Supply chain & logistics
All topics related to immunization supply chain and logistics, including vaccine forecasting and supply planning, distribution systems, vaccine management, vaccine wastage, and waste management.
Posts
With the possible exception of disposal, transport is the most neglected aspect of the vaccine supply chain in spite of its reputation for accidental freezing of vaccines, unreliable availability and high operational costs. So, I hope you will join us in discussing work in progress:
At the vacc...
A new policy paper on the vaccine supply chain, "System Design: Repair or Replace," has recently been released. It's attached and can also be found here: http://villagereach.org/vrsite/wp-content/uploads/2009/08/villagereach-system-design_repair-or-replace.pdf. This paper considers the broader conce...
In case the TechNet community is interested.
Global vaccine supply. The increasing role of manufacturers from middle income countries
[color=#00bb44]DP Francis, YP Du, AR Precioso - Vaccine, 2014[/color]
A design methodology for the economic design of vaccine warehouses in the developing worl...
Dear TechNet Community
Since the endorsement of the decade-long Global Vaccine Action Plan (GVAP) by the World Health Assembly (WHA) in 2012, the WHO Secretariat is mandated to produce and disseminate each year an annual report that analyses progress towards achieving the various GVAP goals and ...
Time to rethink cold rooms.
Inspired by johns rethinking.
A lot has happened since the first vaccine cold rooms were installed.
There is much better access to refrigeration technicians. Butchers and many others are using cold rooms, if something goes wrong it is being repaired.
There is some kin...
A couple of months ago, Médecins Sans Frontières (MSF) produced a package of materials in support of their call for wider use of existing vaccines in the “controlled temperature chain” or CTC.
An issue brief, Vaccinating Children Beyond the Cold Chain, is available in English and French. It is a...
I want to bring your attention to a new supply chain management resource: the Promising Practices in Supply Chain Management series. The series was commissioned by the Supply and Awareness Technical Reference Team (TRT) of the United Nations Commission on Life-Saving Commodities for Women’s and Chil...
New EVM Assessment
I am writing to the group in hopes to receive some insight into EVM Assessments. Are countries require to post their results online? Is there are repository of this results somewhere?
Thank you for your help,
--
Sincerely,
Tatiana Viecco
University of Cambridge Student
Sidney Sussex Col...
Icelined refrigerators have become a dominant standard worldwide for the safe storage of vaccine in areas of unreliable electricity supplies. In the 35 years since the start of the Product Information Sheets not a single upright, domestic compression refrigerator has been posted in the pre-qualified...
Cross-posted from the IAPHL forum with thanks!
We are pleased to announce that the IAPHL website now provides you with access to a FREE online course, called Lessons in Logistics Management for Health Commodities. This is a self-directed learning course that you can take at your own pace, and all...
by Raja Rao, Bill & Melinda Gates Foundation
The Bill & Melinda Gates Foundation recently conducted a landscape analysis of the market for cold chain equipment, in particular vaccine refrigerators and freezers. The analysis was based on extensive interviews with cold chain equipment exper...
WHO is developing a new Vaccine Management Handbook module on cold chain equipment maintenance. We are looking for examples of successful maintenance initiatives covering either (or both) fixed cold chain equipment and transport (refrigerated and non-refrigerated). Examples and/or opinions are welco...
This note has been cross-posted from the GAVI CSO forum with many thanks!
Dear colleagues,
This week on occasion of the World Immunization Week, Médecins Sans Frontières/Doctors Without Borders (MSF) has released a call for greater attention to the need for heat-stable vaccines to facilitate acc...
A recently concluded two-week discussion on the IAPHL Forum addressed the challenges or solutions for managing vehicles for distribution of health commodities in rural areas.
In week one, moderator Matthew Hann from Riders for Health summarized the discussion: "almost everyone mentioned that...
The new WHO EVM Assessment Tool (version 1.0.9) is available for download from the EVM restricted access website: https://extranet.who.int/evm .
To install the tool:
• Login to the restricted access website
• Click Get EVM Tools
• Download the Assessment Tool Installer (version 1.0.9)
• Unzi...
Today in the PG Activity, PGs questioned me about 'Thermal assault' for which I could not get adequate references. As of now we need to keep the reconstituting diluent in the cold chain at least a day earlier to vaccination day so that it will not give a thermal assault to the lyophilized vaccine a...
