TechNet-21 - Forum

This forum provides a place for members to ask questions, share experiences, coordinate activities, and discuss recent developments in immunization.
  1. Project Last Mile
  2. Cold chain equipment
  3. Wednesday, 24 February 2021

Given the need for an ultra-cold chain (UCC) for an initial leading COVID-19 vaccine candidate, Project Last Mile conducted an analysis on the availability of liquid CO2 (LCO2) within the Coca-Cola value chain in 47 countries in Africa to assist in meeting potential dry ice needs to support ultra-cold chain vaccine distribution. This was then expanded to include COVAX countries in Latin America and the Pacific Islands. Ultimately, Project Last Mile completed a rapid assessment examining the feasibility of procuring LCO2 in 70 countries from Coca-Cola partners and suppliers across the three regions.

The upcoming webinar: Findings on the operational feasibility of maintaining ultra-cold temperatures to distribute COVID-19 vaccines – the availability of dry ice within the Coca-Cola value chain in 70 countries will be held on Thursday, March 11, 2021, at 8:00 am PST (UTC-8 hours). At the following link, you can look up the webinar timing in your local time zone:

This webinar will share the culmination of this study. The aim is to contribute significant insights into determining the operational feasibility of maintaining ultra-cold temperatures to distribute COVID-19 vaccines. The findings can also inform where COVID-19 vaccines requiring ultra-cold chain may not be feasible or will require another LCO2 procurement approach.

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Project Last Mile (PLM) is an innovative public-private partnership launched in 2010 between The Coca-Cola Company, The Coca-Cola Foundation, United States Agency for International Development (USAID), President’s Emergency Plan for AIDS Relief (PEPFAR), The Global Fund, and Bill & Melinda Gates Foundation to draw private-sector lessons from across the Coca-Cola value chain to benefit health systems strengthening in Africa.

The webinar will be led by Jonathan Halse, who undertook the analysis for Project Last Mile. Jonathan currently leads Supply Chain Redesign Projects across multiple countries in Africa with Project Last Mile. Jonathan has worked for many leading FMCG leadership brands, including Coca-Cola, Mars, and Pepsi, where he held numerous leadership positions in operations and was deeply involved in capability building in many diverse markets across Africa, Asia, and the Middle East. The webinar will be opened by Alexandra Scott, Director of Program Delivery for Project Last Mile.

Time will be dedicated to answering questions from national and sub-national focal points.

If you haven’t yet registered for this event, you can do so here:

The session will build upon the findings in:

We look forward to welcoming you on the call. Please feel free to ask follow-up questions by replying to this post.

Project Last Mile Accepted Answer

Thanks, Robert for your note.

The management burden is centered around the capability of health supply chains to manage an ultra-cold chain distribution model using dry ice. PLM has seen in many countries in Africa that there is a relative inability at the health facility level to manage inventories of and perform effective order management of essential medicines, with little understanding of true off-take. This leads to significant out-of-stocks, expires, and waste of essential medicines at health facilities, which is compounded by a lack of data visibility through the supply chain. If this occurs when handling ambient commodities, then supplying the correct quantities of vaccines to minimize wastage on a much higher delivery frequency may prove challenging, whilst the increased complexity of managing inventory movements requiring dry ice to maintain a minimum temperature will pose a significant issue.

The analysis was done on 1% of the population over a 30-day period because when the study was initiated back in November 2020 it was expected that the supply of the vaccines would be severely limited. In addition, the original intention of the feasibility study was to review the dry ice needed for only the initial vaccination of health and frontline workers in each country. The analysis does not refer to the potential rate of vaccination, so it is entirely possible to increase the proportion of the population to match the supply of vaccines as long as the increase in the volume of dry ice required is available to be supplied. PLM has modeled up to 40% of the population vaccinated over a 6-month period, and there is sufficient local dry ice capacity in place in many of the countries across the 3 regions.

The number of vaccination sites was determined by the demand model given to PLM. The demand model used the number of health facilities in-country as a proxy for the number of vaccination sites. PLM used the health facility numbers from this source:

The demand model assumes that the vaccinator teams travel to the vaccination site with sufficient dry ice and vaccine doses for a single day of vaccine administration. Thus the volume of dry ice will not get used up based on the assumptions used in the demand model provided. No analysis was made on the effort required for people to travel to the vaccination sites, as the analysis was a feasibility study of the availability of supply of dry ice and liquid CO2 to support an ultra-cold chain distribution model for COVID vaccines.

  1. more than a month ago
  2. Cold chain equipment
  3. # 1
Robert Steinglass Accepted Answer

Thank you for the interesting presentation and slides.

I think it would be good to hear more details about the management burden, which you highlight on the last slide as being a major challenge. 

Have I understood correctly that the assumption for all your analyses is that just 1% of the population can be reached in a 30-day period – and that means it would take 8 years for the entire population in these 70 countries to be reached exclusively using an ultra-cold chain?

Could you please comment about how you determined the number of vaccination sites per country and the data source used to estimate that?  Also what assumptions are you using about the effort required to get people to come to these vaccination sites within the very narrow window of vaccine usability before the dry ice is used up?

Robert Steinglass

Independent Immunization Advisor

Retired, former Director, JSI Immunization Center

  1. more than a month ago
  2. Cold chain equipment
  3. # 2
Project Last Mile Accepted Answer

Thank you for joining TechNet-21 last Thursday for the Project Last Mile (PLM) webinar on Findings on the operational feasibility of maintaining ultra-cold temperatures to distribute COVID-19 vaccines – the availability of dry ice within the Coca-Cola value chain in 70 countries. Here are some links if you missed it or would like to watch it again or share it:

For more information on Project Last Mile:

  1. more than a month ago
  2. Cold chain equipment
  3. # 3

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