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 Vaccine management

HR Country Support Package for Immunization SC Managers

The HR Country Support Package for Immunization SC Managers is available!

The success of immunization systems in countries through the past decades can be attributed to a large extent, to the supply chain and logistics system. This system is one of the backbones of national immunization programmes (EPI) that strives to ensure the uninterrupted availability of quality vaccines and devices, from the national level through to the service delivery points in rural and remote areas. By 2020, countries are projected to manage significant increases in the value, volume, number of doses, and stock keeping units placing increased stress on already weak supply systems. In response to this need, the Immunization Supply Chain Strategy was built around five (5) fundamentals; system design, supply chain leadership, data for management, better cold chain and continuous improvement plans to help achieve the vision that by 2020 immunization supply chains efficiently provide potent vaccines to all.

Supply Chain Leadership
Next-generation immunization supply chains require dedicated and competent managers and workforce as well as adequate numbers of skilled, accountable, motivated and empowered personnel at all levels of the health system. Countries are supported to strengthen and build supply chain managers’ and workforce capacity by providing focused technical assistance, tools, training and other resources. The aim is to help ensure that dedicated supply chain leaders and HR are in place at all levels of the health system, with the right capabilities, authority and accountability in every country.

The HR country support package provides a set of tools and guidelines to support and develop immunization supply chain managers to be able to effectively manage their supply chain to cover the areas described in the HR for health building block. These tools are constantly updated with new ones and also in line with current realities.

Key Questions addressed through the Country Support Package
• What lessons can I learn from other countries and from the private sector? 
• How can I strengthen my leadership skills? 
• How can I build a comprehensive plan to meet all HR issues, not just training? 

These resources can be accessed here: https://www.technet-21.org/iscstrengthening/index.php/en/leadership-documents 

For more information, please contact: sc.strengthening@unicef.org 

#vaccines 
#HR 
#capacity 
#countrysupport 
#people  

Immunization Supply Chain Strengthening subsite

Dear all, Did you know that there is a dedicated subsite on Immunization Supply Chain (iSC) strengthening on TechNet-21? In 2014, the Gavi Alliance partners developed the Gavi Immunization Supply Chains (iSC) Strategy around strengthening country immunization  supply chains, focusing on five fundamentals: Data for Management; System Design; Leadership; Cold Chain Equipment; and Continuous Improvement Plans.  The iSC subsite houses information, tools, and resources that can help country governments and implementing partners aiming to strengthen these five fundamentals. You can find guidance on implementing DISC indicators, system design optimization case studies, HR rapid assessments, and other practical tools and guidance documents.  Explore the site at: https://www.technet-21.org/iscstrengthening. Interested in contributing to the subsite? You can find guidance on the iSC topics page here: https://www.technet-21.org/en/topics/isc

Updated Immunization Delivery Cost Catalogue (IDCC), Webinar and Poster at HSR2018

Dear members, You may remember an announcement in May 2018 when ThinkWell launched a set of products on the Immunization Economics platform (immunizationeconomics.org/ICAN) on immunization delivery costs. Our launch included findings from a systematic review of delivery costs of immunization programs in low- and middle-income countries, including a unit cost database (Immunization Delivery Cost Catalogue – the IDCC) and summary report with seven pooled immunization delivery unit cost estimates.  We are thrilled to announce that the IDCC has now been expanded to include 30 additional unit costs from nine recently published articles/reports. The unit costs include data from nine countries (Benin, Bhutan, Chad, China, Ethiopia, Haiti, Thailand, Togo and Vietnam). The new data covers health facility, school-based and campaign delivery of oral cholera, meningococcal, HPV and PCV10/13 vaccines. More than 400 unit costs are now available. All updates are live on immunizationeconomics.org/ICAN. Updated IDCC companion products (e.g. summary report, pooled immunization delivery unit cost estimates, etc.) will be released later this year. Want to Learn More? Join upcoming events to learn more about the IDCC!  Email ICAN@ThinkWell.global if you’d like to be kept updated about these events and others moving forward. October 12, 2018, 10:30am GMT+1: Fifth Global Symposium on Health Systems Research (HSR2018), Liverpool, UK: IDCC poster presentation October 30, 2018, 9am EST: Webinar on how to use the IDCC with extensive Q&A Written materials and videos with instructions and guidance on using all tools and products are also available at https://immunizationeconomics.org/ican-idcc-instructions/. Call for User Testers Interested in helping improve the IDCC and other products? ThinkWell is looking for individuals to provide structured feedback in person, by phone or via Skype. If you have 30 minutes available, please contact Michaela Mallow at mmallow@thinkwell.global. About ICAN The immunization delivery cost review and analytics were conducted under the Immunization Costing Action Network (ICAN) project. Led by ThinkWell and John Snow, Inc. (JSI), the Immunization Costing Action Network (ICAN) is a project focused on increasing the visibility, availability, understanding, and use of data on the cost of delivering vaccines. ICAN aims to build country capacity around generation and use of cost information to work towards sustainable and predictable financing for vaccine delivery. The ICAN is supported by a grant from the Bill & Melinda Gates Foundation.