Dear all,
I hope this is a place where I can ask a question in the forum.
WHO PQS-qualified refrigerators used frequently at the health facility level (E003) have a holding capacity measured by a particular WHO testing process. However, most fridges also have certain limitations on that holdi...
Oxytocin is a lifesaving drug - it is one of the 13 commodities on the list of the United Nations Commission on Life-Saving Commodities for Women and Children. - See more at:
http://everywomaneverychild.org/component/content/article/1-about/409-un-commission-sets-out-plan-to-make-life-saving-health...
Cross-posted from the IAPHL forum with thanks!
The post summarizes the discussion over three weeks.
Week 1: Introduction to Supply Chain Design
? Supply Chain Design is about achieving objectives (Reliability, Responsiveness, Agility, Cost, Assets) by configuring infrastructure and process...
Immunization supply chains are regularly reviewed and plans made to improve them. All of the GAVI eligible countries carry our regular and comprehensive EVM reviews which help ministries focus their attention on the parts that most need help.
Supply chains for drugs are not so fortunate; assessm...
We think of fridge holdover time (autonomy) in the context of power shortage, whether cloudy weather in the case of solar, or power cuts for A/C systems. While this will see functioning equipment through power shortages and keep vaccine 'safe' for a given duration (a parameter which varies immensel...
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Preventing vaccine freezing during transportation in Immunization Programs throughout the world remains the challenging task. Will reinventing the icepack (wheel) make a difference?
Modified frozen Icepacks compared with conventional (not modified) frozen ice...
by Tina Lorenson, PATH, and Joanie Robertson, GAVI Alliance
Newer vaccines often require more cold chain space and more reliable cooling equipment than traditional ones. For many national immunization programs, these requirements present a serious challenge. Aware of the problem, for the last fiv...
by Patrick Lydon, WHO, and Prashant Yadav, University of Michigan
Project Optimize has recently published a document that examines the benefits, challenges, and rationale for integrating vaccine supply chains with the supply chains of other health commodities. It provides agencies, donors, decisi...
by Michel Zaffran, WHO
In December 2007, a team of talented individuals from PATH and the World Health Organization (WHO) came together to form project Optimize, a five-year collaboration to identify ways in which supply chains can be optimized to meet the demands of an increasingly large and cos...
Ice lining of Ice Lined Refrigerator has many functions other than maintaining cold holdover time. The attachment with photos may substantiate. This I wish to share with the viewers for additional inputs.
Ice-lining.docx...
The need to keep vaccines in a 2°C to 8°C cold chain is a constraining factor for many immunization campaigns due to limited storage capacity and/or limited ice pack freezing capacity; supplementary immunization activities planned across sub-Saharan Africa to introduce MenAfriVac™ are a good example...
This summary is being cross-posted from the IAPHL discussion forum with many thanks!
The International Association of Public Health Logisticians has recently been engaged in an interesting discussion about demand forecasting. Here are a few highlights from the email exchange. This includes dema...
The popular Temperature Stability of Vaccines slides that were originally produced by Dr. Julie Milstien for the TechNet21 2006 consultation have been further updated. The authors have made some graphic changes based on feedback received from field trainings.
You can access the document here: Te...
The USAID | DELIVER PROJECT has just published Alternative Public Health Supply Chains: Reconsidering the Role of the Central Medical Store (report) and Getting Products to People Without a Traditional Central Medical Store (policy brief). This report and policy brief identify a set of approaches th...
Cross-posted from http://deliver.jsi.com/ with thanks!
Risk management for public health supply chains focuses on how to organize the logistics activities of the supply chain in order to ensure that commodities needed for health programs are continuously available, without disruption. The USAID |...
Thank you Dr Robert Steinglass for directing our attention here. This contribution has been cross-posted from the International Association of Public Health Logisticians (IAPHL) with thanks. Those of you interested in subscribing to the discussions on this forum, please click here: http://knowledge-...
The data given for solar-powered refrigerators in the PQS sheets is not given consistently enough so that comparisons of various models can be made.
The data needed for a fair comparison most often is energy consumption at 32 deg C without ice making, energy use with ice making and quantity of ic...
