October 2014, Throughout the month of October, the IAPHL community engaged in a moderated discussion entitled “Improving Immunization Supply Chains.” The moderator was Daniel Thornton, director of strategic initiatives at GAVI. He discussed the new global immunization supply chain strategy that GAVI has developed in conjunction with WHO, UNICEF, and the Bill & Melinda Gates Foundation, and asked IAPHL members to talk about their experiences with immunization supply chains in developing countries. Assistant moderators for this discussion were Jan Grevendonk from the WHO (data for management), Musonda Kasonde from UNICEF (people and practices i.e., human resources for supply chain) and Joanie Robertson from GAVI (cold chain equipment).
Selected comments from IAPHL participants:
“GAVI could look at possibilities like how to contract and monitor the physical storage and distribution of vaccines, letting private enterprise and capital make the investments needed in physical infrastructure (which they partly already have) and let them make the products physically available. And how to contract out monitoring of vaccines programs.” — Per Kronslev (Denmark)
“I am a firm believer in supply chain integration as opposed to program led vertical interventions. With the limited resources in developing countries, leveraging of finances becomes of paramount importance in enhancing supply chain activities. It does not make sense to duplicate efforts i.e two delivery vehicles appearing at the same health facility, one with vaccines supported by the EPI program and the other one with pharmaceutical, medical supplies and lab reagents or with tetanus and anti rabies vaccines purchased by the host government.” –Lameck Kachali (Zambia)
“I would like to emphasize the importance of the professionalization of supply chain managers and having a dedicated person responsible for the vaccine supply chain. Again, this is an important component of the Gavi strategy; the next step is taking the global conversation to the country level to affect change where it is needed.” –Wendy Prosser (USA)
“Many countries are now using a SC system for Immunization that was designed many decades ago. Most norms were developed during that time, as well; for example, having six-month of supplies for Central level, three-month of supplies for district level, and one-month of supply for SDP. I think that by involving new managers with good leadership skills, every country should redesign its SC system based on country-specific context. For example, large countries (such as the DRC) should consider delivering commodities directly to zonal warehouses that are more than 2 hours away by-flight from the capital city. Some bureaucratic people may argue that verification processes, such as regulatory and inspection, cannot be decentralized. Why not?
Redesign makes a lot of sense considering the larger target population and
greater number and volume of vaccines as compared to the nineties. In
addition, progress made in recent years in terms of transportation
accessibility, technology, and networking need to be factored.” –Ousmane Dia (USA)