TechNet-21 - Forum

This forum provides a place for members to ask questions, share experiences, coordinate activities, and discuss recent developments in immunization.

Discussions tagged Distribution system

Gavi Releases Immunisation Supply Chain Software Standards

The Gavi Secretariat has released a global  standards document for immunisation supply chain (iSC) information systems.  A hallmark of effective supply chains is end-to-end (E2E) visibility of supply and demand data that are used to make decisions and take effective action. For immunisation programmes, a critical success factor is access to accurate, complete and timely data on vaccine utilisation and distribution, the performance and deployment of cold chain equipment (CCE), and the routine use of this data to inform operations and management decisions. Growing demand for digital supply chain software solutions—often referred to as logistics management information systems (LMIS)—from Gavi-eligible countries has stimulated software developers and service providers, remote temperature monitoring device innovators, and refrigerator manufacturers to develop and test a variety of software and hardware products. However, the absence of a normative standard of features required of a LMIS has resulted in costly development of bespoke local solutions, and limited choice of off-the-shelf systems that are interoperable, extensible, and scalable. The purpose of the Target Software Standards for Vaccine Supply Chain Information Systems is to help guide the market of potential LMIS solution providers by defining normative standards for LMIS solutions adapted to the unique needs of immunisation supply chains in low and middle income countries. The objectives of this Target Software Standards (TSS) are to ensure countries have access to: Best-in-Class digital LMIS that meet the unique needs of the iSC and a country’s particular supply chain design and strategy; Choice in software hosting, administration, and value-added business intelligence services; A range of cost models that enable cost-benefit analysis of different solutions and sustainable total cost of ownership. While the TSS is focused on vaccines by incompassing cold chain equipment and temperature monitoring data, the standards can be applied to any other pharmaceutial product that requires an LMIS. Gavi has collaborated with The Global Fund and other development partners to ensure that the TSS supports essential medicines, programme products, and diagnostic supplies in the Global Health supply chain. Countries are encouraged to use the Target Software Standards when determining their LMIS needs and seeking off-the-shelf software, or in guiding upgrades to existing systems. Software suppiers are encouraged to use the TSS to inform their software development roadmap priorities to ensure their product supports the range of features called for in the TSS.  Download a copy of the Target Software Standards for Vaccine Supply Chain Information Systems.

Does your immunization programme use refrigerated vehicles to deliver vaccines?

Good morning, If your immunization programme uses a refrigerated vehicle WHO needs your insights and experience to help guide and improve the standards of these vehicles. Take this opportunity to share your expertise with the community and contribute to global improvements.  Please post your answers to TechNet-21 to three questions below: Excluding routine servicing, has the vehicle needed to be repaired over the past three years? Inside the refrigerated body have you needed to fit new shelving or change the method of securing the vaccine or pharmaceutical load?  Have there been any problems with the in-cab temperature monitoring of the vaccine storage compartment during the past three years? 'A Yes' or 'No' answer to each question will be very helpful but even more useful for WHO would a sentence or two describing in more detail the problem and the solution you have adopted. These three questions are taken from a more comprehensive survey posted on TechNet-21 at: https://www.technet-21.org/en/forums/discussions/refrigerated-vehicles-in-immunization-programmes If you choose to answer more answers in the survey, that would be best of all, of course! Best regards.  James Cheyne - contractor to WHO.

SPOTLIGHT: Partnership with Red Cross in Lebanon for Off-grid solar generator with lithium battery storage backpack

Green Energy Limited has developed an off-grid solar generator with lithium battery storage backpack. It is designed to provide continuous off-grid electricity to refugees, disaster victims, medical clinics, schools and matches domestic electricity requirement. We have been conducting a project in Lebanon since April with the Red Cross, testing the performance of our backpack in various settings.  Attached is our latest off-grid solar backpack with lithium battery storage. To stay connected and update with our Red Cross testing project in Lebanon either contact me directly via email: stephen@greenenergylimited.com or follow us on Twitter https://twitter.com/GreenEnergyCo2  We are also at final stages of developing another off-grid solar backpack, equipped with an internal vaccine refrigerator that will provide continuous refrigeration for vaccines in communities without electricity supply. It will also supply additional electricity for health workers in the field. The vaccine refrigerator will be able to connect to wifi and 4G temperature monitoring and allow remote access to control temperature setting.   

Invitation to the Africa Conference on Healthcare Delivery (AHD Conference) 2018, Abuja, Nigeria, June 25-27

Dear Colleagues, You are cordially invited to the Africa Conference on Healthcare Delivery (AHD Conference) 2018, which is to be held in Abuja, Nigeria, June 25-27. The theme of the conference is: "Social Innovation and Health Supply Chain: Engaging Communities and Health System Actors to Develop Local Solutions for Health Supply Chain Challenges." See attached call for abstracts and conference flyer for details. For additional information regarding the meeting, including registration and abstract submission, kindly visit conference website: www.ahdconference.org Thank you Prof Ehijie Enato Chair, AHD Conference

Off-Grid Portable Vaccine Refrigeration

I am developing an off-grid backpack with an inbuilt removal battery powered (8hrs) portable refrigerator that is approx 1.5 litre in size and can transport 2 blood bags. The off-grid backpack has 48hrs of battery supply to the portable refrigerator, however, it is designed to be recharged daily. Our vision is to provide a waterproof backpack that has in-built refrigeration that can provide additional electricity for lighting and other appliances that maybe be useful in the field and that can also provide continuous electricity supply to vaccines refrigeration. What I am trying to identify is if the 1.5 litre is large enough for daily vaccines missions and what other equipment can be used such as lighting, charging phones and laptops, providing power to smart devices to record data and if, needed, bring back blood samples under refrigeration is a benefit? Also is 4g temperature monitoring and temperature control of the refrigerator a workable solution in most locations? My questions are: 1. What size refrigerator is required for daily vaccine missions? 2. Is there a requirement to bring samples back from the mission under refrigeration? 3. Is there ever a requirment to stay overnight during a daily mission? 4. What is the maximum amount of hours required for vaccine missions? 5. What other electricial equipment can be utilised if continuous electricity is availble? 6. Is GPS tracking of benefit? Is there anyone who can assist me with the above information or provide any other information I may require to complete the development of system. If you wish to email me directly, please contact me on stephen@greenenergylimited.com 
Admin

JSI White Paper on UAVs: What should you deliver by unmanned aerial systems?