When should Ministries of Health use refrigerated vehicles to deliver vaccines?

Dear Colleagues, You are invited to contribute to a new discussion on 'When should Ministries of Health use refrigerated vehicle to deliver vaccines?'. Discussion co-moderated by James Cheyne and John Lloyd: There are at least four good reasons for using refrigerated vehicles to replace the classic pickup trucks loaded with cold boxes: The number of vaccines used in national immunization programmes has roughly doubled over the past 20 years and the number of new vaccine introductions is likely to increasing at a similar rate over at the next ten years. Larger volumes of vaccines will need larger vehicles. Refrigerated vehicles with three or four times the carrying capacity cost about the same as a typical pickup truck including the cost of the cost boxes and ice packs. Refrigerated vehicles eliminate the need to freeze hundreds of ice packs for each trip. Furthermore, continuous temperature monitoring in refrigerated vehicles is likely to reduce the amount of vaccine frozen in transit Larger capacity vehicles are better adapted to make round trips to deliver vaccines to several remote stores, saving both fuel and time. There are also at least four reasons for retaining pickup vehicles that deliver the vaccine in cold boxes and not investing in refrigerated vehicles: Existing delivery routes can continue to be used without the need for new route planning and new training for drivers and heath staff. Refrigerated vehicles can be difficult to maintain and spare parts for both the vehicle and the refrigeration unit are not always easy to source. Even with good maintenance and repair services available a backup refrigerated vehicle is needed to keep the deliveries moving when the first vehicle is being serviced or repaired after an accident. When not needed for vaccine deliveries pickup vehicles can be used more economically for non-vaccine deliveries. The world is not this simple, though.  We would like your thoughts and opinions on when you think refrigerated vehicles can be more effective and also when pickup trucks with cold boxes on the back can be the better option.  Or, of course, we would like to hear of any other options you know about to delivering large volumes of vaccines simply and reliably. Finally, if you are already using refrigerated vehicles, please have a look at WHO’s survey of refrigerated vehicles.  The purpose of the survey is to gather information on the performance of refrigerated vehicles that are three years old or older:   https://www.surveymonkey.com/r/PQSrefrigeratedvehicle The information will be used to help PQS develop standards for refrigerated vehicle meet the needs and operating environments of immunization programmes. Your help will be extremely valuable to WHO PQS and the WHO Expanded Programme of Immunization (EPI). Best regards from John and James.  We are both looking forward very much to debating your thoughts, ideas and suggestions.  Many thanks.

Ongoing Registrations for Empower's PGD in PSCM_September 2018

Dear Colleagues,

The 14th Batch of the Post Graduate Diploma Course in Global Health Procurement and Supply Chain Management is scheduled to launch in September 2018. This is an 11-month ONLINE program wherein there are 9 modules. The course is structured to address one topic area per month for 8 months, starting with a module on introduction to PSM and ending with PSM support functions and systems. Each module is supported by Assignments, MCQ's and Assessments. The course ends with a final assessment which will cover all the modules. You will be provided with a direct line of contact to with Course Administrator as well as the faculty, who will guide you through the obstacles if any.
Please find attached the Course Structure of the Program, this will help you understand how beneficial the course is for you. Key takeaway's from the course - its global orientation - sharing of experiences from across countries,
- a practical and applied approach to the extensive use of exercises, case studies, projects and internships
- technical assistance for one-year offered which includes - mentoring/Coaching from the Subject Matter Experts
- Competency Assessment Tool
- a community of Practice (through Empower’s Big Learning Platform)
- a special focus on improving students’ personal effectiveness by building workplace skills,
- use of cutting-edge e-Learning technologies and instructional design to make learning easy and impactful Kindly click on this link and fill in the application form - https://goo.gl/7QpHg2 Regards  --  Ms. Kavya RS  |  Training & Education Coordinator  |  Empower School of Health |  New Delhi . New York  | SkypeID : empower.schoolofhealth  |  +91.95.99.83.50.01 (India) | info@empowerschoolofhealth.org |  www.empowerschoolofhealth.org

WHO-UNICEF cIP Guidance Note launch and review process

Dear immunization and health supply chain professionals,

The Effective Vaccine Management (EVM) initiative has evolved significantly from being solely associated with an assessment tool. It has been transformed to help national programmes make major health systems strengthening investments work as intended – to address the underlying systemic bottlenecks to immunization supply chain performance.

In this context, I am pleased to share with you the WHO and UNICEF continuous Improvement Plan (cIP) guidance note – published here in English (and soon to be available also in French):
https://www.technet-21.org/en/library/main/4911-how-to-develop-a-continuous-improvement-plan-cip

--> This document provides detailed guidance on how to plan for continuous ISC improvement: a practical tool for countries to develop improvement strategies, integrate EVM in existing national planning processes, and thus build a robust investment case for immunization supply chains.

The guidance note became possible thanks to cIP champions in a number of countries, who inspired us with their brave efforts and lessons learned. There will be more innovations and lessons as each country works to develop its own cIP. The Guidance note will therefore not remain static but will evolve with these new experiences.

