2/27/2021 COVID-19: The logistic challenges of vaccine distribution in India

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COVID-19: The logistic challenges of vaccine distribution in India

Experts noted that nothing on the scale of vaccination planned for COVID-19 has been attempted in
India before

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V Venkateswara Rao
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Published: 26 Oct 2020, 9:00 PM

"The challenges would be both in the logistics of the supply chain and in the health workforce
needed to administer the vaccine and monitor the adverse effects. The former may be more easy to
solve. Organising the administration of the vaccine to the huge (1.35 billion) population will call for
a large health workforce," says Professor K. Srinath Reddy, president of the Public Health Foundation
of India. "It will be especially demanding if it is a two-dose vaccine," he added. Experts noted that
nothing on the scale of vaccination planned for COVID-19 has been attempted in India before.

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"I feel the biggest challenge would be cold chain (management), depending upon what vaccine is to
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be deployed," leading epidemiologist Shahid Jameel told The Straits Times. "There would be limited
capacity2. in FLU
India to store,INFORMATION
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minus 20 deg |CBusiness
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2/27/2021 COVID-19: The logistic challenges of vaccine distribution in India
and transport in liquid form (that is, between 4 deg C and 10 deg C) and not the ones that have to be
kept frozen," he added.

"We have never had the need to vaccinate our entire population at one go. The national
immunisation programmes of countries generally take care of paediatric vaccinations” said an
of cial at a consulting organization.

With nearly 250 COVID-19 vaccines under development across seven different technology platforms,
with the WHO reporting 42 candidates in clinical trials, it will be a big logistical challenge to
transport over 10 billion doses globally, a white paper brought out by logistics specialist DHL (with
McKinsey & Company as analytics partner), has said.

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Container ships are the most common and ef cient way of transporting goods between continents,
but the requirements of vaccines are simply impossible to maintain in that environment. The
fallback is expensive air transport. To provide global coverage of COVID-19 vaccines, up to 2,00,000
pallet shipments and 15 million deliveries in cooling boxes as well as 15,000 ights will be required
across various supply chain set-ups in the next two years. Potential bottlenecks along the key supply
chain can happen in intermediate transport, intercontinental shipment, warehousing, downstream
distribution and nal short-term storage at the point of use.

Building a partnership network of both public-private and public-public partnerships, identifying

and ensuring access to required physical logistics infrastructure, establishing IT-enabled supply
chain transparency and creating organisational structures and allocating resources to
institutionalise and coordinate the entire response management including plan, partners,
infrastructure and IT are solutions to overcome the challenges is required, said the white paper.

A number of the leading COVID-19 vaccines under development will need to be kept at temperatures
as low as minus 80 degrees Celsius (minus 112 degrees Fahrenheit) from the moment they are
bottled to the time they are ready to be injected into patients’ arms. That will not be easy. Vaccines
may be manufactured on one continent and shipped to another. They will go from logistics hub to
logistics hub before ending up at the hospitals and other facilities that will administer them. Large
parts of Africa, South America and Asia, where super-cold freezers are sparse, could be left out.

“We’re only now beginning to understand the complexities of the delivery side of all of this,” said J.
Stephen Morrison, senior vice president at the Center for Strategic and International Studies, a
research rm in USA.

In a presentation to the White House coronavirus task force last month, Kathleen Dooling, a disease
expert with the C.D.C., said strict temperature requirements “will make it very dif cult for
community clinics and local pharmacies to store and administer.”

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Pharmaceutical company P zer has designed a special box to transport its hoped-for vaccine. The
boxes, roughly the size of a large cooler, will hold a couple of hundred glass vials, each containing 10
to 20 doses of vaccine. This leads to another problem - glass often cracks in extreme cold.

Planes, trucks, warehouses and health centers will need to be out tted with freezers. Gavi estimates
10 per cent of health care facilities in poor countries have reliable electricity supplies. In such
countries less than 5 percent of health centers have vaccine-quali ed refrigerators.

The funding requirement for distribution of free vaccine to all Indians will be huge. Serum Institute
of India Chief Executive Of cer Adar Poonawalla asked the government whether it had Rs 80,000
crore required over the next one year for distribution of COVID-19 vaccine.

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(V Venkateswara Rao is an alumnus of IIM, Ahmedabad and a retired corporate professional)

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