Cross-posted from the JSI website with thanks! inSupply, JSI’s regional supply chain consulting center in East Africa, in partnership with Llamasoft and the Nichols Group, recently examined the potential for employing unmanned aerial vehicles (UAVs) to deliver life-saving and other commodities within a public health system. They examined the cost-effectiveness of UAVs versus a motorcycle-based system and other well-run forms of land transport, using three sets of data from African countries over 12 months and have prepared a white paper based on their analysis.  Executive summary: As more low- and middle-income countries (LMICs) explore opportunities to improve efficiency and performance in their public health supply chains and diagnostics networks, they face myriad choices about how best to use unmanned aerial systems (UASs) to improve public health outcomes and reach the last mile. JSI Research & Training Institute, Inc. (JSI) and our partners LLamasoft and the Nichols Group wrote this paper to provide countries and public health stakeholders with objective guidance on how to make informed decisions about which health products to prioritize for delivery and by which type of UAS platform to achieve the six ‘rights’ of a supply chain. The team undertook a cost-effectiveness analysis to compare various transport options for a variety of delivery categories using UAS vs. well-managed traditional modes of last-mile delivery, such as land cruisers and motorcycles. The analysis took into account geography, UAS characteristics, and characteristics of products and their demand patterns. We also mined and analyzed 12 months of health-facility data from three country datasets in sub-Saharan Africa to identify five use cases that would allow us to define the cargo characteristics and examine costeffectiveness for each of the following product types: a) safe blood for transfusion; b) long-tail products (small quantity, unpredictable demand products); c) program and essential medicines; d) vaccines; and e) diagnostic specimens. Overall, our findings show that UAS cost-effectiveness is driven by the number of flights per year and increasing flight numbers is dependent on facility density within the UAS range area. Similarly, with the exception of safe blood for transfusion, the results clearly demonstrate that using UAS for single-product category deliveries is not optimal from a cost-effectiveness perspective, and that layering multiple use-cases will increase the UAS cost-effectiveness by increasing the number of flights the UAV will be used for. For safe blood for transfusions, small, fixed-wing UASs can offer both cost and speed/responsiveness advantages over land transport to deliver rare blood types and support-products on-demand. We estimate that for a region of average facility density, approximate annual costs to serve 500 health facilities will range from US$ 1–5 million, depending on the UAS and cargo categories. Ultimately, even projecting rapid improvements in cost and performance, most UASs are still 3+ years away from being transport-cost competitive with motorcycles. The case for using UASs must be examined within the context of the total system costs (considering factors such as inventory holding costs and capital investment for storage capacity), other supply chain objectives such as speed and availability, and broader health benefits. UAS cost-effectiveness is substantially driven by the number of flights per year that can defray fixed costs. Flight numbers can be increased by operating in areas of higher health 8 facility density and selecting UASs that have longer ranges. Flight numbers can also be increased by layering multiple use-cases. Unmanned aerial systems have significant potential to improve the availability of health products in hard-to-reach locations. Every potential use case must be considered individually factoring in geography, UAS characteristics, and product and demand characteristics. However, the following sets of factors are broadly indicative of a potential value-adding use case for UAS:  High density of health facilities (within range of UAS). Difficult to access by road (large proportion of year). High financial value, scarce, or high health value (e.g., life-saving) products. Unpredictable demand (at level of individual facility) products. Expensive, short shelf-life, or difficult to store at last-mile products. Here is a link to the paper: http://www.jsi.com/JSIInternet/Inc/Common/_download_pub.cfm?id=19145&lid=3    

Les inscriptions pour la formation en Logistique de Vaccination sont ouvertes

Le Centre LOGIVAC organise la 3è édition de la formation en Logistique de Vaccination, du 09 avril au 04 mai 2018. Les dossiers d’inscription seront reçus jusqu’au 24 mars 2018. Délivrée entièrement en face-à-face à destination du personnel de santé chargé de la gestion logistique du programme de vaccination aux différents niveaux de la pyramide sanitaire, la formation en logistique de vaccination répond aux nouveaux enjeux de santé publique. A travers des cours présentiels et des travaux pratiques sur le terrain, les apprenants auront renforcé, à l’issue de la formation, leurs capacités professionnelles dans la gestion de la chaîne d’approvisionnement des vaccins. Plus spécifiquement, ils seront en mesure de : concevoir et mettre en œuvre un système logistique ; planifier les activités logistiques pour la vaccination ; assurer la disponibilité des vaccins ; assurer la continuité de la chaîne du froid ; maintenir la sécurité vaccinale et la gestion des déchets ; utiliser efficacement les outils informatiques usuels du PEV ; assurer la supervision des agents. Nous vous invitons à vous inscrire ou à faire une large diffusion dudit message après avoir consulté la plaquette de présentation expliquant en détail le programme de formation et les modalités d’inscription.

Vaccine Transport Supplies Recommendation

Hi, I am in need of the following items and I am looking for supplier recommendations. Just need a few of each for R&D.   Empty vaccine vials with stoppers Glycol solution for vaccine vials Portable vaccine cooler (used to carry vaccine to remote locations)   Thanks for the help  

SOPs for the management and Control of Cold Room fridges

hello every body Can you please share with me your SOPs for the managment and control of cold rooms. Best regards, Tarek

Free access: New issue of Health & Humanitarian Supply Chain Review magazine!

