Over the years the recommendations for diarrhoea treatment have changed.
My understanding is as follows.
We started with ORS alone in sachets for institutions and homemade ORS at home using sugar AND salt (never just sugar alone).
Then the recommendation went to ORS sachets inside institutions and at home with homemade ORS only in emergencies.
Then we went to low osmolarity ORS (in sachets) AND zinc in all situations. This was in 2004 and I think the switch away from homemade ORS may have been at the same time. Perhaps others can help here.
So the ORS AND zinc recommendation is 15 years old but just hasn’t gained significant traction. This is why we think the change to the WHO EML to explicitly recommend co-packaged ORS and zinc is so significant. Our case for co-packaging is here: https://colalife.org/co-pack
The BMA book was wrong even when published in 2001.
HIFA-Zambia profile: Simon Berry is the C.E.O. for ColaLife in the U.K and Zambia. Professional interests: Innovation ORS / Zinc Child Health. simon AT colalife.org