Transportation of vaccines in Nicaragua: By horseback!
Malaka Gharib is currently at the GAVI Partners Forum in Dar es Salaam, Tanzania, where global health and government leaders are gathering to explore ways to accelerate results, innovation, sustainability and equity in the field of immunization.
What do you think one of the biggest issues in vaccines and immunizations is? That’s an easy one, right? Making sure that every country in the world has access to vaccines, of course!
Well, actually, we achieved universal child immunization – way back in 1990. Thanks to collaboration between WHO, UNICEF, countries and suppliers, a system was put in place to bring immunization coverage to nearly 80 percent of the global birth cohort. And it’s a system that’s worked well for a long time.
But now, that system is breaking down. The GAVI Alliance reports that 9 of the 24 countries in which they operate have poor vaccine stock management and vaccine distribution. And more than 20 percent of the GAVI countries’ vaccines go to waste above the expected rate.
It’s not hard to see why. The introduction of new vaccines and increased coverage targets is putting “business as usual” at risk. Since the 1980s, kids need 3 times more vaccine doses per child and there are 2.5 times more diseases to vaccinate. Looking into the future, experts believe that we’ll need 4 times more fridges (vaccines need to stay cold) between 2001 and 2020.
Preparing the pneumococcal vaccine
The conversation now is about how to make the system better, how to make transport of vaccines more reliable, and how to protect and preserve vaccines. The solution that experts are proposing is a clear one: countries need to take ownership of their vaccine supply chain (also called the “cold chain,” since vaccines are temperature-controlled). And they need to be super creative about it, because every country has its own situation and infrastructure – it can’t be a one-size-fits all strategy.
I had the wonderful opportunity to listen to supply chain experts like Michel Zaffran from the World Health Organization, Dmitri Davydov from UNICEF and Dr. Bruce Lee from the University of Pittsburgh, and country health officials from Benin, Tanzania and Uganda discuss this issue at the GAVI Partners Forum yesterday. I was particularly interested in listening to some of the innovative ways that countries were tackling some of the challenges with their vaccine supply chain.
– Hon. Huda Oleru from Uganda’s Parliamentary Forum for Immunization, says that they’re using an SMS tool called U-Report to crowdsource problems with the vaccines distribution system from Ugandan citizens. She says that her team is using the feedback to learn about some of the holes in the Ugandan supply chain – and fix them.
– Dr. Bruce Lee leads the team that developed a software called HERMES, a computational tool to design, plan and manage vaccine supply chains. What’s neat about it is that it can even predict estimated future needs, which will help in reducing vaccine wastage, stock outs and problems with storage. Currently, it’s being tested in Benin, Thailand and Niger.
Fridges are an important part of the vaccine cold chain.
– The World Health Organization, GAVI, UNICEF and the Bill and Melinda Gates Foundation are finding that the cold chain itself is a barrier to routine immunizations – and it’s not getting the funding it needs. The world needs to invest more in cold chain hardware, like fridges and packaging. And there’s some cool stuff that they’re looking at on the horizon, including solar-powered fridges and vacuum insulation that lasts for up to 30 days.
ONE members fought hard last year to make sure that world leaders gave GAVI the funding it needed for their pneumococcal and rotavirus vaccines – and we succeeded. But now, it’s up to countries to ensure that these much-needed vaccines actually get to the people who need it most. There will be more vaccines to distribute and more people to immunize in the future – and if countries can find the holes now, strengthen their supply chain and invest in technologies, we can achieve GAVI Board Chair Dagfinn Hoybraten’s one wish for the world: “that the children may live.”
Follow @ONEinAfrica and #GAVIPartners for live tweets from the GAVI Partners Forum.