As mass immunisation programme emerges as the next challenge for nations after development of coronavirus vaccine, the question remains how well Bangladesh is prepared to carry out this task. It first needs to secure vaccine doses and then distribute them among the citizens.
Has the government consulted with relevant experts to develop effective supply chain networks and manage it with cold storage facilities? "Planning for the immunisation campaign should start immediately, and further investment is needed into the infrastructure to ensure the health systems are ready," said Catherine Duggan, CEO of the International Pharmaceutical Federation (FIP).
According to lab reports, Pfizer's vaccine requires temperatures colder than Antarctica's during the winter -roughly minus 94 degrees Fahrenheit. Moderna's vaccine also needs cold storage, though of less cooler temperature than Pfizer's.
So, the importance of maintaining cold supply chain cannot be underestimated as anything of this size has never been attempted before. Any failure in the cold-chain could make it useless.
"Requirements across the supply ecosystem are monumental and require innovative responses in order to stem the dire socioeconomic consequences resulting from this pandemic. Planning and cohesive, public-private partnerships that enable safe and inclusive outcomes are vital for accelerating vaccine distribution," observed Margi Van Gogh, Head of Supply Chain & Transport Industries at the World Economic Forum.
This supply chain management should include useful vaccine storage, handling, stock management; meticulous temperature restriction in the cold chain; and adequate logistics management through information systems. Data loggers can be used in vaccine distribution applications.
In the US, DHL, FedEx and UPS are working on distribution plans. In Bangladesh, we are yet to know with certainty the partners for vaccine distribution. Authorities are yet to develop a proper supply chain network engaging private or public sectors.
In a statement, Glenn Richey, the chair of the supply chain management department at Auburn University said, "With pharma executives reporting typical spoilage rates for other vaccines during transport at 5 per cent to as much as 20 per cent because of inadequate temperature control, getting cold storage shipping control just right is critical to the expansion of availability."
In view of this, the government needs to plan how much it wants to buy. It's all about typical supply chain management that encompasses six rights: (a) Right product, (b) Right quantity, (c) Right condition, (d) Right place, (e) Right time, and Right cost.
Logistics support is critical to immunisation services to assure availability of proper facilities and a sufficient supply of high-quality vaccines and immunisation-related elements to all programme levels. It is imperative to ensure the exact implementation of appropriate strategies. They include vaccine management and monitoring, cold chain management, and immunisation safety.
In Bangladesh, as practice goes, the vaccines will be transported to distributors for allocation to hospitals, pharmacies, and vaccination centres. A 20 per cent vaccine loss due to cold chain issue would create a serious problem. It's a wake-up call for the Bangladesh government. In un-integrated supply chains, securing temperature controls becomes further complicated as cargoes are divided into separately packaged lots, handled by diverse carriers.
Hospitals, pharmacies, and clinics are expected to be among the first vaccination points, though most are not equipped with ultra-cold freezers and could not stock the vaccine on-site for more than a short time. Vaccines that demand more than one dose will complicate and conceivably undermine administration if viable booster shots do not come on time.
In Bangladesh, routine immunisation reaches over 82 per cent of the children with the vaccines they need to protect them against diseases like polio, measles and tetanus. Researchers stress that the government must significantly expand its distribution channels and partnerships for vaccine administration to reach target groups with a Covid-19 vaccine.
The arrangement of a national temperature-controlled supply chain is not an easy task. It can involve different steps, including packaging, distribution, holding, bulk storage, and local storage. Sustainable cold-chain growth will help support existing immunisation and cold-chain programmes and of course a Covid-19 vaccine.
Mohammad Ashraful Islam Khan is president of Alliance of Supply chain professionals in Bangladesh.
khan.ashraful@gmail.com