Dear Colleagues, PSA is pleased to share the new issue of “Health & Humanitarian – the supply chain review” magazine. In this issue, read about: Vaccine Distribution in DRC by VillageReach The professional career of Joanie Robertson, PATH The Yeksi Naa Project from Senegal by Modibo Dicko Procurement reforms by SAMES in Timor-Leste and more… Access your free copy here: https://goo.gl/bxxign   For comments or questions, please contact Sara Khan at sara@pamsteele.co.uk.   Kind regards,
Sara A Khan Head, Communication & Org. Learning --------------------------------------------------------------------------------------- Pamela Steele Associates Ltd                              e. sara@pamsteele.co.uk | skype. SaraKhanPSA Prama House, 267 Banbury Road, Oxford, OX2 7HT, United Kingdom www.pamsteele.co.uk | Office.+44 (0)1865 339370 | Fax.+44 (0)1865 339301 ----------------------------------------------------------------------------------------

B Medical Systems Appoints Raja Rao as Director of Immunization Logistics

We are pleased to announce the appointment of Raja Rao as Director of Immunization Logistics effective January 22, 2018. In his new role, Mr. Rao, who has over 20 years of experience in global health and development, will head initiatives aimed at strengthening vaccine cold chain and delivery systems across more than 100 countries, particularly in the developing world, represented mainly as members of Gavi, The Vaccine Alliance.   Please find hereafter a press release with more details on this.

White Paper on Cost Effectiveness of UAS for Cargo Delivery

As more low- and middle-income countries explore opportunities to improve their public health supply chains and diagnostics networks, knowing how best to use unmanned aerial systems (UAS) to improve reach in the last mile is critical. Under the inSupply project, JSI Research & Training Institute, Inc., and our partners LLamasoft, Inc. and the Nichols Group provide objective guidance for countries and public health stakeholders on how to make informed decisions about which health products to prioritize for cost-effective delivery using UAS vs. well-managed traditional modes of last-mile delivery, such as land cruisers and motorcycles.  The analysis took into account geography, UAS characteristics, and characteristics of products and their demand patterns. The paper focuses on examining the cost-effectiveness for each of the following product types: safe blood for transfusion long-tail products (small quantity, unpredictable demand products) program and essential medicines vaccines diagnostic specimens The executive summary is attached and the full white paper can be downloaded here. Please let us know if you have any questions about this white paper or want to know more about our work.

Soren Spanner's death

Soren Spanner died in hospital in Denmark on the 28th December, I am told by his sons. Soren was dedicated to help build cold chain systems all over the world and he was a true expert in refrigeration. I was fortunate to meet him in the early 1980s and we remained close, working friends for the next thirty seven years. Many others who worked with him in African and Asian countries will remember his tireless enthusiasm in field work and repair and maintenance training.  Perhaps his greatest contribution to the vaccine cold chain was his discovery that refrigerators and cold-boxes had been so successfully engineered to remain cool even in the highest tropical temperatures that they actually placed the potency of some vaccines at risk of freezing! Soren’s findings and his tests that confirmed the problem, resulted in modifications to equipment and vaccine handling procedures globally. Soren will not only be remembered by us of the 'EPI Dynasty‘* for his enormous contrbution to the cold chain but also as a warm human being with an infectious giggle and a strong sense of the ridiculous! Our last laugh was in the summer when Soren arrived suddenly and without warning on a motorcycle as big as a ship - in the mdiddle of our garden. During the weekend that followed he installed a solar-powered water pump to irrigate our vegetable garden, drawing from a deep, ancient well. The installation went beautifully but when switched on for the first time there was no water in the well. We laughed until we found beer to celebrate. Soren Spanner, second from left, in Copenhagen last year with his friends.   Smile in peace, Soren; we shall miss you. With love, John

Last Mile Delivery for Public Health Supply Chains

Measuring Accountability for Last Mile Delivery The Interagency Supply Chain Group (ISG) comprising of 15 global agencies are actively involved in supporting supply chain efforts across all disease areas. The purpose of this group is to provide better coordinated and more effective support to country efforts in ensuring sustainable access to high-quality essential health commodities. The group meets quarterly to address priority issues, with technical working groups established for specific focus areas. This includes opportunities to strengthen collaboration at the country level and leverage institutional support around key technical issues.  The ISG has recently published a four-page brochure, the focus of which is an operational definition and metrics for Last Mile Delivery. Please feel free to reach out to me if you have any questions.  Many thanks,  Hitesh    Hitesh Hurkchand
Interagency Supply Chain Group
Hosted by the World Health Organization UNICEF, New York Email: hhurkchand@unicef.org Email: hiteshph@me.com 
Mobile: +1.917.975.9743
Skype: hitesh_h

Home-based record stock-outs: updated data

A new report has been released that updates information on the occurrence of home-based record (e.g, vaccination cards, child health books) stock-outs. The open access article can be accessed online, and is also attached here. Similar to vaccine stock-outs, disruptions in the supply chain of home-based records (HBRs) are avoidable events that create inefficiencies for immunization service delivery. Several key words there: DISRUPTIONS, AVOIDABLE, INEFFICIENCIES. Following a review of data on HBR stock-outs reported by national immunization programmes, the new report highlights several important themes. First, many programmes confront on-going challenges with ensuring the availability of a durable HBRs in the right place, at the right time and in the right quantity. In 2016, 29 countries reported a national-level HBR stock-out, more than in 2015 or 2014. Second, some programmes appear to not have mechanisms in place to monitor and track the HBR supply chain. During 2016, one-third of countries reporting to WHO failed to report whether a stock-out did or did not occur. Whether countries lack this information; have the information, but not in a readily accessible form for reporting; or are choosing not to report information on supply levels when information exists is unclear. And lastly, HBR financing and printing are complex processes that often involve the national immunization programme and its many partners. In 2016, 44 countries reported two or more HBR funding sources and 22 countries shared responsibility for printing HBRs. It is very possible that these complex financing arrangements may be associated with the occurrence of HBR stock-outs. Immunization programmes are encouraged to take time to evaluate their HBR system along with their partners in the Ministry of Health if immunization and nutrition along with other maternal and/or child health programmes share responsibility. Resources from a prior workshop are available to help guide the evaluation. Let's work together to critically assess the HBR system in each of our countries and identify and implement appropriate, sustainable solutions.

