhere Lifebuoy Social Mission Stewardship – A HANDWASHING MESSAGE THAT WILL DRIVE to the following key principles: Building in-house capacity BEHAVIOUR CHANGE IS NOT SOMETHING THE LIFEBUOY • We will share our expertise based on evidence that our On 18 November 2009, more than 150 people working with Lifebuoy BRAND CAN DO ALONE. THEREFORE THE NEED FOR programmes are effective in 21 countries took part in a unique online event, informing them PARTNERS WHO SHARE OUR VISION AND GOALS IS KEY about all aspects of the Lifebuoy Way of Life. . They received training • We understand the need for local partners to own their on the key principles of handwashing, learnt how to work effectively TO IMPLEMENTING THE BRAND’S SOCIAL MISSION. campaigns. As a result the outputs of our training and capacity with partners and how to deploy higher implementation standards of building are locally owned campaigns, into which public bodies handwashing activities. can invest their own resources Through the Lifebuoy brand’s 114-year heritage of running The aim of this event was to ensure that people working with the

Welcome to the hygiene promotion programmes we have built valuable • We recognise that we can learn skills from the public sector and it Lifebuoy brand fully understand the importance of handwashing with Handwashing Master Class hygiene marketing skills. In order to share our knowledge is important that the capacity building angle is a dual process. soap, and feel motivated and inspired about the Lifebuoy brand’s social mission. A Lifebuoy Handwashing Master Class was developed and and skills with public sector partners, we have developed a We believe it is vital for Lifebuoy brand teams to partner with made mandatory for all working on Lifebuoy.

capacity building programme so that by working together our local and national governments to take the vision of universal Start handwashing forward. The more people hear about the benefits of campaigns can have a greater impact in promoting positive Online Learning Module handwashing with soap from varied sources, the better chance we behaviour change. have to establish social norms around handwashing.

UNILEVER LIFEBUOY – STEERING COMMITTEE MEMBER OF THE PUBLIC PRIVATE PARTNERSHIP FOR HANDWASHING.

The Public Private Partnership for Handwashing was initiated in 2002 (see http://www.globalhandwashing.org) and is a collaboration between several organisations such as several organisations including Unilever, Procter & Gamble, UNICEF, Colgate, USAID and the London School of Hygiene and Tropical Medicine, with the aim to promote handwashing with soap.

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PROJECT CHAMPION: In Safe Hands: SharIng marketing expertise with the public sector ENCOURAGING HANDWASHING BEHAVIOUR AT SCALE THROUGH AN THE IN SAFE HANDS PROGRAMME IS ONE OF THE MOST ONGOING PARTNERSHIP BETWEEN SIGNIFICANT PRIVATE SECTOR CONTRIBUTIONS TO THE PUBLIC UNILEVER AND UNICEF PRIVATE PARTNERSHIP FOR HANDWASHING WITH SOAP.

