State of play: COVID-19 vaccine procurement and distribution in emerging economies
This article is a follow-up to the discussion: "Are you ready for the last mile? COVID-19 vaccine procurement and distribution in emerging economies."
The COVID pandemic and its impact has been with us for nearly two years now, and over 270 million cases have been confirmed1. Eight billion doses have been administered globally2; however, the pandemic is far from over. New variants are raising alarms, and vaccine equity threatens global protection from this deadly virus.
"There may be plenty of vaccines available, but uptake of the vaccine has not been equal."
Getting vaccines to countries in need is critical, as is distribution within those countries. Last-mile logistics have proved to be a significant challenge, there are reports of logistical issues resulting in precious vaccine doses expiring and being destroyed before they make it into people's arms.
In July 2021, we invited experts from the WHO, the Africa Medical Supplies Platform (AMSP), and the Brazilian Society of Infectious Disease (SBI) to discuss these challenges and strategies for addressing them.
"As low-income nations gear up to receive and distribute these doses, it is important to understand what works, and why." Jaqueline Escotero, Regional Vice President for Latin America at World Courier, said in her introduction to the panel discussion: "Are you ready for the last mile? COVID-19 vaccine procurement and distribution in emerging economies."
Addressing many challenges at once
"In the morning, we would tell the population that the vaccine is good, the vaccine is safe... on the other side, the politicians would always question the safety of vaccines, the necessity of vaccines."
What is the global outlook for COVID-19?
"Unfortunately, I agree with the majority of people," said Dr. Ritchmann, who explained that she would be more optimistic if the expiration dates on vaccines got extended, which would aid distribution efforts. Every dose counts, even if we cannot stop the virus completely. "The donations from the upper-income economies are very important to help countries mitigate another wave of the pandemic."
The key, she explained, is to maximize the limited supply available by ensuring that proper planning is in place to ensure nothing goes to waste.
Regarding whether the infrastructure is in place to ensure effective vaccine distribution, Chidi-Anene agreed, "... in the cities, yes, they have adequate infrastructure," she said, "but when you go into the interior and rural communities, there's little or no infrastructure, especially for cold chain equipment."
Ritchmann countered that low-income countries have previously responded well to public health emergencies. "Planning, collaboration, and communication need to be heavily focused on to overcome those potential shortfalls of infrastructure," she urged.
COVAX is working to improve its resources for low-income countries to fill those gaps. In some cases, Castro said that governments have also successfully worked with third parties to coordinate and execute vaccine distribution. Ultimately, she said, everyone needs to learn from past mistakes and adapt for the future, "we are all learning."
Planning is crucial, said Escotero of World Courier. This includes time and temperature requirements, security measures, quality management, storage solutions, ideal travel routes, and contingency plans.
Last minute shipments across Africa
As of December 2021, Africa is the least vaccinated continent. In many African countries, the share of the population who have received at least one coronavirus shot is below 10%. And while wealthier countries have ordered a steady supply of vaccine doses directly from manufacturers, the availability of vaccines for lower-income countries can be unpredictable, making planning more difficult.
Earlier this year, the South African government decided not to use one million doses, as they were concerned that the vaccine was not effective against a strain of the virus. World Courier was tasked with redistributing the doses to 14 African countries. Time was of the essence, as they were due to expire in just six weeks, so quick thinking, planning, and distribution were necessary.
Are you ready for the "Last Mile"?