Joanie Robertson Senior Manager, Vaccine Supply Chain, GAVI Alliance wants your views on vaccine investment strategies and the vaccine supply chain. The GAVI Alliance is currently developing two strategies, and your views are important for both. The Vaccine Investment Strategy and the Supply Chain...
What range of humidity is permitted in a refrigerator to ensure vaccine safety?...
Often we are not so familiar with the objects which we use very frequently. Knowing a little more helps in working with more confidence and perfection. Cleanliness is usually taken for granted. Revitted strap which keeps the lid entangled may be cumbersome to operate but it does an important functio...
While monitoring Routine Immunization sessions, finding fully melted relatively warm ice-packs but Vaccine Vial Monitor(VVM) in usable condition is common, but finding frozen ‘T’ series vaccines with unconditioned ice-packs in the field is also common. VVM being heat sensitive cannot measure freeze ...
Sun Frost is considering building a cart-mounted vaccine storage refrigerator. It would incorporate mountain-bike type wheels so that it could be moved over rough terrain. The refrigerator would have a net storage volume of about 40 litres. It would be a side-opening one and similar to the refrigera...
by Beth Balderston, PATH and Heidi Lasher, consultant
To accompany the article “Traveling exhibit highlights supply system innovations” in the May 2013
Op.ti.mize newsletter, project Optimize has published a photo set on Flickr of its traveling exhibit at the TechNet Consultation in Dakar, Sene...
by Bjorn Melgaard, Judy Roberts, Prashant Yadav, Anup Akkihal, Robert Steinglass, and Gisele Corrêa Miranda, Optimize Project Advisory Group members
Following the 2013 TechNet Consultation in Dakar, Senegal, members of the Optimize Project Advisory Group (PAG) met for the last time to discuss pro...
With the launch of a new Decade of Vaccines (DoV) as outlined in the Global Vaccine Action Plan (GVAP) endorsed by the World Health Assembly in 2012, the world will be embarking on ambitious strategies to introduce the next generation of new vaccines and raise vaccination coverage to desired levels,...
In 2009, key staff at Tanzania’s Ministry of Health and Social Welfare (MOHSW) and Medical Stores Department (MSD) declared the council health management team (CHMT) of the Iramba district to be one of the poorest performing teams in the country in the stock management of medicines and supplies. Tod...
Nigeria’s Federal Ministry of Health (FMOH) and partners have worked hard to combat maternal, newborn, and child health (MNCH) illnesses, but the burden of these conditions in Nigeria remains high. Last summer, as part of several strategic interventions to increase MNCH services for the most vulne...
The USAID | DELIVER PROJECT has published three new documents that can help health supply chain programme managers understand and track key performance indicators for the procurement process.The Procurement Performance Indicators Guide—Using Procurement Performance Indicators to Strengthen the Procu...
Sun Frost has been building vaccine storage refrigerators for the past 20 years. Sun Frost is now building a direct-drive ice pack freezer. Some new technologies incorporated into the design allows the freezer to run even at very low light levels. On a cloudy day if the output of the PV array is les...
Health supply chains in developing nations may benefit from new models of performance improvement that link rewards with results. By looking at examples of performance-based financing (PBF) in the commercial sector, the USAID | DELIVER PROJECT has outlined four of the essential components for creati...
by Dan Brigden, PATH
In November 2012, the first immunization campaign to use a controlled temperature chain (CTC) took place in Banikoara in northern Benin. This photo set contains photographs taken during the campaign, where over 155,000 people were vaccinated using the CTC approach.
Access ...
by Simona Zipursky, PATH; Mamoudou Harouna Djingarey, WHO/AFRO; Olivier Ronveaux, WHO/AFRO; Sylvestre Tiendrebeogo, Consultant
In November 2012, the first immunization campaign to use a controlled temperature chain (CTC) took
place in Banikoara in northern Benin. MenAfriVac is a meningitis A vac...
Four new technical briefs from the USAID | DELIVER PROJECT offer guidance on important ways to strengthen malaria supply chains in developing countries. From techniques for stakeholder collaboration to identifying potential causes of commodity leakage, these publications address critical aspects of ...
Hi,
I would greatly appreciate your expert opinion on a technical question regarding extensive field monitoring of solar generator. The objective is to carry out a long-term, rather in-depth field monitoring of solar (DD) fridge installations for their long-term performance evaluation and programma...