The opportunity: The opportunity: Project Champion’s mission is to make a contribution The biggest challenge faced by national to Millennium Development Goal Four – reducing handwashing campaigns is getting people to adopt child mortality. We’re working with UNICEF to do handwashing with soap as a permanent habit, this by designing, testing, packaging and making and few public sector officials responsible for such Deby Sadrach, Vice available an approach to encourage the habit of campaigns have experience of developing effective President Home & Personal handwashing with soap among caregivers for the behaviour-change communication techniques. By Care Unilever Indonesia, under-fives in poor communities in developing providing marketing training to such professionals officially opened the Health countries. The campaign focuses on making school- and sharing Unilever’s experience in driving Expo preceding the In aged children a key route of influence into homes. behaviour change, we see an opportunity Safe Hands Workshop in to significantly increase the effectiveness of Indonesia. Project activities: handwashing behaviour-change campaigns. “The Lifebuoy brand has a social mission that Phase one of Project Champion was completed in has been deeply embedded in the brand late 2008, examining two key hypotheses. The first Programme activity: ever since it was launched in Indonesia. was that the project should take a global approach In Safe Hands was designed by Unilever’s Through the brand’s involvement in the – a theory which was validated by desk research, Marketing Academy and the Lifebuoy brand public-private partnership activities and by expert interviews and literature reviews. The second team, and has been implemented successfully in sharing our marketing expertise, Unilever hypothesis was that children could play a key role in Vietnam, Kenya, Tanzania, Uganda and Indonesia. gets excellent opportunities to enhance the influencing adult behaviour at home. We carried out Lifebuoy brand’s social impact for positive a proof of principle study in rural Uganda to test this, Through the programme, senior decision makers behaviour change in the country. Going with encouraging results. Within the public health and policy formers are educated on the role forward, we are committed to continue doing sector children are often seen as agents of change, and value of marketing in achieving behaviour this, and widen further the impact towards but this was the first study that actually measured change, including taking part in live consumer more and more Indonesian families”. the impact children have on health at home. immersion exercises to see how effective Capacity marketing activations can really make an impact Our achievements to date on communities. Upon completion of the training, Unilever teams support public sector organisations and next steps: Chris Nsubbugga, to develop real-life handwashing campaign Handwash Coordinator, building and Findings from Phase one of Project Champion support communications. Water & Sanitation 2 the case for a global approach to encourage the habit Programme Africa, of handwashing with soap in poor communities in Our achievements to date: received In Safe Hands partnerships developing countries. We believe a global approach More than 300 public sector professionals have training: to this initiative is valid, but marketing will need taken part in the In Safe Hands programme. to be tailored to suit the different and diverse Continued As a result, several Lifebuoy-backed national “Since taking part in the In Safe Hands communities in which Lifebuoy has a presence. handwashing campaigns are now at various stages programme, we have found a common of development: campaign idea to promote handwashing with Our research also offered direct evidence that soap in the East Africa region – ‘Hands to be children can influence more than just attitudes • In Uganda and Tanzania, a ‘Hands to be proud proud of’. It’s a great concept and we would among the adults that care for them at home, of’ campaign is being rolled out, tailored for never have reached this stage without the helping to foster lasting good habits in handwashing. each country to suit the local context. Over support from In Safe Hands and the Lifebuoy US$700,000 has been raised to run the campaign. brand. I found the immersion exercise during Older girls are the most influential audience for this the workshop really useful. Being able to go project, with two key behaviour-change catalysts • In Kenya a national taskforce to promote out into the community, talk to consumers having the biggest impact: handwashing with handwashing with soap has been established, and understand their needs enables us to soap as a social norm, and the feeling of disgust at led by the Ministry of Public Health and find out so much about them.” unclean hands. We’re certain that through education, Sanitation, and supported by partners including older children can become valuable messengers of UNICEF, Water & Sanitation Programme Africa, change in this vital area. PLAN International and CARE. A communication campaign is currently in development, and the Kenya team is aiming to raise over US$800,000 to run the campaign.

• In Indonesia, the Public Private Partnership for Handwashing with Soap has requested Lifebuoy’s support in developing an effective Unilever-UNICEF partnership communication campaign. The communication brief is currently being drafted.

24 25 Lifebuoy way of life Annual Review 2008 - 2009

GLOBAL HANDWASHING DAY Launched in 2008, Global Handwashing Day is an annual event backed by the Public Private Partnership for Handwashing with Soap, of which Unilever, through its Lifebuoy brand, is a founding partner. THE OPPORTUNITY: The annual celebration of Global Handwashing Day is designed to foster and support a global and local culture of handwashing with soap, raising awareness of its benefits, and shining a spotlight on the state of handwashing in each country taking part.

In the long term, we hope Global Handwashing Day will become a powerful platform for advocacy aimed at policy makers and key stakeholders, and an occasion for public commitment to action that will instil behaviour 3 change at scale. PROGRAMME ACTIVITIES: The Lifebuoy brand works with over 50 partners across the globe to bring the health Advocacy and hygiene message to millions of consumers in countries selling Lifebuoy.

ADVOCACY IS A CENTRAL ELEMENT OF OUR EFFORTS TO PROMOTE GLOBAL HANDWASHING WITH SOAP BECAUSE IT HELPS TO SET THE RIGHT ENABLING ENVIRONMENT FOR THE HANDWASHING PROGRAMMES WE SUPPORT, EXTENDING OUR REACH AMONG INFLUENTIAL AUDIENCES AND SPREADING THE MESSAGE THAT HANDWASHING WITH SOAP CAN BRING MUCH-NEEDED HEALTH BENEFITS TO COMMUNITIES. WE BELIEVE THAT – THROUGH THE LIFEBUOY BRAND - WE HAVE A VALUABLE PART TO PLAY IN PROMOTING THE IMPORTANCE OF HANDWASHING WITH SOAP, AND ALSO HIGHLIGHTING THE ROLE THAT PRIVATE SECTOR PARTNERS CAN PLAY IN THIS AREA.

