TechNet-21 - Forum

Ce forum est un lieu d'échange où les membres peuvent poser des questions, partager leurs expériences, coordonner des activités, et discuter les récentes avancées en matière de vaccination.
  1. Project Last Mile
  2. équipement de la chaîne du froid
  3. mardi 12 janvier 2021

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

Given the need for ultra-cold chain (UCC) for an initial leading COVID-19 vaccine candidate, PLM was asked to conduct an analysis on the availability of liquid CO2 (LCO2) in the Coca-Cola value chain in 47countries in Africa to assist in meeting potential dry ice needs to support ultra-cold chain vaccine distribution. This was then expanded to include COVAX countries in Latin America and the Pacific Islands.

PLM completed a rapid assessment examining the feasibility of procuring LCO2 in 70 countries from Coca-Cola partners and suppliers across the three regions. This final report represents the culmination of this assessment. The aspiration is that this assessment will contribute significant insights to determining the operational feasibility of maintaining ultra-cold temperatures to distribute a new COVID-19 vaccine. It can also help inform where the COVID-19 vaccine may not be feasible or will require another CO2procurement approach.

Pièces jointes
Robert Steinglass Réponse acceptée
Appropriate product selection and effective use will be enhanced and confusion reduced by providing simple job aids about how to store and handle the different vaccines, especially when several vaccines are likely to be used in the same country. Here are the links to two CDC job aids, one on each of Pfizer and Moderna vaccines, followed by a handy link from the Immunization Action Coalition comparing these two vaccines.
 
 
 
 
Robert
David Sarley Réponse acceptée

Thanks Robert and of course country partners and experts will need to review.

The intention of the PLM work was to determine the pre feasibility of using dry ice to support UCC. The study looked to answer the question of whether there was sufficient existing dry ice capacity and if not whether liquid CO2 could be procured along with dry ice making equipment. The modeling work you mention was the same work by LLamasoft, now called Coupa that Sid Rupani presented to iSC2 partners WHO UNICEF and Gavi. The model looked to simulate vaccine delivery for 1% of the population requiring UCC. I don't have that original analysis but will check with Kelly Hamblin and Sid on whether it can be shared here. Both the Coupa modeling and the PLM analysis has been shared with iSC2 partners and shared and discussed with Pfizer.

The PLM report suggests options that can be considered for using existing dry ice capacity combined with some expansion of capacity and cross border transport. Any option would need full feasibility analysis with the experts you mention. This will clearly require careful consideration of the materials handling challenge as well as the capital and operating costs.

One key conclusion is that dry ice might present a lower cost option for UCC that may only be a transitory need as other C-19 Vx candidates become available that do not require UCC.

Regards,

 

David

 

Robert Steinglass Réponse acceptée

Thank you very much for sharing the highlights from this “Project Last Mile LCO2/Dry Ice Supply Feasibility Assessment for UCC vaccine storage/distribution in 70 Countries”.  

However, for the outputs of this work on managing a dry ice chain at scale within and across countries to be seriously considered, I believe that the underlying assumptions must be transparently and fully communicated, so that experienced immunization policy-makers and technical officers, managers, logisticians, and providers can then interpret these highlights and assessment findings -- and then decide whether the assumptions are appropriate and conclusions relevant in their local context.

Robert Steinglass  

Dan Brigden Réponse acceptée

Sharing below the key findings from this report as they are worth highlighting:

  1. There is abundant LCO2 capacity within Africa to support the ultra-cold chain requirements for the COVID-19 vaccination programme up to 1% of the total country population.
  2. There is immediate available capacity to produce dry ice in 15 countries, covering 59% of the target population for vaccination. There is sufficient dry ice capacity in those 15 countries to supply the remaining 32 countries immediately if air transport is used to move the excess capacity between countries. For Comoros, air transport appears to be the only viable option for dry ice supply. Estimated cost for immediate supply across all 47 countries is $13.9m for 1% of the total country population.
  3. Where air transport is unviable or undesirable, excess dry ice capacity from the 15 countries can be immediately transported to 13 neighbouring countries and by air to Comoros. For the remaining 18 countries, 15 dry ice plants can be installed in 13 countries and truck transport used to distribute excess dry ice capacity from the new plant installations to 5 countries. This will require sequencing for these countries, with potential delays of supply of between 12 to 30 weeks, dependent on whether additional LCO2 storage is required for the new dry ice plant installations. Estimated cost for sequenced supply across all 47 countries is up to $13.3m with up to $2.8m of that cost being investment in dry ice plant installation to supply to meet demand for vaccination of 1% of the total country population.

With thanks to Project Last Mile for sharing. 

Christine Ro Réponse acceptée

I would be interested in a presentation, thanks.

David Sarley Réponse acceptée

If there is demand we can propose a presentation and Q&A between the PLM team and country and global partners who may be interested in the feasibility of UCC for Covid-19 Vx. We can also organize some 1:1 or regional calls if you are interested in exploring this further. The PLM team are based in Europe, Turkey, South Africa and Eastern USA, so we are no constrained by Seattle PT time. Given limited resources, regional calls may be more efficient.  



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