In the coming months, we will launch an interactive process on the TechNet-21 web platform, through moderated discussions on EVM and cIP topics and a country champions group. Please consult the cIP resource page for more information:
https://www.technet-21.org/iscstrengthening/index.php/en/improvement-plans-about

We look forward to your engagement, and in the meantime, I would like to wish you, on behalf of the WHO and UNICEF teams, a good reading.

Warm regard,

Ousmane Dia

Finding the Perfect Temperature for Vaccines

Finding the Perfect Temperature: Protecting Lifesaving Vaccines in Remote Areas
Immunization is one of the most successful and cost-effective public health interventions in history, saving 2-3 million lives every year. In Tanzania, JSI is installing remote temperature monitoring devices to strengthen the immunization cold chain and ensure that vaccines make it to the last mile. Click here to view the photo essay.  

SPOTLIGHT: National Logistics Working Groups (NLWGs)

Dear TechNet-21 community, You may have heard about National Logistics Working Groups - either because your country has one or wants to have one, or because you came across this concept in your daily job.  A national logistics working group (NLWG) is a mechanism for coordinating national immunization supply chain and logistics activities, as well as investments made by government agencies and development partners. NLWGs have been instrumental in improving the performance of supply chain management at the national level. To learn more about or get the most up-to-date guidance documents on NLWGs, visit our topic page dedicated to them here (https://www.technet-21.org/en/topics/nlwgs). You will find not only guidances for either establishing or reinforcing NLWGs, useful related tools and resources, but also a cool map displaying known NLWGs (if your country is not in it, it should! Please contact me and I will connect you with the people in charge of this topic page). Wishing you an interesting read! If you have any follow up questions, please feel free to post them by answering to this post! Yours, Olivia    

Successful completion of the International workshop on Ensuring Product Quality in PSM (April 2018)

Dear Colleagues, The agenda of the ‘International Workshop in Ensuring Product Quality in Procurement and Supply Chain Management’ was to present face-to-face opportunity to the participants from National Medical Supplies Fund (NMSF), Federal Ministry of Health, Sudan in gaining a comprehensive understanding of concepts of Quality Assurance (QA) of pharmaceutical products and processes in procurement and supply chain. The workshop was held in Al-Fateh Idris Hall in the Abdul Hamid Ibrahim Training Centre (AITC-NMSF) from 13th - 19th April 2018 and was attended by 29 participants. The workshop was led by Professor Andy Barraclough and Ms. Radhika Singh and provided an excellent opportunity to learn from daily work experiences with other participants from different states and districts as well. The participants evaluated the workshop highly in terms of content and methodology. The participants found the workshop well-structured, comprehensive, rich in content and useful for implementing the QA agenda in their respective departments. Field visit to NMSF central warehouse, case studies, and group work were rated highly. The arrangements of the workshop and the hospitality and commitment of the NMSF staff was highly appreciated by all participants. Click here for newsletter: goo.gl/aRyGG5

A Failure to Communicate - When is Inventory not inventory?

As a relative newcomer to the EPI supply chain world, but not to healthcare supply chain I have always struggled with some of the terminology. One term in particular bugs me. And not just because I can be a bit pedantic but because its genuninely confusing: the term "inventory management" when used in EPI Supply Chain terminology. Now I always understood inventory to be something you or your organization/value chain/supply chain worked on, added value to, to ultimately resell or pass along to an end user. Medicines can be inventory (for a manufacturer or a supply chain). Widgets. Now in the EPI world inventory management is often used to refer to what I would refer to as "assets". To me refrigerators are only inventory if you are making them or are distributing them. If refrigerators are something you use to store vaccines, they are an asset (or a piece of hardware) but they are not inventory. So in meetings when people talk about inventory management, one half of the room thinks we are talking about managing vaccines, and the other half thinks we are talking about assets like fridges and freezers. Words matter, we need to speak the same language. A plea: can we talk about inventory management when we refer to managing medecines/vaccines/ etc and asset management when we talk about fridges, freezers (and indeed trucks and other hardware)? (And of course you could do an inventory on your assets - i.e. count your fridges - just to confuse things even further but I believe asset managmeent or "cold chain asset managment" is a better, more encompassing term)

Call for grey literature on immunization delivery costs in low- and middle-income countries

ThinkWell is currently accepting submissions of GREY LITERATURE about immunization delivery costs in low- and middle-income countries (LMICs). Resources need to be published between January 2005 and January 2018. Please upload your submissions directly to https://collaborativedev.egnyte.com/ul/pbf7fBiKXV. Submitted resources will be considered as part of a systematic review of the current evidence base on immunization delivery costs (IDC) in LMICs, conducted as part of the Immunization Costing Action Network (ICAN), led by ThinkWell and John Snow, Inc. (JSI) to increase the visibility, availability, understanding, and use of data on the cost of delivering vaccines. The three-year project includes this systematic review, country costing studies and a peer learning network and is supported by a grant from the Bill & Melinda Gates Foundation. To access systematic review findings already collected and analyzed, please visit www.immunizationeconomics.org/ican. This initial round of the review considered over 13,000 articles/reports published between January 2005 and January 2017 on the topic. Ultimately, ThinkWell drew from 54 articles/reports on immunization delivery costing data without restricting to a particular vaccine, delivery strategy, type of cost analysis, or setting. Resources available include a standardized and richly annotated Immunization Delivery Cost Catalogue (IDCC) (Excel workbook and web tool) of the data extracted, a summary reporting including immunization delivery unit cost estimates for vaccine delivery through a variety of strategies and in a variety of contexts. and companion interpretive products (e.g., detailed methodology note and user guides). To provide feedback or seek clarification on any of the ICAN resources, please contact ICAN@thinkwell.global.