Dear colleagues,
With the GAVI Partners' Forum and Africa Regional Conference on Immunization taking place in Dar Es Salaam in the coming two weeks, and with the recent endorsement of the Global Vaccine Action Plan, immunization is receiving a great deal of attention. Over the past three years, t...
Cold chain handlers, medical officers and district immunization officers often face problems in calculating the cold space required for storing vaccines at the planning unit level. Hence, the volume of each carton is measured and arranged as per the existing guidelines to simplify the theoretical pr...
An interview with Lisa Ganley-Leal and Pauline Mwinzi, Epsilon Therapeutics
Earlier this year, Lisa Ganley-Leal and Pauline Mwinzi were awarded $100,000 by the Bill & Melinda Gates Foundation through its Grand Challenges Explorations initiative. They hope to demonstrate that selling vaccines ...
by Hamadou Modibo Dicko, Philippe Jaillard, and Benjamin Schreiber, AMP; Bruce Y. Lee, University of Pittsburgh; and Heidi Lasher, consultant to project Optimize
To improve immunization program performance, the Government of Benin is using cutting-edge modeling tools to better understand how chan...
Success has many fathers, failure is an orphan. Yet, we can learn so much more from failure than successes. The amazing safety of modern flight is a result of this systems-based analysis of failures. In contrast, medical safety continues poorly with a culture of 'blame' focusing on individuals rat...
Many thanks to Mojtaba Haghgou for sharing this article with the forum. Vaccine cold chain functional inventory and gap analysis: Looking at all existing cold chain equipment at one go Ministry of Health and Medical Education, Iran, July 2011 By Dr. Mohsen Zahraei, EPI Manager and Mr. G. Zamani, V...
Cool Containers has developed and introduced the PharmaPort 360 container for 5C transport of vaccines and bio-pharmaceuticals. Recently UPS delivered $9 Million worth of Flu Vaccine to Laos, it was a tricky 9000 mile delivery:
http://youtu.be/p5V6f-KRWiE
Cool Containers is very interested in wo...
by Dr. Thierno Seydou Nourou Guèye, Pharmacie Régionale d’Approvisionnement de Saint-Louis; Madjiguène Ndiaye Coulibaly, SNEIPS*; Ibrahima Leye, consultant
A project in Senegal that uses a specially equipped truck to transport vaccine supplies has proven so successful that it is now being expande...
New IATA regulation
Dear all
IATA regulation changes for Time & Temperature Sensitive Pharmaceutical shipments, with regard to the logging devices, additional text is proposed in the IATA regulations for Chapter 17 of the Perishables
http://www.iata.org/whatwedo/cargo/Pages/perishables.aspx
Temperature Logging...
The “Autonomy Tool” is a method of sizing solar power systems. It was developed several years ago. I recently reread the instructions describing the application of this sizing technique. From my interpretation of the instructions the “Autonomy Tool” can be used to size battery powered systems or dir...
by Joanie Robertson, PATH, and Steve McCarney, Solar Electric Light Fund
Field-tests conducted in the cloudy north of Vietnam suggest there may be a bright future for battery-free solar refrigerators in low-light conditions.
As reported in the Op.ti.mize October 2011 issue, project Optimize ...
by Hai Le and Kien Vu, PATH
To accompany the article “Do battery-free solar refrigerators work in low-light conditions?” in this month’s newsletter, Optimize has published a photo set on Flickr that reveals how the solar refrigerators were installed and tested.
The photo set includes photogr...
by Kristina Lorenson, PATH
Regional distribution centers (RDCs) may be a realistic option for countries that distribute large quantities of vaccines and need to invest in cold chain infrastructure, according to a report by project Optimize. The report, completed this month, assesses the cost of ...
Cross-posted from the January 2012 [i]Global Immunization News issue. Many thanks. [/i]
31/01/2012 from UNICEF Central and Eastern Europe and the Commonwealth of Independent States (CEECIS)
The suggestion that I post this news came from Mojtaba Haghgou--the VSSM expert.
Following the decision...
While immunization partners involved in supporting vaccine supply chain (WHO, UNICEF’s CCL and Project Optimize ...) are collaborating and building on each others’ experiences, there are several pertinent questions to the field yet to be addressed:
1. Questions related to standby generators:
Alt...