Although the last decade has seen great Lifebuoy brand teams are dedicated to progress in raising handwashing on the advocating handwashing with soap, and deliver agenda for governments and private sector presentations about our work, research and organisations, the full benefits of handwashing goals at high profile meetings and conferences with soap are still not appreciated or around the world. As a founding partner of understood in many parts of the world. Policies Global Handwashing Day, the Lifebuoy brand is and programmes on handwashing promotion helping to raise the profile of the issue to the are still not widely practised – and that’s an whole world. issue we seek to address.

26 27 Lifebuoy way of life Annual Review 2008 - 2009 OUR ACHIEVEMENTS TO DATE

GLOBAL HANDWASHING DAY 2008 GLOBAL HANDWASHING DAY In India 15,000 children washed their hands 2009 at the same time to attempt to break the The inaugural Global Handwashing Day was Guinness World Record. The event was co- celebrated in more than 75 countries, including In 2009, over 85 countries celebrated Global ordinated by the Lifebuoy brand, WHO and the 23 Lifebuoy markets. Handwashing Day including 23 Lifebuoy Indian government. markets. COUNTRY HIGHLIGHTS IN 2008 In Cambodia, Lifebuoy teams organised school COUNTRY HIGHLIGHTS IN 2009 events across the country to generate coverage In South Africa, Lifebuoy brand teams worked In Vietnam the Lifebuoy team launched the in three national newspapers and 4 popular with the Department of Water Affairs (DWAF) to global ‘Germ Fighter Drawing Contest’ across consumer magazines. host a handwashing event as well as organise a the country and organised a Guinness World “clean up” of schools across the country. Record attempt. In Uganda, the Public Private Partnership for Handwashing, UNICEF and the Government In Sri Lanka, the Lifebuoy brand teamed up with In Indonesia, 1,609,000 people participated of Uganda joined the Germ Fighter drawing government Public Health Inspectors to create a in Lifebuoy activities on Global Handwashing contest and got 13,000 schools across the handwashing pledge for school children. To help Day. The team generated $284,200 worth of country to participate. spread the word they travelled around schools PR coverage. in a Lifebuoy branded bus educating children on the importance of handwashing with soap. Paul Polman In Malaysia the Lifebuoy team organised a adressing month long handwashing campaign which Unilever reached 62,000 children across the country. employees Activities included handwashing pledges on Global and educating children about handwashing Hadwashing techniques. Day

GUINNESS WORLD RECORD IN BANGLADESH

Lifebuoy teams in Bangladesh worked with the Department of Public Health Engineering, UNICEF, the World Health Organisation and other coalition partners to bring the Global LIFEBUOY GERM FIGHTER Handwashing Day message to 75,000 schools DRAWING CONTEST across the country. The activities reached more Global Handwashing Day revolves around schools than 15 million children, and gained media and children, with activities designed to increase coverage from all five national TV channels, 26 their participation in handwashing with soap. To national newspapers, and a wealth of regional raise awareness of the Global Handwashing Day publications. campaign and its important hygiene messages among children, the Lifebuoy team launched its As part of the day’s events, the Lifebuoy global ‘Germ Fighter Drawing Contest’ in 2009. team and its partners broke the Guinness School children aged between 5 and 12 across World Record for the most people washing many Lifebuoy countries participated. their hands with soap at the same time - and made a significant step towards a long-term To date, the Lifebuoy team in Indonesia has working relationship with Lifebuoy’s partners in received over 15,000 entries and 13,000 schools Bangladesh. in Uganda entered the competition, with several 2 other countries still collating the poster entries. The prize is a visit to the UN palace in Geneva, Switzerland, supported by the Water Supply Advocacy Sanitation Collaborative Council.

