No one likes it when a delivery fails to show, but when it happens with vaccines it costs lives.
Currently, millions of children go unimmunized each year because of delivery problems, including anything from vaccine supply chain breaks and ineffective cold chain equipment to poor vaccine stock management in developing countries. Shockingly, these kinds of issues account for a substantial number of the children who miss out on their shots.
That has got to change. These supply chain inefficiencies may be contributing to the deaths of 1.5 million children each year from vaccine-preventable diseases, the vast majority in developing countries.
Without the protection of vaccines, children in developing countries are at risk from diseases like measles, meningitis A, pneumonia, rotavirus, hepatitis B, yellow fever and polio. And of those that are fortunate enough to escape death after contracting such a disease, many are still left with debilitating consequences.
Indeed, the economic and social impact of caring for children and adults who have been debilitated by disease is huge: education is often not completed, parents are tipped into poverty, labor productivity remains low and long-term health costs skyrocket.
Common challenges within the vaccine delivery chain include weak information systems, outdated processes and a lack of “cold chain” infrastructure (storage and transport of vaccines), often in dire conditions.
At the same time, the strong value of immunization is recognized globally, leading both to a near doubling of the number of vaccines recommended by the World Health Organization, to 11 today from six in 2000, and increased demand for them by the governments of developing countries. These governments also naturally are asking for the new highly impactful vaccines, which have increased by five times cold chain volume requirements compared to the traditional schedule of vaccines. Unfortunately, all of these factors have exacerbated the supply chain’s weaknesses.
Tremendous progress has been made over the past decade or so to improve global childhood immunization rates. Thanks to the GAVI Alliance, immunization rates among the world’s poorest are at an historic high. But further progress won’t be made – or even worse, could actually be reversed – if gaps in vaccine supply chains, particularly in countries like India, Nigeria and Pakistan, do not dramatically improve.
And yet successful global businesses operate large and complex supply chains that are much more effective and efficient. They have end-to-end views of their supply chains and attach a high priority to managing them. In sharp contrast to the difficulties the public sector faces in moving vaccines down to the local level, leading companies effectively utilize supply chain models and systems that permit them to deliver their products successfully to remote rural villages in many developing countries.
So, while supply chain practices have remained largely static in the public sector over the past 30 years, the corporate sector has moved forward by innovating and adopting new technologies, such as feedback loops between product planning, development and delivery, and the use of supply chain management software and radio frequency identification tags.
It’s a model the public sector really needs to pay attention to. As the world’s largest purchaser of vaccines for developing countries, GAVI is now urgently seeking innovations that will allow governments to reach more children and maximize the dollars spent. The stakes are high. Since 2000, the value of GAVI-funded vaccines has increased tenfold, from US$ 94 million to US$ 921 million in 2011.
These vaccines flow through a delivery system that is large, complex and contains many levels. In the 73 countries supported by GAVI, there are more than 130,000 health facilities administering vaccines to poor children.
So starting in 2014, we are working to convene a supply chain “Centre of Excellence” of committed global corporations that would provide advice to GAVI on our broader supply chain strategy and individually work with partner governments and technical specialists to tackle several of the most pressing problems, such as stock monitoring, cold chain breakdowns and poor data quality. Cash and the value of in-kind contributions made by companies involved in the Centre would be doubled under the GAVI Matching Fund, a matching program for corporations and private foundations.
Certainly, the majority of issues will still need to be addressed by the governments involved, together with major GAVI Alliance partners, such as UNICEF and the World Health Organization. And although leading companies may be savvier at remote delivery, most do not face the additional challenges of keeping products cold and at a constant temperature in transit.
My belief is that Centre members will bring a fresh perspective and dynamic to the good work already underway and help develop long-term sustainable solutions in key areas. We can learn a lot from the private sector while helping them gain market knowledge and possibly catalyzing commercial solutions at the same time.
This type of collaborative partnership would be a win for all involved, but most importantly for those children who await the opportunity of a healthier life.
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Dr. Seth Berkley is the CEO of the GAVI Alliance, a public-private global health partnership that has helped vaccinate more than 370 million children in the world's poorest countries, preventing more than 5.5 million future deaths from vaccine-preventable diseases.