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Covid-19 vaccine logistics

T

he coronavirus deaths have exceeded 2.5 million worldwide.

The Ministry of Health shows that the coronavirus disease has claimed about 1125 lives from the country’s 33 700 confirmed cases since it was discovered in China in 2019.

The development of Covid-19 vaccines with the efficacy levels of 60 to 95 percent has happened at a record speed.

While this is encouraging news, the whole supply chain has brought to light entirely new technical and logistical challenges of getting the vaccines to where they are required.

Some of logistical challenges with Covid-19 vaccines include cold chain capacity, storage, logistical infrastructure and last-mile delivery.

The biggest challenge will be the cold chain capacity which has limited capacity to transport and store the vaccines which require supercool refrigeration of well below -70 degrees Celcius.

Vaccines require a robust cold chain system to maintain the desired temperature throughout the supply chain— from manufacturing to where they are administered.

While Pfizer’s high-efficacy vaccine needs ultra-cold storage conditions of -70 degree Celsius for up to five days, Moderna can be stored at -20 degree Celsius and can remain effective up to six months.

AstraZeneca, which Malawi has procured, can be stored and handled at normal and standard refrigerated conditions of two to eight degree Celsius for six months.

The vaccine can be stored in ordinary refrigerators and does not require a freezer.

Other challenges will occur in remote areas where electricity is unavailable or unreliable and cold chain infrastructure is inadequate.

If refrigeration fails due a power outage, the vaccines would likely be rendered useless.

Storage facilities will be hampered further by the volumes required as  rural areas are home to over 80 percent of Malawi’s population.

Poor logistics infrastructure will have an impact to achieve the last-mile delivery.

This is complicated by sheer scale of transportation and distribution effort nationwide while prioritising rural health centres.

It will    be difficult to access some rural areas due to impassable roads and bridges. Then there are tricky places like Likoma and Chizumulu islands that can be quickly accessed using air transport.

In short, Malawi does not seem to have proper logistical infrastructure and internal connectivity to facilitate swift transportation and distribution of Covid-19 vaccines.

Governments must allocate enough funds towards procurement of extra cold chain equipment to maintain and improve vaccine storage in health centres, mostly in rural areas.

Extra funds should be set aside for transport, fuel, solar energy, generators and paraffin for refrigerators.

There will also be need to train and employ additional healthcare workers to ensure safe and efficient Covid-19 vaccine administration.

The Malawi Defence Force personnel might use their expertise in logistics for major  operations to transport the vaccine doses by air to places like Likoma District.

Where governments do not possess the financial capacity, infrastructure or expertise to handle the vaccine supply chain themselves, outsourcing components of the supply chain to the private sector might be a viable solution to improve the efficiency.

Outsourcing the supply chain would free resources, healthcare workers and storage space for other primary government care services.

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