Continued

28 29 Lifebuoy way of life Annual Review 2008 - 2009

Lifebuoy Way of Life: Tracking social and business Impacts IMPACT EXAMPLES FOR 2008-09 IN 2008-2009, • AWARENESS OF GERMS AND LIFEBUOY • LIFEBUOY BRAND EQUITY BRAND SALIENCE The equity of the Lifebuoy brand has been tracked THE IMPACT One of the ways in which the impact of the in countries where social mission activities have Lifebuoy Swasthya Chetna programme has been been ongoing, with significant improvement OF LIFEBUOY evaluated in India is to measure the awareness recorded in brand attributes in these countries. of germs, the association of diseases with poor PROGRAMMES hygiene and Lifebuoy brand salience. The table For example, in Vietnam brand attributes below shows the impact of the programme were found to have been improved, such that HAS BEEN following its implementation in 9 states agreement with the statements: across India.

TRACKED USING Pre-Intervention Post-Intervention + Cleanse the skin deeply to increased from Awareness of germs 52% 83% remove invisible dirt 65%-> 85% A VARIETY OF Associating germs with disease 35% 57% + Is a brand that you increased from Lifebuoy Brand Salience 28% 51% can trust 65%-> 97% MEASURES, INCLUDING TRACKING FROM 2010 ONWARDS In 2010, a complete measurement framework also been reviewed by external partners, such as AWARENESS will be established that will track the impact of UNICEF and the World Food Programme, to ensure Lifebuoy Social Mission programmes on societies compatibility with existing external frameworks. OF GERMS and business. The overall success of these programmes – and therefore the success of the SIMPLE PRINCIPLE AND DISEASES Lifebuoy Social Mission - will be measured by the The metrics are based on a simple principle: what impact that Lifebuoy activities have on changing we put in (the inputs) and what we get out (the ASSOCIATED handwashing behaviours over a 5 year timeframe. outputs). Tracking progress will help to achieve our goals by WITH POOR identifying whether we are on plan to deliver the For inputs: this means tracking expenditure Lifebuoy Social Mission and business target. made by the Lifebuoy or Unilever brands and any HYGIENE, AND external collaborators. THE PILOT BRAND EQUITY The Lifebuoy brand has been selected by Unilever For outputs: this means tracking the short- to pilot the new Unilever Social Mission Framework term and long-term effects of our mission on MEASURES FOR & Metrics, establishing an activated tracking our business and on society. These outputs mechanism in every country. These metrics have will include the PR value generated by social LIFEBUOY. been developed in 2009 by a central team, mission activities, brand equity, sales results and including representatives from the Lifebuoy brand awareness of germs and salience to the and external consultants. The framework has Lifebuoy brand.

Social Mission Metrics essentials: Inputs and Outputs

Goals Inputs Outputs Impacts

30 31 Lifebuoy way of life Annual Review 2008 - 2009 Rewind and Recap

The Lifebuoy Everyone is doing it! It’s good manners! Make it easy! Use the power of social norms. Mums teaching kids good How you can change the situation Make handwashing with soap seem manners is what good so people don't have to work hard ubiquitous; don’t talk about how mums do. to handwash. For example, keep a rare the practice is, as this will make small piece of soap nearby; create 1 people wash less. 4 7 special moment in routine for handwashing.

The Yuck factor! Get the habit! The power of the Disgust is the evolved motivation Handwashing is everyday pledge! for hygiene, the key motivator, so behaviour and highly habitual. Create a club. Make the use it! Target kids: get people early, handwashing with soap pledge before they've formed bad public. TOP 2 5 practices. 8

Frame it! Provide rewards. Badge it!. Make sure you frame your message A strong emotional reinforcer Become a handwashing person/ positively. Don't use fear or disease helps instill habits. household. Wear the name threat. 3 6 9 proudly! hygiene and health lessons Reminders! learned from 2008-2009: Use signs, wall-writing, billboards, anything in a public space, where it can be seen and 10 reinforce the behaviour.

32 10 33 Lifebuoy way of life Annual Review 2008 - 2009

The biggest challenge ahead is to lay the right foundations in Our next steps 2010 for the Lifebuoy brand and its partners to achieve the By Anuj Rustagi, Lifebuoy Global Brand Director vision of changing the hygiene behaviour of 1 billion people by The Lifebuoy Way of Life Challenge – 2015. This will be the biggest contribution of the Lifebuoy brand Join us and let’s change the hygiene behaviour of and its partners to the Millennium Development Goal 4, which aims to reduce child mortality by two thirds by 2015. To see 1 Billion people by 2015 how you can get involved, contact us: [email protected]

References

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34 35 Lifebuoy Germ Fighter Drawing Contest entries - Global Handwashing Day 2009

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