Revision of vaccine storage code in the new model of ILR & Keeping ice-packs in brick style

Dear viewers We wish to share the attached revised version vaccine storage code in the new model of Ice Lined Refrigerator, supplied recently to the planning units in Karnataka and India. Karnataka is going to practice soon and we hope the whole country may also follow the same as it is practicable. Keeping ice-packs in brick style practically feasible way is also demonstrated.   With best regards Holla n team KVG Medical College

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 ----------------------------------------------------------------------------------------

INVITATION - WHO Global Routine Immunization Strategies and Practices (GRISP) Scholar Commencement Event

The World Health Organization Global Routine Immunization Strategies and Practices (GRISP) course team invites you to join our digital (online) Commencement Event to recognize the work and celebrate the achievement of the WHO GRISP Scholars Date: 12 December 2017 Time: 14h00 (2 PM) UTC+1 Geneva (check time) Registration: https://attendee.gototraining.com/r/6845807171822769665 Training ID: 502-385-612 Contact: grisp@learning.foundation During this event: Commencement speakers will address course participants to recognize their work and achievement GRISP Scholar participants will present the action planning they have developed to implement a GRISP transformative investment in their country. Participants will also share their experience and insights gained from connecting with EPI colleagues from over 30 countries through intense dialogue and peer review. You are encouraged to download the invitation and share it with your colleagues and professional networks. This WHO digital course used the Scholar Approach, developed by the University of Illinois College of Education and the Geneva Learning Foundation to support effective learning for global health and humanitarian work. This approach combines community of practice, knowledge co-construction, and peer review to support project-based learning. It was first piloted in 2016 by WHO to support country-level action planning based on the Global Routine Immunization Strategies and Practices (GRISP) guidelines. The GRISP Scholar course will be offered in French in the first quarter of 2018.  

Fake drugs

Here is a link to an interesting article that a colleague sent me: http://www.foxnews.com/health/2017/11/28/tens-thousands-dying-from-30b-fake-drugs-trade-who-says.html Basically, it reports on a study of the (potential) extent of damage from fake, adulterated or expired vaccines.  My question is more specifically whether someone has studied similar effects of losses in the WHO-EPI suite of vaccines due to supply chain problems (e.g., lack of temperature control, mistimed deliveries, wastage, etc.), and if there has been any research into systematic interventions that could mitigate these effects. Thanks Jay

OpenLMIS Vaccine Module Webinar: November 30 at 8 AM PST

Dear TechNet-21 Members, Please join OpenLMIS on November 30th at 8 AM PST/ 5 PM CET/ 7 PM EAT for a webinar presenting details on the current roadmap and latest developments in the OpenLMIS v3 vaccine module. This webinar will serve as a refresher for those involved with the development of the vaccine module and a presentation of the roadmap and recently developed features for those interested in learning more about how OpenLMIS manages vaccines. Please register in advance for this webinar by visiting: https://zoom.us/meeting/register/9b1a18dcc87534aec5b9141539e44ee6 After registering, you will receive a confirmation email containing information about call-in details to join the meeting. We look forward to speaking with you soon! Please feel free to forward this invitation to your colleagues as well. Best regards, Tenly Snow, OpenLMIS Community Manager

EVM questionnaire for research purpose

Good day...i'm planning to use EVM as one of my tools to acess the vaccine management in my country in few selected primary health care centers in remote areas. Clearly my country is not using this model....is it advisable for personal research use? Im quite attracted to the scopes that the survey covers, its comprehensive. 

Launched today: Special Edition of Vaccine “Building Next Generation Immunization Supply Chains"

