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 changes to the vaccine supply chain impact vaccine availability and cost. If successful, this approach could be replicated in other countries wishing to optimize their supply chain. Like many countries, Benin has seen its immunization coverage stagnate or even decrease in recent years in spite of efforts to improve performance. An external review conducted in 2008 by the Expanded Programme on Immunization (EPI) suggested that supply chain and logistics problems could be inhibiting vaccine availability and access. To address the problem, the government sought support from the LOGIVAC project, a joint effort of Agence de Médecine Préventive and the World Health Organization to optimize the vaccine supply chain in Benin. In July 2012, the government and partners worked through the first phase of the optimization process, which involved several assessments and analyses, including a Cold Chain Equipment Manager inventory, Effective Vaccine Management (EVM) assessment, and an analysis of supply chain costs. Considering goals of the EPI, including planned introduction of new vaccines, the government then discussed and selected several different optimization scenarios they wished to model. Between July and September, the HERMES team at the University of Pittsburgh and Pittsburgh Supercomputing Center, funded via the Vaccine Modeling Initiative, populated its HERMES (Highly Extensible Resource for Modeling Supply Chains) software with data from Benin to generate a simulation model of the entire Benin supply chain, including virtual representations of each storage location, refrigerator, freezer, vehicle, personnel, route, vaccine vial, and vaccine product. Once populated, the model serves as a virtual laboratory with millions of different vaccine doses flowing through the model simultaneously to simulate how the supply chain would perform in each scenario. In September, partners gathered again in Benin to review the results of the HERMES simulation model and determine which scenarios result in higher vaccine availability and increased access to vulnerable populations. A parallel costing effort by Optimize, working in collaboration with the HERMES team, provided cost comparisons for each scenario compared to the baseline system that currently exists in Benin. Following the September workshop, the government of Benin will have an opportunity to evaluate EVM results and the feasibility of different optimization scenarios modeled by HERMES. From there, the government can develop a detailed optimization plan and implementation roadmap. The supply chain optimization approach used in Benin is noteworthy because it is systematic and potentially replicable in any country wishing to embark on supply chain optimization efforts. Over the next several years, nearly all developing countries introducing new vaccines into their EPI systems will be assessing the performance of their vaccine supply and logistics system and determining how to address deficiencies. By applying a similar model of assessment and by making use of modeling tools like the HERMES software and PATH’s costing methodology, countries can more easily determine which scenarios might make the most sense in their country. We encourage your questions or comments. Please click reply at the bottom of the page.