As we enter 2021, the whole seems to be revolving around the Covid-19 vaccine and its availability. As various governments give a nod to the vaccines, one of the critical questions, which needs to be answered is how will the vaccine reach billions of people. The vaccine makers are working 24/7 to come out with the best solutions and making sure that the vaccine would stand good against the new mutated version of the virus. Out of four vaccines which are showing great results three are exceeding 90% efficacy which is showing a sign of success in fight with this pandemic. However, the challenge of eradicating this pandemic isn’t limited to developing a vaccine but also distributing it to the masses.
According to the WHO ACT- Accelerator Framework countries will first get 3% doses, then 20% of the population and in the end full vaccination. This Accelerator is not a decision-making body but a collaboration platform to bring together governments, scientists, civil society for equitable access to COVID-19 vaccines and treatments. Key challenges which are going to come as we cover the entire global population: supply chain management, logistics and transportation, storage and inventory management, maintaining adequate production and most importantly who gets vaccinated first. Countries need to identify vulnerable populations to distribute the vaccine. Most of the vaccines require at least two doses which again complicates the distribution and manufacturing.
How Supply Chain and Logistics works in an Immunization drive:-
National immunization program has scope to improve their performance to provide the right vaccine at the right cost, in the right condition at the right time. Effective Vaccine Management (EVM) includes the following:
Vaccine arrival: Vaccine arrival procedures make sure that shipment of vaccine from a manufacturer reaches its destination in a country with no damaged vaccines in it.
Temperature control: With WHO-recommended temperature range for the type of vaccine diluents and vaccine distributed and stored within a cold-chain system.
Storage capacity: Supply chain system must have transport storage capacity, quality cold storage with sufficient dry storage.
Infrastructure: Cold-chain equipment, storage buildings and vehicles with status make the supply chain to function effectively.
Maintenance: Storage buildings, cold-chain equipment and vehicles require standard and operational maintenance systems.
Stock management: – Technologies and systems for good warehousing practice, physical inventory, disposal for damaged vaccines and adequate stock-level policy.
Distribution: High effectiveness required for the transport of vaccine between each level in the supply chain with best packing practices with coolant packs and temperature indicators.
Vaccine Management: Use of diluents, monitoring of vaccine wastage, use of vaccine vial monitors are adopted and implemented according to the recommended policies for vaccine management.
Information systems: Logistics Management Information Systems (LMIS) is effective including vaccine-needs forecasting and standard operating procedures.
According to WHO less than 25% of countries are meeting criteria of stock management, maintenance, distribution almost 29% of countries are meeting criteria of minimum standards for temperature control. WHO recommends that national immunization programs must analyze their supply chains for related supplies, to reduce avoidable wastage and to improve the distribution of the covid-19 vaccine.
Supply Chain Challenges with COVID-19 vaccine: –
Global scientist community is working at a breakneck pace on the development of vaccines but its distribution will pose tremendous logistical challenges for governments. There is a good degree of risks involved in the transportation of vaccines, which cannot be ignored. The global vaccine demand is to produce the vaccine for 7.8 billion people. Air Cargo capacity in 2021 will be in high demand to deliver the vaccines to various parts of the world. Key challenges with the distribution of the covid-19 are as follows: –
- Temperature: – Temperature needed for storage of COVID-19 vaccine is between -60 degree Celsius to -90 degree Celsius, which also requires specialized transport and storage channels to manage the vaccine temperature.. UNICEF is going to have 65,000 solar cold-chain fridges in less developed countries. Vaccines will require large cold storage facilities with man-power having adequate handling expertise.
- Safety: – Because of high demand with limited supplies in the initial days will make it an easy target for theft. Logistics of vaccines requires secured loading, special planning to avoid pilferage and robbery. Panic can create a situation of tampering and robbery in the supply chain. Secured loading and Safeguarding of vaccine is required like that of valuable goods like currency notes, gold, defense equipment etc.
- Prioritization: – Governments will make decisions about which groups should be vaccinated first. The equitable distribution will require identification of vulnerable populations in a transparent manner. Most of the national vaccine programs are designed for children immunization, not for adult vaccination.
- Connecting distributors, vaccinators and consumers: – Vaccine manufacturers require optimal distribution systems in a complex web of stakeholders i.e. manufacturers, public health officers, distributors, pharmacists and others for efficient delivery of vaccines. It will help in forecasting the demand and will improve the just-in-time delivery of vaccines. Manufacturers have to collaborate with stakeholders to exchange data like potential delays in real-time, expected delivery dates and number of vials shipped to ultimately model the supply chain. Most of the vaccines require at least two doses which increase complexities in logistics and supply.
Solutions to Tackle Vaccine Supply Chain Challenges: –
It is important to know how to measure to efficiently forecast supply and demand, store and deliver vaccines with the help of tools and processes for regular and reliable data. It’s a continuous quality improvement process comparing with best-practice benchmarks. In major national immunization programs data may be lost, geographically dispersed, not recorded on paper or systems. To prioritize areas where attention and improvement are required to use supply chain management solutions that can analyze immunization supply chain system from distributed data and store them in information systems.
- Plan and implement improvements: – After measuring the immunization supply chain system and how it handles supply, demand, storage and delivery and how it represents key metrics and provides actionable insights to the key stakeholders. By taking the advantage of gathered data large scale changes can be done supported by proven and novel approaches. Supply chain redesign is the logistical analysis for the reconfiguration of processes such as increasing the frequency of shipments or changing warehouse locations. Logistics Management Information Systems (LMIS) helps in improving the information such as received, administered or wasted, stock-on-hand.
- Increase awareness and investment: – Immunization programs need funding, people and data to prevent disease. Investment is required to train, incentivize and reward data managers, managers, warehouse workers and logisticians are the backbone of Immunization supply chain system.
- Effective Logistics Management – An effective logistics system is going to be the backbone of this immunization drive. Effective cold chain logistics service providers, real-time tracking and dispatch planning will hold the key to effective distribution of the vaccine. Real-time visibility and rapid exceptional handling capabilities would be needed to manage the delivery of vaccine from origin of manufacturing to the final delivery point.
An effective supply chain management system must have the capability to manage these elements – right quantity, right product, right time, right condition, right place, right service provider and right cost.
Where does India stand in vaccine supply chain management?
India has better access to vaccines compared to other developing countries but the distribution of the vaccine with existing cold chain capacity seems to be a daunting task. Serum Institute of India will be producing 1 billion doses of the vaccine by 2021. Currently, India has a 28,000-unit cold storage point, 76,000 cold chain equipment, 55,000 cold chain handlers, 2.5 million health workers, 700 reefer vans which are used for national immunization program but there is no company which can manage the supply chain of vaccines that require -25 degrees Celsius according to The Indian Express. If it is going to be a two-dose vaccine India will require a large health workforce to administer more than 2 billion doses. The Indian government is working on to identify cold chain storage facilities that have the capacity for storing vaccines. Food cold-chain storage (FCI) can be utilized for the last-mile availability of the vaccine. The Indian government is aiming to vaccinate most vulnerable 300 million people with 600 million doses by August 2021 which seems a hard target to achieve with current cold storage infrastructure.
How will the entire global population be vaccinated remains an interesting question? And one can say confidently that in this age of cutting edge technology and effective digitized Supply Chain Strategy would be needed to manage the global distribution of the COVI-19 vaccine
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Sources : Business-standard, Live-Mint