PATH is pleased to present “Building Next Generation Immunization Supply Chains” a special edition of Vaccine journal which brings together evidence from global experts in 31 articles representing decades of work by country governments, implementing partners, and donors to improve immunization supply chains (iSC). The articles address the impact of iSC on vaccine coverage, current challenges, and successful pilots, promising ideas and innovations, and upstream solutions that can all help mitigate these challenges. Guest editors of the journal include Benjamin Schreiber (UNICEF), Bruce Lee (Johns Hopkins Bloomberg School of Public Health), and Raja Rao (Bill & Melinda Gates Foundation). Compiled in this way for the first time, the evidence presented in the special edition will serve as a ready reference for supply chain practitioners, underscore the importance of iSC performance for all partners in vaccine discovery and delivery, and help elevate performance improvements onto the priority agendas of global, regional, and country level stakeholders. To support the special edition and to tell the story of how strong immunization supply chains help vaccinate more kids and save more lives, PATH developed an accompanying digital feature: Connecting the Dots: How to get vaccines to more kids. The feature is designed with animated illustrations and social media friendly content to help build awareness for this important aspect of immunization programs. We invite you to check it out and share it with your networks using the social media toolkit below. What can you do? Learn More · Visit Connecting the Dots: How to get vaccines to more kids · Read Building Next Generation Immunization Supply Chains Share with your networks · Easy retweet: https://twitter.com/PATHtweets/status/847508916422496256 · Share on Facebook: https://www.facebook.com/PATHglobalhealth/posts/10154185969685059 · Social Media Toolkit: http://pathisc.nptoolkit.org/

Immunization eLearning Initiative: Quick Access Guide

Attached is anewflyer that lists all the online courses available as part of the Immunization eLearning Initiative. This digital learning program wasdeveloped by WHO and UNICEF expertstoprovide knowledge vital toEPI advancement.Everyone working in support of Immunization can participate in the online courses, including staff, SSAs, consultants, partner organizations,MoH, and other interested audiences.Theflyer providesaccess information, including log-in instructions. Some quick facts about the online learning courses: 1) the onlinecourses areavailable 24/7 to everyone; 2) learners can pick and choose which courses to complete -- some take less than one hour; 3) the courses are very engaging and scenario-based; 4) learners can start and stop without losing progress; and 5) certificates are available following successful completion.

Immunization eLearning Initiative courses are now available to all immunization professionals.

WHO and UNICEF announce the availability of Immunization eLearning Initiative courses to all consultants, partners, and staff supporting immunization.
The course series provides training in areas considered vital to EPI advancement. It will help immunization professionals to align their knowledge and get up-to-date on the latest immunization systems and protocols. The courses are highly engaging and flexible. They can be taken in any order and learners can start and stop without losing progress.
Access them by registering as a guest at https://agora.unicef.org/. (Enter “immunization” in the search window to locate the courses.)
Courses include: Immunization Supply Chain Management, Communications for Immunization, Immunization Coverage Data, and Multi-Dose Vial Policy. Courses coming soon include: Vaccine Vial Monitors, Microplanning, and Temperature Monitoring. There is also an Immunization Staff Orientation course to provide foundational knowledge.

Multi-dose vaccine in ampoules

Hello All,
In the website for WHO PQ vaccines BCG and Yellow Fever are the two vaccines which have multi dose preparations packaged in ampoules. As soon as we open a mulit-dose ampoule and administer the first dose, we are leaving the remining doses in the ampoule exposed to environment (very often the not so clean undersurface of the vaccine carrier as the opened ampoule is kept in a slit in the top sponge and the VC closed).
Grateful if someone can enlighten me about the safety of this practice and whether there is any evidence comparing relative incidence of AEFI from multi dose vaccines in an ampoule vs. a vial.
Thanks and regards,
Anindya Bose

Supply Chain 2035: Preparing for the Next 20 Years

Over the last two decades, increased investments in health have yieldedsignificant gains in health outcomesfor tens of millions of people around the world. At the same time, economic growth has raised hundreds of millions out of extreme poverty and helped fuel a vast expansion in information technology that has revolutionized the way people communicate. Inspired by the 20th anniversary of the first World Development Report to focus on health,the Lancet Commission on Investing in Health releasedGlobal Health 2035: A world converging within a generationin 2013. This visionary report asserts that we can achieve significant health gains in low- and middle-income countries (LMICs) by 2035, thus achieving agrand convergence. These gains are predicated on three key assumptions:

Continued economic growth in low- and middle-income countries will enable increased investment in health.
Insurance will be a primary tool in achieving universal health coverage (UHC) in low- and middle-income countries.
Non-communicable disease (NCD) will dominate disease burden.

Butachieving the grand convergenceand theSustainable Development Goals for healthdepends on a profoundevolution in the supply chainsthat deliver the medicines, vaccines, and other commodities required to maintain and improve health and well being. With large-scale investments in health programs, a widening portfolio and volume of products, and expansion of services to new populations, supply chains must be more flexible, efficient, and responsive. Here are just a few of the scenarios that will require new approaches to health supply chains in LMICs:

Universal health coverage insurance schemes and continued economic growth will foster a more robust marketplace, encouraging the private sector retail pharmacy market to expand. But insurance schemes must be designed to assure quality products in ahealthier marketplace, and to promoteequitable access to productsand services for people—especially in rural areas—whom the private sector do not serve. Thefull cost of supply chainsmust be factored into insurance payment mechanisms.
As more countries achieve middle-income status, donor funding will phase out, creating risks as graduating countries take full stewardship of their health systems including the cost of ensuring access to health commodities.Supply chain stewardsmust focus on maintaining and extending equitable access while managing risks of disruptions at every level of the supply chain. Atotal market approachthat embracesmultiplicity and redundancyin the supply system is essential.
Continued advances in technology and information systems will enable greater end-to-endsupply chain data visibility. Supply chain data will be integrated with patient records and financial systems, automating resupply and payments, while biometrics will be used to validate client identities, improve adherence, and promote rational use. But greater visibility must be combined with the capacity of supply chain managers at every level of the health system toanalyze data and take effective action, within an institutional culture that values data quality and use.
Storage and transportation systems will routinely leveragealternative energy technologiesas well asautonomous vehiclesfor reaching remote locations. These technologies will require management systems and skilled personnel dedicated to keeping them running, maintaining and replacing equipment and vehicles as they near the end of their usable life, and staying abreast of technology upgrades and innovations.
Human resources for supply chain management will still be a challenge, as it is currently throughout the public andthe commercial supply chainsectors, but outsourcing, vender-managed inventory, and direct delivery from venders will be commonplace and will mitigate the HR challenges. Supply chain stewards must embraceprofessional competenciesand promote career paths andperformance-based incentive mechanismsto recruit and retain supply chain talent today.

The grand convergence predicted for 2035 will require universal access to health supplies, and the range of skills and knowledge required to achieve that goal is more diverse than ever before. We require a command of health financing, insurance formularies, health informatics, risk management, business reengineering, market segmentation, pharmaceutical markets and regulation, and human resource management. Supply chain simulation technologies and costing applications are now essential tools in system design, optimization, and market segmentation. Career development and incentive mechanisms are as important as training curricula in preparing and retaining a capable supply chain workforce and leadership.
In order for public health supply chains to evolve, the people who support and work within them must also evolve. There will be many different models and many innovative approaches, and JSI will continue to help envision, design, and build supply chains for the future to meet Global Health demands in 2035.
Chris will lead a discussion on this topic onIAPHLin the coming weeks. This post was originally published on JSI's The Pump.

New Blog on OpenLMIS - eLMIS in Benin for Immunization Commodities

Greetings TechNet Community, I hope this message finds each of you well and successful in your work. I am the new OpenLMIS Community Manager working with the OpenLMIS Initiativeand Community to develop and share this functional and customizable eLMIS solution. Many of you may be familiar with the open source eLMIS system, OpenLMIS.Currently utilized in five geographies throughout Africa, OpenLMIS is acost-effective and widely customizable eLMIS solution built to address the data visibility challenges of low-resource environments. A non-proprietary solution, the product empowers countries to own, customize, extend, and manage their eLMIS, providing shared investment, shared learning, and reduced up-front development costs. Please visit the OpenLMIS Wikior website for more information. OpenLMIS is currently deployed in Beninthrough AMP, where it supports an informed push system for immunization commodities. One of our colleagues has written an excellent pieceon how OpenLMIS has improved data collection and visibility in Benin –an article I believe would be of great interest to the public health professionals of TechNet. The article may be accessed here: http://www.villagereach.org/2016/03/24/what-do-vaccines-and-vending-machines-have-in-common-using-data-to-improve-vaccine-delivery-in-benin/ Best of luck in your work, and please reach out with any feedback, questions, or discussion. Warm regards, Tenly --- Tenly Elizabeth Snow OpenLMIS Community Manager tenly.snow@villagereach.org CELL: 1.406.544.4856 FAX: 1.206.860.6972 SKYPE: tenly.snow.vr OpenLMIS.org~HingX~OpenLMIS Wiki

2nd Global Analysis of WHO/UNICEF Effective Vaccine Management (EVM), 2009-2014

Dear Colleagues: We are pleased to circulate the 2nd Global Analysis of Effective Vaccine Management (EVM), 2009-2014. To date, 82 countries have conducted EVM assessments between 2009-2014, of which 26 countries have conducted the assessment twice. The slide deck follows the same format as the 1st Global Analysis and provides analysis organised by: EVM composite score EVM criterion scores (including by WHO Region) Context scores Selected sub-indicator scores reflecting supply chain objectives of Availability, Quality and Efficiency. Notes at the end of the slide deck explain the data in further detail. The analysis is currently provided in English at the WHO website below and can also be found on the Technet website. The French translation will be posted shortly. http://www.who.int/immunization/programmes_systems/supply_chain/evm/en/index4.html http://www.technet-21.org/

Dose per container partnership (DPCP) launched

Earlier this month, the Dose Per Container Partnership (DPCP) project was launched. This Bill and Melinda Gates Foundation project is implemented by JSI and partners (PATH, Agence de Médecine Préventive (AMP), Clinton Health Access Initiative (CHAI), HERMES modelling team and the International Vaccine Access Center (IVAC) / Johns Hopkins University). The project will help identify evidence needed to support better-informed decision making related to the trade-offs between cost and health systems impact of vaccine doses per container (DPC). The project runs from February 2016 to December 2017 and has potential to influence country, regional and global equity and systems related policies, and have impact on supply and demand sides of various DPC options with three main deliverables: i) A global review of current decision making tools and processes related to DPC; ii) Prospective research studies in Tanzania and Senegal, including data collection to improve modeling efforts and economic analysis of this topic; and iii) Synthesis of data and harmonization of tools supporting global level policy and country decisions. Attached is an overview of the project and more details are available at http://jsi.com/JSIInternet/IntlHealth/project/display.cfm?ctid=na&cid=na&tid=40&id=22641

