3rd Global Meeting on Implementing New and Under-utilized Vaccines, 16-18 June 2009
Workgroup 5. Cold chain and logistics systems for preparedness for the introduction of PCV, Rotavirus, HPV and other new vaccines
Background
Logistics needs are more than just cold chain capacity - they encompass human resources, ongoing operational costs, transportation and distribution, maintenance guidelines, dry storage needs, and many other aspects. Storage and distribution of pentavalent, pneumococcal and rotavirus vaccines are big challenges which needs careful consideration.
UNICEF estimates that the additional costs for expanding cold chain will be between $1 and $20 for an extra 100 cm3 storage per child in the birth cohort, depending on the type of equipment needed. The UNICEF estimate for upgrading at national level has a range whose midpoint is close to the WHO estimate of just under $1 per child to accommodate the additional volume.
These challenges are being largely addressed with ongoing efforts to adapt products and technologies to developing country situations and through the provision of tools that will assist in the management and planning for effective distribution of these vaccines. Building the capacity of logisticians and health care staff must also be emphasized.
Main Topics of Discussion
- Cold chain capacity requirements for new vaccines introduction are significantly greater than countries are used to
- Cold chain and storage capacities at national/sub-national and district/service delivery level vary widely, and need to be accurately estimated
- Tools exist that enable the space required to be plotted against the space available and an accurate estimate of shortfalls to be generated
Recommendations
Five immediate priority action items were agreed upon:
- Develop guidelines to help countries strengthen CCL systems
- Establish a cadre of consultants qualified to provide technical assistance to countries as required
- Implement the Effective Vaccine Management (EVM) Tool to identify needs and demonstrate CCL readiness to add new vaccines
- Ensure appropriate equipment and technologies are available and used
- Identify funding and mobilize resources needed for CCL
Participants also identified areas of work that are essential to start now, but are more comprehensive in nature and will take longer to complete. The top four long term action items are:
- Strengthen human resource capacity: value and professionalize the logistics role by national governments
- Explore innovative options for supply chain efficiency gains from integration and using best practices from other sectors
- Establish ongoing monitoring and evaluation of national CCL performance
- Modelling of future scenarios to address uncertain future needs