In North Africa, temperatures can range from 43 deg C in summer to near freezing during the winter. Is this a hot, temperate or moderate zone? Perhaps it would be most beneficial for the purchaser to know at what temperature range the refrigerators will provide proper storage conditions. For example...
With many thanks to John Lloyd for this post.
Countries that currently use absorption refrigeration (gas, electric or kerosene-powered) are facing increasing pressure to switch to solar photovoltaic-powered refrigeration for vaccine as manufacture of absorption equipment shrinks. We have a substa...
by Kien Vu and Hai Le, PATH
In many developing countries, vaccine storage in refrigerators is very costly for immunization programs. For years, solar refrigeration has helped those countries increase cold chain capacity and decrease energy costs and consumption. However, problems with battery mai...
Courtesy: Carin Hall (http://www.energydigital.com)
Inspired by the global need for the storage of vaccines, Adam Grosser describes a project in progress to supply inexpensive refrigeration that doesn't require electricity, propane, gas, kerosene or consumables. Using an historical concept of int...
by Patrick Lydon, World Health Organization; Chutima Suraratdecha, PATH; Michelle Arnot, Western Cape Department of Health; Ticky Raubenheimer, Collaborative Centre for Cold Chain Management; Arthorn Riewpaiboon, Mahidol University; and Cha-oncin Sooksriwong, Mahidol University
In recent years, ...
by Juanita Folmsbee, SCMS and Hai Le, PATH
While project Optimize seeks innovative supply chain solutions for vaccines, it often finds those solutions already being implemented in other supply chain systems. In this article, we explore a success story from the Supply Chain Management System (SCM...
Written by: Madjiguène Ndiaye, SNEIPS; Ibrahima Leye, Consultant; and Mariama Gueye, PATH On October 27, 2010, the Government of Senegal officially launched a new project to demonstrate the impact of various changes and upgrades to the vaccine supply chain including the use of mobile warehouses to...
New Vaccine Wastage
Till now, many countries were using relatively cheap vaccines for their EPI program and therefore the issue of vaccine wastage was not given much importance as the focus was on reaching maximum number of beneficiaries. But now given the fact that many countries have now introduced or are in the proc...
Hi all!
I'm looking into what health workers/users and health programs like to see in a vaccine carrier and/or what specifications they wish vaccine carriers had. In particular, what are you looking for in a vaccine carrier that is used for outreach activities to remote or hard-to-reach areas f...
Cool Containers, a new company based in Marietta, OH has developed an innovative, active shipping container called the PharmaPort 360. This first product has been designed for pallet-sized shipments of vaccines and other temperature sensitive products by ground and is FAA approved for air transport...
Hi all! Though I've looked around TechNet before and found some very insightful info, this is my first time to post!
I'm a student intern at an organization that seeks to better understand the problems of the cold chain and reasons for vaccine wastage. With immunization programs in developing c...
PATH is investigating the potential of low-cost, post-market modifications to improve the performance of domestic refrigerators for vaccine storage, as an intermediate step to procurement of a WHO PQS pre-qualified vaccine refrigerator.
We would like to learn more about the use of domestic vacci...
PQS Data
I was recently trying to compare PQS data for direct drive refrigerators. Data for two parameters of prime importance are not always given:
- Solar radiation reference period
- Power consumption: Stable Running
Data is also usually given for 43 deg C and sometimes for 32 deg C. D...
Recently, I have seen a number of relatively large RFQ’s for direct drive refrigerators. These refrigerators do not have an ice pack freezer. From past feed back from our customers and WHO we have heard that ice packs are necessary to distribute vaccines to more remote areas. We are concerned that t...
New Cold Revolution
All vaccines are to be kept between 2 to 8 degree C both in Public and Private sector. I feel there is a need for 'COLD REVOLUTION' to immunize the vaccinated.
Cold-revolutionP1.pdf
Cold-revolutionP2.pdf...
Looking at the product sheets for carriers and cold boxes, I can see their vaccine storage capacity of 1 L, 2L, etc. But how does that translate into the number of vials that carriers and cold boxes typically hold?
Many thanks in advance to your feedback!...
This questionnaire comes from Andrew Garnett. Please do respond.