APPLY NOW : Empower's 8th International Workshop on Quality Assurance in PSM

​​Dear TechNet Members, Greetings. We are pleased to announce that Empower School of Health (ESH), a Centre of Excellence for Global Health Supply Chain Management, is organizing 8th INTERNATIONAL WORKSHOP ON QUALITY ASSURANCE IN PROCUREMENT & SUPPLY CHAIN MANAGEMENT, scheduled from 29th Jan – 02nd Feb, 2018 in GOA, INDIA. The key topics being covered are: Pharmaceutical Product Quality Rational Quality Assurance System National Quality Assurance Plans and Manual Procuring Good Quality Pharmaceuticals Maintaining Quality throughout supply chain Comprehensive Quality Assurance Systems Besides sessions with experts, we have also arranged for field visits to WHO Pre-Qualified Manufacturing Facilities. We are currently offering group registrations discount. Please follow this link for the online application form- goo.gl/yTkEFJ Regards --  Ms. Kavya RS  |  Training & Education Coordinator  |  Empower School of Health

IAPHL Webinar may focus on integrated distribution of medicines and vaccines

IAPHL are debating the agenda for their next Webinar. Some are suggesting a focus on aspects of logistics integration for CD and NCD programs. For me, this is the 'Elephant-in-the-room' of future distribution strategy for country health pogrammes. Incorporating the distribution of vaccines and the fast-growing category of medicines that require cooling (i.e. insulin) and CT storage would have much to discuss, including the following three strategic issues: 1. Defining and achieving high efficiency distribution by: requiring that every national list of medicines contains the secondary packed volume of each generic and name-brand medicine so that cooled storage capacity can be correctly anticipated at time of tender; requiring that every medicine procured declares storage conditions (temperature range, humidity, sensitivity to light radiation) to ensure availability of required conditions of transport and storage; assessing in the country context whether the stages of transport in distribution can be more efficiently handled by active-refrigerated vehicles or passive-cooled insulated cold boxes/packaging; employing back-loading practices to bring sealed sharps boxes containing used syringes to central disposal hubs. 2. Optimizing the distribution network by: minimizing the number of stages of transport and storage at which products are handled and repacked for onward distribution; exploiting the current state-of-the-art energy management technologies in the design of new warehousing and for transport. As autonomy of electric vehicles now reaches 400 kms, take advantage of greater efficiency of electric vehicles, lower maintenance and cost reduction by solar-grid linked electricity management; using IT applications to maximise efficiency of supply trips and vehicle loading and also to provide GPS tracking and temperature monitoring with remote alarms. 3. Calm the fears of 'silo' programme logistics officials and support them by: using IT and communications technologies to maintain the control functions (distributing specific groups of vaccines or medicines) entirely in their hands via computer applications; offering freedom of access to vehicles and warehousing for PH officials to ‘control quality’ by inspection and routine review meetings with the distribution central management; as plans are laid for transition to integrated distribution, build time and progressive implementation stage by stage to allow time to build confidence. If outsourcing is introduced or expanded, allow for contract supervision and quality monitoring. Join the IAPHL debate and add your thoughts to theirs?  Lloyd John 26 Novmber 2017  

Scaling up of the Informed Push Model Project (IPM) in Senegal

The IPM Project (funded by the Gates Foundation and "MSD for Mothers" - Merck - and implemented by the Senegalese Ministry of Health with technical support from Intrahealth International) managed to cross the "Death Valley" where many projects die after successful pilot phases. Indeed, since October 1, 2017 it is no longer Intrahealth that implements IPM but rather the National Supply Pharmacy (PNA) of Senegal! The struggle lasted 5 years, i.e. two years longer than expected. The horizontal scaling up was completed in 20 months (August 2013 to March 2015) when IPM distribution of contraceptives through private 3rd party logistics service providers (3PLs) covered all 14 Regions, 76 Districts and 1,408 health centers and posts across the country. On the other hand, the vertical scaling up or institutionalization that was to end in July 2016 fired in length until September 30, 2017, i.e. 30 months after! It should be noted that in the meantime, the IPM model was extended from 10 contraceptives to almost 90 health products, including UN lifesaving commodities, products of public health programs (HIV, Malaria and TB) as well as generic essential drugs. The goal is to reach all 118 health products that, according to national policy, make their way up to health posts. The links below will take you to a national TV report on the transfer ceremony of the IPM approach to the PNA, to two short movies on the implementation and results of the project as well as to a technical report on the project: TV Report: https://www.youtube.com/watch?v=7aV3_sSqnh0 Movie on implementation: https://www.youtube.com/watch?v=n325yUICWsY&t=3s Movie on results: https://www.dropbox.com/s/tue0rqt2psaqe1s/film%20les%20bons%20points%20de%20l%27Approche%20IPM%202017.mp4?dl=0 Technical report (MSD for Mothers) :
http://msdformothers.com/docs/senegal-informed-push-model.pdf In order to ensure that the project is well rooted in the national health system, Intrahealth continues its technical assistance to PNA under the leadership of Dr Oumy Kalsoum Ndiaye Ndao, the current IPM Project Director.