Next Generation Supply Chains – A Dialogue with EPI and Child Health Managers

Reposted from JSI's The Pump Jeff Sanderson,Senior Technical Advisor African immunization supply chains need to be transformed. Between 2010 and 2020, new vaccine introductions will quadruple the volume of vaccines per immunized child. The number of vaccine doses that health workers will administer is increasing six-fold. Evidence fromEffective Vaccine Management(EVM) assessments in70 developing countriesfound that in nearly all countries, immunization supply chains are not functioning well enough to ensure vaccine availability and potency and to meet coverage targets. Worse, only a few countries have prioritized supply chain strengthening as a strategy to strengthen immunization program performance. The future of immunization supply chains was the topic of an evening dialogue at the January 25-29, 2016 “Exchange of best practices workshop on Reaching Every Community (REC); Equity and Integration of Child survival interventions in East and Southern African Countries” in Cape Town, South Africa. The key theme of the meeting was to support the increase of coverage for immunization and child survival interventions through the reaching every community/child approach. This evening session, organized by John Snow, Inc. in collaboration with PATH, featured a panel of EPI officials from four African countries that aretransforming their public health supply chainsto accommodate the increasing demands on these supply chains from immunization and other health programs. Each of the four panelists discussed ongoing changes in their country supply chains; their key points are in the full blog post here.

Short course SCM Capacity Development opportunities, Feb 2016 in Dubai

Dear Technet Members, In February, Pamela Steele Associates (PSA) and Dr Andrew Brown will be drawing on their extensive experience in the health and humanitarian sector to deliver three popular training courses in Dubai, U.A.E: i. HEALTH SUPPLY CHAIN MANAGEMENT (14th – 18th Feb 2016) ii. SUPPLY CHAIN CAPACITY DEVELOPMENT (21st – 25th Feb 2016) iii. MANAGING HUMAN RESOURCES IN HEALTH & HUMANITARIAN SUPPLY CHAINS (21st – 25th Feb 2016) PSA use dynamic interactive approaches to engage participants in learning theory while equipping then to apply knowledge and newly developed skills to their local context. Detailed course descriptions can be found below, but if you require further information please do not hesitate to email us at info@pamsteele.co.uk. Apply now to register your interest, with payment due by the 17th January to secure your booking. Regards, Andrew N. Brown PhD BPharm Pamela Steele Health Systems Strengthening Consultant Director and Principal Consultant +61411137625,anbrown.hss@gmail.com +44 (0)7876699436,pam@pamsteele.co.uk Skype: andrew.brown.uc Skype: pamela.awuor.steele HEALTH SUPPLY CHAIN MANAGEMENT (14th – 18th February 2016) What is it about? Supply chain excellence requires that all of thefunctions of a supply chain work together efficiently. For example, decisions aboutproduct selection must inform decisions aboutdistribution modes, frequency of delivery, and storage specification. Similarly, rational use of pharmaceuticals is a critical for accurate quantification – which, in turn, effects procurement planning. Any supply chain strategy must consider these interactions and the associated trade-off’s between alternative approaches. The course structure is based on the 6 + 1 rights of a health supply chain: the right goods, the right quantity, the right cost, the right condition, the right place, the right time, and the right interventions. PSA’s training focuses on the higher–order skills required by supply chain managers to understand the end-to-end requirements for a sustainable health supply chain, rather than a narrow focus on individual activities.It is therefore important for everyone involved in supply chain management to have a demonstrable competence in each function. Who should attend? The training is targeted at people who areresponsible for planning, procuring, distributing or monitoring health programme supplies. It will be especially of use to those with a health professional background who are entering the health logistics and supply chain environment.Specific positions may include: Procurement Officers Pharmacy Managers Warehouse or Distribution Managers Health Programme Managers Information Systems Managers Staff of Central Medical Stores Technical Assistance providers Donors supporting commodity programmes For further information… Visit: http://www.pamsteele.co.uk/courses/health-supply-chain-management-hscm-dubai-2016/ Email: info@pamsteele.co.uk SUPPLY CHAIN CAPACITY DEVELOPMENT (21st – 25th February 2016) What is it about? Supply Chain Capacity Development (SCCD) is crucial for meeting the growing demands on aid delivery and as a key component of health system strengthening. SCCD is a complex and costly undertaking, which requires skills and knowledge beyond operational supply chain expertise. It is no longer about forecasting or procurement for the next campaign, or fire-fighting stock-outs. It is about systematically preparing for and undertaking capacity improvements. The course focuses on national health supply chain systems strengthening and related theories of change. Participants learn about what makes a supply chain functional, and how to approach supply chain capacity-building systemically, to make the most of supply chain development activities. Participants will also learn aboutthe tools and techniques for embarking on SCCDreforms within their organization, to detect early warnings of potential stock shortages, and to manage the entire supply chain capacity development programme cycle for successful and sustainable development. Who should attend? If you are seeking a good understanding of the overall SCCD process that breaks the silo mentality, struggling to build a compelling case for your SCCD programme or want to make informed SCCD decisions that lead to greater SCCD programme impact – this course is for you.Specific positions that will benefit from this courseinclude: Senior managers Decision and policy-makers Programme Managers Supply chain professionals (logistics/supply officers) from public and private sectors Technical Assistance providers who want to engage in meaningful SCCD action Students who want to learn more about SCCD tools and techniques For further information… Visit: http://www.pamsteele.co.uk/courses/supply-chain-capacity-development-sccd-dubai-2016/ Email: info@pamsteele.co.uk MANAGING HUMAN RESOURCES IN HEALTH & HUMANITARIAN SUPPLY CHAINS (21st – 25th February 2016) What is it about? This course uses a ‘plan-do-check-act’ approach to help supply chain managers better understand the importance of systematically engaging in the capacity development ofhumanresources. We use a locally-grounded approach which looks at five areas:‘policy and planning’, ‘leadership development’, ‘workforce development’, ‘performance management and retention’ and professionalization’. When applied, the strategies, tools and techniques developed in this course will enable participants to engage in meaningful management and long term capacity development of thehumanresourcesthey rely on to manage their supply chain. Who should attend? This course will be beneficial to any mid- or upper-level manager responsible for managinghuman resourcesin health and humanitarian supply chains, and capacity development employees from technical and multilateral organisations who engage with governments to promote systematic development ofhumanresources. For further information… Visithttp://www.pamsteele.co.uk/courses/managing-hr-in-health-and-humanitarian-supply-chains-strategies-tools-and-techniques-dubai-2016/ to see a more detailed description of the course content and the learning outcomes, as well as having the opportunity to watch a short video introduction from Dr Brown.

