Making the leap into the next generation: A commentary on how Gavi, the Vaccine Alliance is supporting countries’ supply chain transformations in 2016–2020

Gavi, the Vaccine Alliance is a global public-private partnership with the goal of supporting the national governments of low-income countries in their efforts to increase equal access to vaccines. Gavi aims to immunise 300 million children between 2016 and 2020, preventing 5–6 million future deaths in the process. One precondition to achieving this goal, however, is strong, adaptable and resilient supply chains. Through its supply chain strategy, the Alliance supports countries in driving change and delivering improvements across five fundamental supply chain components – thus helping to realise the next leap forwards. These components are: an evidence-based, continuous improvement approach; robust data and information management systems; sufficient and skilled staff; reliable and efficient equipment; and, optimised design of systems. Today, these supply chain components often constitute bottlenecks and national governments and their local partners find that efforts to reach many communities are impeded [7] ; [8]. Too often, focus is limited to just one aspect of one supply chain component, lacking sufficient scale and breadth to drive sustainable, systemic improvements [7]. For example, countries might purchase more of the same cold chain equipment without systematic efforts to introduce devices that offer better value, more appropriate size or greater reach to under-served parts of the country [9]. Similarly, an array of diverse information management systems have been developed to meet countries’ specific needs, but in the absence of clarity on how the data will be managed across the country or how the computer programme will be maintained [10]. What’s more, to overcome the diffuse and deep-rooted causes behind these bottlenecks, improvements must take place in parallel, because the components are often so closely interconnected. Like the cogs of a machine, as one part turns, so must the rest. Driving change across each component, and in parallel, calls on coordinated responses from the full range of immunisation supply chain stakeholders. Yet too often, individual organisations work on tools, policies or funding without interconnection, or without linking to the countries and logisticians that will utilise them. The Vaccine Alliance sits at the intersection between the manufacturers of supply chain products and their end-users, between immunisation policy-shapers and those who help fund programmes. The wide range of Alliance partners offer their comparative advantages from the technical expertise of development organisations, like the World Health Organization (WHO) and UNICEF, to the market knowledge and innovations of industry. The crucial alignment of actors that makes up the Vaccine Alliance is well-placed to support transformational change.