People that Deliver Newsflash October 2017

The October edition of the People that Deliver Newsflash is now available:  http://conta.cc/2xxizFp In this issue:  PtD elects a new Chairperson Building a strong supply chain workforce in Ghana The transition of the public health supply chain for medical commodities in Kenya News from our Board member organizations Resource spotlight Upcoming events Should you have any queries, do not hesitate to contact us: info@peoplethatdeliver.org Visit our website: www.peoplethatdeliver.org
Follow us on LinkedIn: www.linkedin.com/company/people-that-deliver or on Twitter: @PplthatDeliver

Advancing distribution technologies and techniques

This is the second topic in my six-part Vaccine Supply Chain Futures series, and concerns advancing technologies of cooled-distribution. Pleae share your thoughts! What advances in technology and technique--available now or in the near future--that are likely to be critical success factors for the vaccine supply chain? I propose four important advances: Distribution of supplies in today’s world is achieved by pre-planned, regular, timely delivery from higher level to lower level stores. Quality and efficiency will never be achieved by ad-hoc collection of vaccines; Rates of vaccine consumption and utilization at the point of administration and in real-time can and should drive vaccine requirements forecasting at all levels. Data transmission technology to implement this is becoming available everywhere; Accidental freezing of vaccines that remains as a persistent problem particularly during immunization outreach and campaigns can be eliminated by new cooling technologies; Innovative, HYBBRID refrigerator option powered by solar or grid and that share the same energy buffer to achieve continuous, high quality cooling will merge in a single, universal product to replace yesterday’s complex procurement choices. These four sub-topics are discussed in more detail in the attached file. I invite you to click on this link to complete five multiple option questions: https://www.surveymonkey.com/r/GTC82DX I will return the analysis to you at the end of this week and the results will be posted before TECHNET for all five topics. Thank you!

Vaccine Supply Chain Futures 1/6: Merging vaccine and medicine distribution

Friends and Family of Immunization, I hope you will join me over the next six weeks before the TechNet Conference in Portugal to debate important futures for the vaccine supply chain. Each week, I will start a discussion on a topic and ask for your reactions. If you participate, you will also have the chance each week to respond to an online survey, just one or two questions, to express your agreement, interest or despair! The choice of topics is mine, not necessarily shared with any organization or individual. I chose them because they seem to respond to the changing needs of the vaccine cold chain and, collectively, they respond to most of the important challenges and opportunities that are on the horizon. They are: Merging vaccine and medicine distribution Advancing technologies of cooled-distribution Changing vaccines and their administration Introducing data-driven, remote oversight Addressing safety to maintain acceptance At the end of these discussions, it may become clear whether collectively we are aligned towards this view of immunization futures or towards a different course. I will present the results of the survey in a summary posted before Technet. We expect to organize an event at the TechNet Conference to give a further chance to discuss these topics with other participants.   Topic one: Merging vaccine and medicine distribution In the late 1970s, the vaccine supply chain was deliberately separated from other medical distribution systems. It was recognized at that time that vaccines occupied a small storage volume compared to that of medicines. Vaccines were different from medicines. They required special cooled handling procedures, a higher frequency of distribution and more timely arrival of fresh supplies.   Increased need for cooling of medicines The volume of cooled medicines (+2/8C & +20/25C) is likely to be in the order of twenty times that of vaccines within the next few years. The demand for certain temperature products, such as insulin, is increasing and international standards (EU, US) have recently been established for handling all medicines. This is provoking extensive re-equipping of stores and re-mapping of transport. Ministries of Health are recognizing the economies of merging the distribution of vaccines with pharmaceuticals. WHO expressed the goal of integration in the Global Vaccine Action Plan 2011-2020 (GVAP) and many countries have already moved to integrate specific components of the supply chain. The volume of cooled medicines (+2/8C & +20/25C) is likely to be in the order of twenty times that of vaccines within the next few years. The demand for certain temperature products, such as insulin, is increasing and international standards (EU, US) have recently been established for handling all medicines. This is provoking extensive re-equipping of stores and re-mapping of transport. Ministries of Health are recognizing the economies of merging the distribution of vaccines with pharmaceuticals. WHO expressed the goal of integration in the Global Vaccine Action Plan 2011-2020 (GVAP) and many countries have already moved to integrate specific components of the supply chain.   Rationalization of the distribution network So many countries have now choosen to establish para-statal organizations that handle the distribution of vaccines, medicines and supplies. The process of integrating warehousing and distribution needs for medical products compels Ministries of Health to reconsider the network of intermediate stores linking districts with the central, national store. Instead of 40m3 ready-made, ‘plug-and-play’ cold rooms that are fitted into spare storage spaces, large-scale 5000m3 cold-room facilities are planned for large countries on the basis of efficient use of the road network and optimizing storage sites. Discussion point #1: Do the existing primary stores and transport infrastructure provide the most efficient network for future distribution of temperature-sensitive medicines and vaccines?   Vaccine volumes now require refrigerated vehicles Cold boxes or vaccine packaging cooled by ice-packs are typically loaded onto trucks and used for most journeys between stores. Frozen ice-packs increase the risk of freezing in transport and a high level of compliance is needed to reduce the risk. The increased volume of vaccines to be transported is becoming unmanageable. Hundreds of packs are loaded into 25l insulated boxes that occupy six times the storage volume of vaccines to be transported and exceed the capacity of trucks.   Integrated transport by refrigerated vehicle Refrigerated vehicles are efficient in the use of transportable volume per km. They require less re-packing time and staff resources and most already carry temperature-recording devices that will soon be merged with the monitoring equipment standardized for vaccine refrigerators. In addition, satellite-positioning systems in the trucks will enable LMIS systems to automatically track distribution timeliness and arrival at each delivery point on optimized road circuits. Refrigerated vehicles will improve the timeliness of the delivery system and will raise the standard of vaccine handling. Refrigerated vehicles are the mode of choice for store-to-store pharmaceutical distribution and will replace passive cooling at central and intermediate stores. Icepack freezing will still remain an important option at the level of service delivery. Discussion point #2: When planning transport for store-to-store delivery of vaccine, do country managers evaluate the costs and benefits of sharing refrigerated vehicles and integrating with supply of temperature controlled medicines?   Please click this link to complete a short questionnaire: https://www.surveymonkey.com/r/3F6K5TL I will return the analysis to you at the end of this week and the results will be posted before TECHNET for all five topics. Thank you!  