WHO and PATH are developing specifications for a new generation of large capacity cold boxes. We believe that these will improve the efficiency and security of vaccine deliveries at the national and provincial levels, helping countr...
Health Centers are provided with Ice Lined Refrigerators for keeping the vaccines of one mothh requirement. ILR has 3 baskets, one in the bottom 'A' zone with lower end temperature and 2 upper baskets in zone 'B' at higher end of critically set temperature of 2 to 8 degree centigrade. Since the heat...
New 'VACCINE SAFE'
Sharing the photos of 'VACCINE SAFE' a fridge for keeping vaccines which is locally designed for the private sector are attached. It has one zone maintaining 2 to 8 degree C temperature....
Currently Abhay Clinics are providing vaccine refrigerators to private practitioners in their network. Government agencies use the old Bluestar or VestFrost ILRs at the block and district levels and Walk In Coolers above this. Voltas does not seem to make ILRs. The new Haier ILRs appear to be of a d...
WHO recommends that "Every refrigerator storing vaccines should have a freeze indicator" [Immunization in Practice, Module 3: The cold chain, 2004 update]. This is because the risk of freezing may be a more important danger to vaccines than heat, especially with Vaccine Vial Monitors (VVM...
I'm looking for any studies or documents comparing the implementation operational considerations for refrigerators by energy type. For example, we often hear that solar refrigerators are hard to maintain, petrol are difficult to keep a consistent temperature, etc. I'm looking for a documented source...
by Steve McCarney and Joanie Robertson, PATH
Many health facilities in remote areas operate without grid electricity, have unreliable electricity, or find that using electricity is too costly. In these settings, solar energy is a promising solution for powering the storage and transportation need...
The current issue of the alumni magazine from the Stanford Graduate School of Business (http://www.gsb.stanford.edu/news/bmag/) has a feature on supply chain management. There are many links to explore:
A Global Supply Chain Forum (http://gsb.stanford.edu/scforum/) An article on the supply chain 'Bu...
Are dairy chains and routine vaccine chains complementary? In Karnataka (South India) milk unions pick-up milk from even remote villages with amazing regularity/predictability (without special technology to speak of). Vehicles with "chillers" travel empty, and return with milk to the semi-urban proc...
by Yves Chartier, WHO, and Olga Popova, Crucell
Worldwide immunization programs have had an enormously positive impact on health and health care since 1974 when the World Health Assembly launched the Expanded Programme on Immunization. However, like all great achievements the effort has unveiled ...
by Steve McCarney, John Lloyd, and Joanie Robertson, PATH A group of public- and private-sector partners are collaborating with project Optimize to evaluate a range of innovative transportation and storage containers for heat-sensitive drugs and vaccines that operate in environments with or without...
I recently was looking at specifications for solar powered vaccine refrigerators in the PIS and PQS specifications. I was trying to do a comparison of the various models and found it difficult.
For each model the data given is for different test conditions. For example, energy use data for True E...
In solar powered vaccine storage systems high quality wet cell batteries have the potential of lasting longer than sealed batteries. However, they periodically need the addition of distilled water. Distilled water can be hard to obtain in remote areas. Sun Frost has developed a method using waste h...
New Vaccine Wastage
Does anyone have any idea where I could possibly find information about the number of vaccines wasted due to problems with things like freezing?
Thanks....
Compressor Replacement Without a Vacuum Pump Replacement of a compressor requires the use of a vacuum pump. Solar powered vaccine refrigerators are generally located away from the utility grid. Most vacuum pumps are powered by AC grid power making compressor replacement difficult. We have develo...
New User's manuals
User manuals always disappear.
I would suggest that manufactures are requested to stick the manuals on the lid/door.
Naturally the stickers must be of good quality, like the do's & don'ts on the VESTFROST ILRs
merry christmas
soren spanner...
In my humble opinion Michel and Robert have asked a useful question. Very often polio or other campaigns displace Measles and Bcg in subdistrict stores. The unwritten convention is to move them to the freezer. Especially since the vials are not as breakable as the old ampoules used earlier Usually f...
by Olivier Ronveaux, WHO, and Mojtaba Haghgou, Vaccine Management Consultant
Maintaining required temperatures in vaccine refrigerators and freezers is one of the more thankless tasks of a cold chain manager as it requires painstaking manual recording of the temperature of each piece of equipment...
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