The news from Pfizer and Arcturus over these last few days gives one reason to believe that a viable vaccine will be available to many across the globe in the next few months.
When approved, the next challenge will be to safely and securely ship these vaccines to where they will be available to citizens in every part of a country. The likely possibility that these vaccines will require shipment at temperatures below zero degrees Celsius will further compound accessibility. Temperature excursions, which is the term used to describe any period when pharmaceutical products like vaccines are stored or shipped at a temperature outside of the specified temperature range defined on the label of the product, could affect the vaccine’s efficacy. Prolonged or extreme temperature excursions could even render them useless.
Transport from the point of manufacture to capital cities will not be the main issue. The challenge will be when temperature-sensitive vaccines need to be shipped anywhere and everywhere within a given country or region – such as the 17,508 islands in the Indonesian archipelago. We will need to ensure these are shipped at the correct temperature and that batch and lot numbers of these vaccines are tracked and tagged to ensure they are not lost, stolen or misdirected to the wrong destination. We will also need to ensure the shipment of adequate ancillary items like syringes and swabs occur with the vaccines. Also, the necessary reverse logistics must be addressed as well as the need to provide accurate and timely monitoring of vaccine inoculation to stakeholders like the manufacturers, NGOs and, governments.
The review of customs and international trade procedures is necessary to prevent delays, deal with disruptions, and address potential nationalistic issues. Where possible, expedited green lanes may be implemented to streamline these urgent shipments. The destruction or reduction of vaccine efficacy may result from cargo hold-ups and delays due to poor temperature control, mishandling, or incorrect documentation.
Environmental and sustainability issues also need to be considered in distributing vaccines, including innovative packaging solutions, recycling opportunities, and waste management in the use of one-way packaging. From the disposal of syringes and other paraphernalia to the reusability of the specialised temperature controlled packaging material deployed in what is the largest, single supply chain challenge ever experienced by humankind. Additionally, if the forewarning by health officials is correct, Covid-19 is likely the first of a plethora of viruses humankind will face over the next century. The learnings from the handling of Covid-19 and its resolution will be useful in future scenarios.
All of the issues highlighted are the tip of the iceberg and many cannot fathom the scale and magnitude of vaccine distribution globally. This situation is amplified more extensively in the global south, where the vagaries of weather are more extreme, and where a more considerable extent of the population is in the lower half of the socio-economic scale and part of a larger population base.
There is also the potential for the solutions put in place to have additional benefits for countries in facilitating future trade and financial flows. These benefits will occur by building infrastructure such as supply chain control towers, payment and insurance mechanisms, and cold chain traceability. The capabilities of these tools extend beyond the VDE, and have an additional impact on food supply chains.
One company, government, or NGO cannot solve the century’s largest supply chain challenge. Even before the pandemic, real-time visibility along supply chains was a challenge due to the limited willingness of stakeholders to share data. This supply chain will be more complicated due to the increased number of stakeholders involved. The hypothesis is that countries and even groupings of countries like the ASEAN or EU will go beyond the formation of public-private partnerships (PPPs) and form Vaccine Distribution Ecosystems (VDEs) supported by technology. These VDEs will work in concert with all necessary stakeholders to adopt and implement the best available technology platforms and tools to integrate seamlessly with one another and provide visibility through a unified control tower. Many will have limitations, however extensive collaborations in the form of VDEs will dramatically reduce the loss of life. Countries and stakeholders should not take the most readily available option but focus on models that will be better positioned to save humanity and provide a framework for future solutions, including ensuring international trade facilitation.
The three authors have today published a 36-page blueprint guide on how best to handle the global vaccine distribution. It is available here.