Addressing Adoption and Sustainability of Unmanned Aerial Systems (UAS) in Public Health

Dear colleagues, Please find attached from the Interagency Supply Chain Group. Kind regards,
Hitesh
Coordinator for the Interagency Supply Chain Group (ISG)   Hitesh Hurkchand
Interagency Supply Chain Group
Hosted by the World Health Organization
Mobile: +1.917.975.9743 [WhatsApp, Viber]
Skype: hitesh_h
New York, New York

Registrations Open - ePGD in Procurement & Supply Chain Management - September 2017

Greetings. ​​Empower School of Health launches the next batch of the online ​​Post Graduate Diploma in Global Health Procurement and Supply Chain Management (PSCM), in collaboration with ​​Kent State University (KSU) & UNAIDS. How this programme Empowers you:
- Opportunities with leading organizations (UN organisations and MoHs)
- On-demand mentorship on PSCM subjects related to Public Health
- Holistic understanding of supply chain
- Empower Yourself for Global Health Leadership Please know that we have a few partial Scholarships seats left for the Batch starting on ​​18th ​September 2017, which makes the Tuition Fee ​​USD 1750. To apply for this course and to know more, please find the ​​Application form: goo.gl/0fcCLc Block your seat today. Kind Regards
--
Ms. Kavya RS
Training & Education Coordinator
info@empowerschoolofhealth.org

Empower launches Indian Resource Centre for Public Health Procurement & Supply Chain Management

Dear Public Health, Procurement, Supply Chain and Logistics Professionals, Greetings from Empower School of Health, a research, consulting and academic institute focused on building capacity at scale. We have delivered over 1 million hours of training to several thousand people across 50 countries and 48 organizations. As part of our capacity building efforts, we are pleased to announce the launch of an Indian Resource Centre for Public Health Procurement & Supply Chain Management (PSM). Click here to know more - goo.gl/QqeaEH Everyone who signs up for the IRC, automatically becomes a member of IAPHL India chapter. So, join us and stay tuned for an exciting journey on the road to PSM excellence in India. Best Regards,

Shortage of Anti Diphtheric Serum

Dear Friends, This week, we have seen two patients with diphtheria in our district Bilaspur in chhattisgarh. One was a 6 year old boy from Kharasiya village who came sick to the regional medical college with heart failure and inability to swallow liquids. He could not get the much needed Anti diphtheritic serum which could have saved him, and he died after 48 hours. The other child is a 13 year old girl from village Ghonghadih who came with fever and inability to swallow any fluids or food and had a bull neck swelling. As I write, even 48 hours after having admitted her in our hospital and tried everything to procure the drug from reaching out to the district and the state health authorities, to trying out in the pharmaceutical manufacturers in the other cities of Chhattisgarh, West Bengal and Maharashtra and Delhi, and drawing a blank. The two infectious diseases hospitals in Delhi and Mumbai said that they have the drug but want the patients to come and get admitted with them, but would not dispense it to us. However, that is an impossibility for people to travel to these cities. Meanwhile, this child admitted with us is getting worse today than when she was admitted. Finally the child got a dose from Indore I am also reminded of another 4 people with diphtheria in the last 2 years of which 3 died . All 4 could not get this drug because it was not available. While even occurence of such sporadic cases of diphtheria should concerns us, i wish to highlight the unavailability of life saving drugs. Unavailability of medicines directly impedes right to health and adversely affects the patients right to life (as enshrined in our Constitution). Needless to say, the State in turn has the responsibility to ensure that availability of these life saving drugs even in the remote areas or districts within their territory. At least at a state level, the drugs controller should ensure that such drugs should be available at all times in some volumes, small as they may be. The fact that they are required infrequently, and that some stocks may expire before they are needed cannot be reasons that they are not given importance.The upstream problem with poor supplies is the lack of interest in producing these drugs due to poor demand for them. Though the Central Government has published a National Treatment Guidelines, 2016, there seems to be little effort been made to ensure the availability of medicines enlisted under the treatment program. Both the centre and state should commission domestic manufacturers to produce, in the larger interest of public health.   Yogesh

"Quality Risk Management Mental Modelling: Examples of exposure in everyday life" is now available for free download

