Five ‘fundamentals’ for stronger supply chains: supporting countries to improve immunisation delivery systems.
Delivering vaccines to a remote village in Kenya.
Credit : Gavi/2013/Evelyn Hockstein
As immunisation programmes expand to include new vaccines and strive to reach more people, they are increasingly constrained by outdated supply chains.
As vaccine volumes are expected to quadruple between 2010 and 2020, there is an urgent need for improvements in immunisation supply chain infrastructure and systems.
Gavi’s immunisation supply chain strategy
Developed by WHO, UNICEF, Bill & Melinda Gates Foundation and Gavi, the immunisation supply chain strategy provides an end-to-end perspective of the supply chain. It focuses particularly on the country level, from the arrival of vaccine doses at the port of entry or the national storage facility to immunisation sessions at the health clinic.
Every year, Gavi buys vaccines for more than US$ 1 billion. In 2015 alone, this catalysed more than US$ 130 million in additional co-financed vaccines paid for by developing countries themselves. Supply chain improvements are critical to ensuring that all these vaccines stay safe and effective, and that they reach the children who need them.
Stronger supply chains do not only help to reduce under-five mortality and improve overall health in countries; they also contribute to the Vaccine Alliance’s goal to increase immunisation coverage and make it more equitable.
The five fundamentals
At the core of the strategy are five fundamentals essential to strengthening immunisation supply chains:
1. Supply chain leadership
Next-generation immunisation supply chains require dedicated and competent managers as well as adequate numbers of skilled, accountable, motivated and empowered personnel at all levels of the health system. The Vaccine Alliance helps countries strengthen and build supply chain managers’ capacity by providing focused technical assistance, tools, training and other resources.
2. Continuous improvement & planning
Supply chains are dynamic systems that must be continuously monitored, managed and improved. The new comprehensive Effective Vaccine Management (EVM) approach provides a structure for continuous improvement. Regular comprehensive EVM improvement plans should be implemented as part of comprehensive multi-year immunisation plans and financed through health system strengthening support or other funding. The Vaccine Alliance provides guidance and technical assistance to countries as they engage in this process.
3. Supply chain data for management
Managers need reliable and relevant data to manage key aspects of immunisation supply chains, including vaccine availability, quality of storage and transport facilities, and stock management efficiency. The Vaccine Alliance provides guidance and technical assistance on data standards and use to countries as they develop supply chain dashboards tailored to their needs.
4. Cold chain equipment
Reliable, well-maintained and cost-effective cold chain equipment is vital to ensure that there is adequate, sustainable vaccine storage for current and planned vaccines, maintenance requirements are kept low and running costs are reduced. The Vaccine Alliance provides guidance, technical assistance and financial support to countries to help them better plan for, select, install and manage their cold chain equipment.
5. Supply chain system design
New approaches to supply chain design aim to improve supply chain performance and contribute to increasing immunisation coverage. The Vaccine Alliance provides technical support to countries that are embarking on immunisation supply chain system redesign projects, focusing on change management.
In support of these five fundamentals, the Vaccine Alliance provides ongoing direct technical support, develops relevant tools and resources, collaborates with equipment manufacturers and the private sector, leverages financial support mechanisms, and supports policy changes to help countries improve the performance of their immunisation supply chains.
Benefits to immunisation programmes
Through Gavi’s immunisation supply chain strategy, countries do not only benefit from tailored technical support and financial assistance. National immunisation programme leaders and supply chain managers also have access to more effective management tools, increased numbers of trained personnel and better technologies to help them reach their immunisation goals. The increased focus on and investments in strengthening supply chains make it possible not only to reach more people who currently miss out on immunisation services, but to do so with a full set of safe and viable vaccines.