Vaccine Alliance partners launch their supply chain strategy, with four new initiatives to help countries put the fundamentals in place for improved immunisation supply chains.
Health workers travel often by any means possible to reach and immunise rural communities.
Credit : GAVI/2013/Evelyn Hockstein
Recent investments in immunisation programmes worldwide have the potential to substantially decrease illness and death associated with an increased number of preventable diseases. However, as immunisation programmes expand to include new vaccines and strive to reach larger populations in more remote areas, programmes are increasingly constrained by poor infrastructure and inefficient immunisation supply chains. Furthermore, with vaccine volume expected to quadruple between 2010 and 2020, the need for meaningful, systematic improvements in immunisation supply chain infrastructure and systems is clear.
The 3+1 approach
Developed by WHO, UNICEF, Bill & Melinda Gates Foundation and Gavi, the global immunisation supply chain strategy encompasses an end-to-end perspective from the manufacturer to the health worker. It focuses most intensively on the country level from port-of-entry (or national store for domestic vaccines) to the beneficiaries.
Our ‘3+1’ approach to the supply chain strategy focuses on ‘3’ key elements of immunisation supply chain management, which will enable the successful roll-out of new vaccines and provide more equitable access to hard-to-reach populations. The additional ‘+ 1’ initiative includes an in-depth analysis and redesign of country immunisation supply chains to improve their performance.
The ‘+1’: system redesign
Many in-country immunisation supply chains continue to operate with a network design that was promoted since the early days of Expanded Programme on Immunisation (EPI) over 30 years ago. While this design has contributed to the success of EPI, it has reached its limits. Increasing performance beyond existing levels to support the ambitions for raising coverage and introducing new vaccines is going to be difficult without rethinking the network design for the future.
Initially, four to six countries will be prioritised for support for system redesign either because they have already started a supply chain change process, because they are planning to introduce significant numbers of new vaccines, or because there are particular issues with the current design. With these countries, the Vaccine Alliance partners will provide technical support, focusing on change management to help the countries achieve a successful redesign of their immunisation supply chain system.
In support of these 3+1 initiatives, the Vaccine Alliance partners and other implementing partners are committed to providing on-going direct technical support, developing relevant tools and resources, establishing financial support mechanisms and undertaking policy changes that might be necessary to institute these fundamental changes.
Supply chain managers
The first initiative focuses on supply chain management and establishing or reinforcing the post of immunisation supply chain manager and ensuring that these managers have the appropriate level of expertise, authority and resources to oversee the supply chain within a strengthened overall management system. The Vaccine Alliance will support countries to hire and strengthen supply chain managers by providing focused technical assistance, tools, access to training and other resources.
Supply chain management and improvement plans
The second initiative is designed to help countries develop concrete national supply chain management plans, building upon and expanding the scope of the current Effective Vaccine Management assessments and improvement plans. These comprehensive national supply chain management plans will be integrated into the broader immunisation and health sector plans. The Vaccine Alliance will provide guidance and technical assistance to countries as they develop and implement these plans.
Supply chain dashboards
The third initiative supports countries to develop management dashboards including key supply chain indicators for use at all levels of the supply chain. These dashboards will help managers monitor supply chain performance and implement improvements listed in the comprehensive plans. The Vaccine Alliance will provide guidance and technical assistance on data standards and use. Dashboards will be developed by national partners to ensure each dashboard is relevant and feasible in that particular country.
Benefits to immunisation programmes
In addition to tailored technical support and financial assistance, national immunisation programme leaders and supply chain managers will have access to more effective management tools, increased numbers of trained personnel and better technologies to help them reach their programme goals. The increased focus on supply chains will enable programmes to not only reach more people currently missed by immunisation services, but to reach them with a full set of safe and viable vaccines.