Dear colleagues,   "Quality Risk Management Mental Modelling: Examples of exposure in everyday life" with 15 chapters, 120 photographs, 89 references, countless tables and graphs, links and QR codes to 13 videos as well as 26 best quotes on risk management is now available in printable interactive PDF and interactive ePUB3 formats from http://kartoglu.ch/qualityriskmanagement/    FREE DOWNLOAD for both PDF and ePUB3 versions.   This book is prepared to help readers to build robust mental models on quality risk management using everyday life examples. Mental models are a set of tools that we use to think. They offer us frameworks that we can use to look at a problem or a process. Mental models help us to shape our behaviour, set an approach to doing specific tasks, as well as explain our own thought process about how the ‘real’ world works. Through mental models, we see the relationships between different steps of a process, causations, and consequences. This book suggests taking a look at some of our daily routines from a risk management perspective in order to better understand the process.   This work comes under a Creative Commons (CC) Attribution-NonCommercial-ShareAlike 4.0 International License (CC BY-NC-SA 4.0) and is offered to the global charity that has been initiated by the Creative Commons with the purpose of widening the spectrum of open knowledge and free culture.   Of course, you will undeniably learn a lot by studying risk management publications related to your technical area and excel by practice. But in my experience, one good way to build mental models is to read outside the norm. When I read or listen to something new and different, I always think of how this new information could connect with information I already know, or to my technical expertise. With my involvement in QRM, I have developed a habit of wearing ‘risk spectacles’ wherever I go and in whatever I do. Looking through such spectacles on the things that we typically consider as outside our technical areas reveals a deeper understanding of the issues around the risk management. I often look for answers in unexpected places.   In this book, I invite you to wear my ‘risk spectacles’ at home, outside – on the way to your office, and at work. I hope you enjoy this book that is different from the classic risk management literature.   Kevin O’Donnell, Market Compliance Manager at Health Products Regulatory Authority, Ireland, welcomes the book as a development in the field of quality risk management that focuses on understanding the cognitive processes that relate to risk assessment:   “In this excellent book, Dr. Kartoglu recognises the difficulties and problems in risk assessing and managing complex processes such as pharmaceutical supply chain management. While the application of quality risk management principles to supply chain control has been the subject of much work in recent years, the focus Dr. Kartoglu gives in this work to understanding the cognitive processes that relate to risk assessment, and that relate to how hazards and risks are perceived, render this work an important new approach in this area. He teaches readers how to actually think about hazards, not only in terms of their relationship with harm and risk, but also in terms of how human behaviour and cognitive processes can influence one's perception of those hazards, and the risks they may present. This is a very welcome development in this field, and it has definite relevance to the application of quality risk management principles in efforts to secure the supply chain of vaccines and other important medicines.”   Hope you find it useful.   Happy downloads…   Cheers and all the best,   UMIT

Immunization Supply Chain Management Experts Pool

UNICEF supports countries in achieving their national immunization goals. The achievement of these goals depend on having strong Immunization Supply Chains Management (ISCM) systems in place that are routinely assessed and improved through the comprehensive Effective Vaccine Management Assessment. The objectives for ISCM are to achieve adequate supply for every immunization session without temperature damage and at the lowest possible cost per fully immunized child. To achieve these objectives the country’s immunization programme needs strong cold chain equipment management systems and also need dedicated capacity at all levels of the country to maintain and expand the cold chain and to adopt new innovative cold chain technology that is more robust with lower operating costs. Many countries have expressed demand for technical assistance for comprehensive planning and upgrading and expanding their cold chain system so that they are aligned with their coverage and equity goals. Furthermore countries have requested support to choose the most optimal and appropriate technology that is aligned with the country context. UNICEF and partners have worked with the GAVI Alliance to establish the GAVI Cold Chain Optimization Platform (CCEOP) that provides financing to countries to ensure adequate and optimal cold chain capacity is available at subnational level to help achieve the programmatic coverage and equity objectives. It will also help countries to accelerate the deployment of higher-performing technologies that have lower operating costs. This priority also aligns with the strategic goals of the WHO and UNICEF immunization supply chain Hub to strengthen the capacity of countries and to intensify and coordinate efforts to catalyse immunization supply chains improvements through the comprehensive EVM process. Purpose The purpose of this announcement is to establish a pre-screened Experts Pool of Supply Chain Specialist in Cold Chain Equipment management and Temperature Monitoring and Control that can be deployed on as needs basis. These experts are expected to work in close collaboration with UNICEF Programme Division, Supply Division, WHO, Regional and Country Offices and other external partners (such as CHAI, PATH, AMP, JSI,…) in providing technical assistance and applying latest guidance, tools and methods at country level to strengthen the country’s cold chain equipment management system. Tasks include to support the process of conducting national cold chain inventories that can be updated regularly, developing and supporting the implementation of rehabilitation and expansion plans; preventative and corrective maintenance plan; cold chain equipment deployment and installation plans. In addition, qualified experts from this pool may be tasked to help the national counterpart to prepare Cold Chain Equipment Optimization Platform (CCEOP) application submission, work with partners in improving and updating global guidance, tools, methods and capacity building efforts including supporting countries to establish or strengthen National Logistics Working Group (NLWG). In particular the consultant will: (a) Support countries by providing technical assistance to improve the cold chain equipment management systems and implement priorities as identified through the EVM process and to support the application to and implementation of GAVI Cold Chain Optimization Platform that is aligned with country plans (cMYP, EVM improvement plans, GAVI HSS). Support also includes prepare and review documentations of CCEOP applications if required and as requested by the Ministry of Health. (b) Review, update and develop guidance, tools and methods for cold chain equipment management in collaboration with the stakeholders. (c) Develop training materials and implement trainings for cold chain equipment management including CCEOP application processes in the role of “subject matter expert”. (d) Undertake studies to measure impact of iSC interventions such as CCEOP but not limited to it on coverage and equity. (e) Support countries to establish NLWG or strengthen it if already exist and weak in order to ensure national ownership of all planned activities. (f) Conduct studies/research and generate evidence to document best practices in improving iSCM. (g) Conduct cost benefit analysis of innovative solutions such as adoption CTC vaccines. Expected results (based on country needs): Based on country needs, the consultant should be able to provide appropriate technical support in the following three (3) categories. Applicants are advised to indicate in which technical areas below they are applying. They can select all these three areas or can opt only one depending on their expertise: Technical Area1: Cold Chain Equipment Management (CCEM) · Support and/or coordinate part or the whole CCEOP process as per Gavi CCEOP application 2017 guidance Cold chain inventory and its report Rehabilitation plan Maintenance plan CCE deployment plan Segmentation of health facilities · Provide support at the country level to complete the CCEOP application form and budget to the highly acceptable level · Support the country for CCEOP equipment deployment and implementation processes Technical Area 2: Temperature Monitoring and Control (TMC) · Conduct a temperature mapping study in the vaccine cold rooms in selected countries using WHO tool (protocol, training, data analysis) and build national capacity to conduct future studies · Coordinate a temperature monitoring study in the vaccine distribution routes in selected countries using the WHO protocol and the UNICEF guide (temperature monitoring handbook) and build national capacity to conduct future studies · Support the development and deployment of guidance, training materials and SOPs to ensure adoption and sustained use of the system by health workers and managers Technical Area 3: Other Immunization Supply Chain Catalytic activities and studies · Undertake studies to measure impact of iSC interventions such as CCEOP but not limited to it on coverage and equity. · Support countries to establish NLWG or if exist and weak strengthen it to ensure national ownership of all planned activities. · Conduct studies/research and generate evidence to document best practices in improving iSCM. · Conduct cost benefit analysis of innovative solutions such as adoption CTC vaccines. Duty Station Remote with trips as requested by the countries among UNICEF Headquarters, Regional Offices and Country Offices. May vary depending on deployment. Timeframe: The Expert Pool will be valid for a year from its establishment. Start date: 1 August 2017 End date: 31 July 2018 Mid - Senior Level Competencies · Strong analytical, oral & written communication skills · Proven track record in project management with the emphasis on planning, budgeting and reporting · Effective presenter including ability to adapt the message and visual aids for multiple audiences to deliver concise, impactful presentations · Effective facilitator with proven ability to engage and train a group of individuals (through an interpreter if necessary) · Demonstrated ability to work in a multi-cultural environment · Demonstrated ability to work in a team Technical skills and knowledge on some or all of the following · Proven experience working in multi-stakeholder and multi-cultural settings · Experience in developing inventories and cold chain rehabilitation and expansion plans at country level · Experience in writing complex funding proposals, developing multi-year budgets and operational plans for cold chain equipment management and temperature monitoring devices · Experience in training, planning and delivery of technical assistance · Proven track record in interfacing with national ministries of health · Proficiency in WHO PQS-listed cold chain equipment · Experience and knowledge on the Gavi CCE OP application documents and process · Proficiency in the development of technical SOPs for cold chain equipment management is an advantage Work experience on some or all of the following · An Advanced University Degree in public health or other health related area or social sciences is desired. · Demonstrated solid experience in development of the Gavi CCE OP, temperature monitoring studies. · At least 3-5 years of experience in international public health programme with experience in resource-limited environments · Experience of EVM assessment and cIP development in at least one country outside his/her country of residence is an advantage · Must have experience in conducting cold chain equipment inventory outside his/her country of residence · Experience in temperature monitoring systems implementation, and studies · Experience in SOP adaptation support outside his/her country of residence Languages · Fluency in written and spoken either English or French is required. Proficiency in Arabic language is highly desired. Knowledge of local languages is an added value.