Cold Chain Policy vs. Cold Hard Reality: Thinking Inside the Box

Recently, I was sitting with the Expanded Programme on Immunization (EPI) Manager, his senior staff, and technical assistance (TA) partners in an African country, discussing support for better visibility and analysis of immunization supply chain data. The EPI Manager was willing to listen, but wasn’t sure his team needed help in data analysis. As for visibility, that was already being addressed: they using a web-based inventory management system that, among other things, providecold chain volumetric data (total capacity and used capacity). As we discussed plans to deploy the online tool at the district level and in facilities with internet connectivity, I asked if data was also collected on the other, non-EPI commodities that we know are often stored in the cold chain: some lab reagents, certain antiretroviral medicines, oxytocin, insulin, etc. The team seemed surprised by the question; “those aren’t our commodities,” the program logistician explained. True, I replied, but they do frequently take up room in the fridges (even if only in the short-term), so if it isn’t captured as part of inventory, then your volume data won’t give you the true picture of what percentage of capacity is really being used... Read the complete blog post here

Global polio vaccine switch confirmed for April 2016

The Strategic Advisory Group of Experts on immunization (SAGE) convened by WHO on 20 October 2015 has confirmed that the globally coordinated withdrawal of the type 2 component in the oral poliovirus vaccine (OPV) will take place in April 2016. SAGE’s landmark decision follows the endorsement by the World Health Assembly (WHA) in May 2015, when Ministers of Health from 194 member states adopted a resolution on the global effort to eradicate polio, as part of the Polio Endgame Strategy. In a milestone towards the switch, wild poliovirus (WPV) type 2 was recently declared as eradicated worldwide. WPV type 3 has not been detected globally since November 2012, and the only remaining endemic WPV type 1 strains are now restricted to Pakistan and Afghanistan. The globally synchronized switch is therefore of great significance for the polio eradication programme with tremendous public health benefits. Countries have already demonstrated an exceptional level of commitment to meeting the timelines of the Polio Endgame. In the lead-up to April 2016, countries should begin to intensify their preparations to be ready to switch nationwide from trivalent oral polio vaccine (tOPV) to bivalent OPV (bOPV) on any one day in the window from 17 April to 1 May 2016. It is also critical that countries meet established deadlines to protect populations by moving the world towards destruction of WPV2 type 2 stocks or their appropriate containment in designated ‘poliovirus essential’ facilities. The requirements for containment are detailed in the Global Action Plan III and steps for countries are summarized here. For more information on the OPV switch and reference materials to guide switch implementation, communications, training, and monitoring, please consult the OPV switch section on the Polio Endgame objective 2 website. In addition, the summary report from the SAGE meeting that confirmed the switch date is available here, and a statement from the Global Polio Eradication Initiative can be found here. Any questions on the switch can be directed to Alejandro Ramirez Gonzalez (ramirezgonzaleza@who.int) or Lisa Menning (menningl@who.int).

Travelling North (-25C – 15C)

WHO recommends 2 temperature ranges for keeping all vaccines at health facilities (+2C +8C) and (-15C -25C) for OPV above district level. The rationale for using first range is explained in “Thermostability of vaccines”. What is the reason for use of second range (-15C -25C) for OPV and some freeze-dried vaccines? Could (-5C -15C) or (-10C -20C) or other T range work instead?