Lesson learnt from PHC Kollamogru: Year April 2016 to March 2017.

Dear viewers Sharing the following with the viewers who are the true Polio Eradicators / planners / managers / authorized implementers & policy makers of the programme Good intentions alone are not enough for the successful outcome. Intention of healing is always good but it can produce stricture with consequent obstruction and dilatation of proximal part leading to long term complications. Since April 2016, GOI introduced two doses of Inactivated Polio Vaccine as an endgame strategy of Global polio eradication. Routine Immunization is one of the biggest national programmes in operation. Service providers are trained and reoriented on a regular basis in the public sector. In good performing planning units, coverage of any new vaccine will be at par with that of all other antigens. But due to causes and constraints beyond the scope of author to understand, supply of IPV was regularly irregular and inadequate created very low coverage. For the effective impact on the community, ≥85% sustained vaccination coverage is required. What will be the epidemiological impact with coverage as low as 65% of the first dose and 30% of the 2nd dose, with >70% population immunity gap on Polio Eradication is a real concern. This is the true story of one very good performing Planning units; what will be the cumulative effect of ~28,000 Planning Units of India – 2nd most populous country??

Next IAPHL Discussion: Mind the Gap: Linking Program and Supply Chain Data

If you haven't seen on IAPHL, next week starts a new discussion relevant to our TechNet community. Details are below. If you aren't yet signed up on IAPHL, you can do so here: http://iaphl.org/ Dear IAPHL community, We are excited to announce the topic of our next moderated discussion, set to start on Monday June 12th-- Mind the Gap: Linking Program and Supply Chain Data. The most recent IAPHL discussion on quantification noted that generally population/demographic data or consumption/service data are used for quantification and for supply chain planning. The discussion highlighted many of the issues and challenges that we face with having inaccurate population estimates or consumption data. In this next discussion, we want to build on that topic to explore the potential link of supply chain data to programmatic data, and programmatic data to supply chain data, specifically for immunization programs but drawing on experiences across all program areas. Most often, Ministries of Health define immunization success by coverage rates, but coverage is based on often inaccurate population estimates for the denominator. This fundamental flaw can result in skewed estimates for coverage rates and also drastically affects quantification, as this group noted in the previous IAPHL discussion. With this topic, we want to explore options for triangulating data to better inform immunization service delivery planning from a program perspective and thinking about coverage rates. Are there opportunities to bridge the gap between supply chain data and program data to better manage and report on immunization activities? This discussion will be hosted by: Chris Wright, JSI Vidya Sampath, VillageReach Brian Taliesin, PATH Wendy Prosser, JSI The IAPHL Team IAPHL- Your Global Gateway to Health Supply Chain Management
Website: http://iaphl.org/

Imperial Short Courses: June to August 2017 Open For Registration!

Dear Colleagues, Take a moment to think about what health care providers use every day to treat patients. Providers use a myriad of items, such as syringes, prescriptions drugs, gloves and many more. Employees involved in healthcare supply chain management are responsible for stocking organizations with the products providers need and managing inventory. However, managing supply chain is not as simple as making sure providers have enough gloves. Imperial is offering the newly designed short programs that will assist any supply chain specialist with better understanding, measuring and management skills relevant to the supply chain environment. For more information please contact academy@ihs.za.com