Discussions marquées : Ice-lined

WHO PQS Manufacturer Consultation Report

Denise Publié dans :
Dear TechNet Community, On Tuesday 10th July 2018, the WHO Performance, Quality and Safety (PQS) Working Group conducted its first face-to-face technical consultation with manufacturers of PQS prequalified immunization products and devices from the E003 (Refrigerators and freezers) and E006 (Temperature Monitoring Devices) equipment categories - some of you may also have followed the event in real time via the TechNet-21 Twitter account. Thirty industry representatives took part in the meeting, alongside ten non-industry members and partners of the WHO PQS Working Group, to discuss and agree on a path forward for some significant proposed changes to immunization cold chain equipment standards. The PQS Manufacturer Consultation proved to be a highly successful first step towards greater collaboration with manufacturers on PQS standards-review and standards-setting processes. In particular it provided manufacturers with greater visibility on in-country realities and complexities and helped solicit industry insights and inputs on technical and product solutions to meet varying challenges in EPI program environments. More insights on the themes covered during the meeting as well as key discussion points and meeting outcomes have been provided in the PQS Manufacturer Consultation Report. The report can be accessed in the TechNet Library by clicking on the following link: https://www.technet-21.org/en/library/main/4926.  Enjoy the read! On behalf of the PQS Team,  Denise 

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

Total Cost of Ownership (TCO) tool version 1.4 available now

We are happy to announce the latest version of the Total Cost of Ownership tool for cold chain equipment (v1.4) is now available to download and use. If you have been using an earlier version of the tool, please download the latest version from the link below.   Version 1.4 includes filters for CCEOP eligible equipment, as well as filters for refrigerator/freezer combination devices.  The latest version of the TCO tool contains PQS pre-qualified equipment as of May 2017. Please download the latest version (in English or French) for the most up to date products and pricing. http://www.path.org/publications/detail.php?i=2576  If you have any questions or would like any training/demos please email Matt Morio mmorio@path.org

Ice-Lined Refrigerator & Freezer

Dear Colleagues, As known that Ice-lined refrigerators are the best choice wherever there is at least 8 hours electricity a day, but what about producing ice-packs for immunization session (e.g. outreach sessions) under the same supply of electricity (=< 8hrs)? What will be the better decision to make here? maybe consider the combined icelined refrigerator/ freezer (not many options are available on WHO PQS devices catalogue) , or consider a stand- alone deep freezer for ice production (even though the holdover time for the most modules is about 3 hrs) ! Best regards,

Measurement of Condensation

We are working with ILRs. While daily operations, it was found that there is formation of water droplets inside the device. We want to measure the amount of condensation taking place inside the device in a day. We also tried to calculate the Dew Point Temperature but not much useful. Kindly suggest some method or way to measure the condensation. Regards Akhil

Vaccine Storage in Cold Climates

Most ice-lined refrigerators in India are fully functional at 5 - 45 degrees Celsius (ie, they are able to maintain an internal temperature of 2-8 degrees Celsius when the external temperatures are between 5 and 45 degrees Celsius). Some states of India have an extremely cold climate during winters (for example, the areas of Jammu and Kashmir, Uttarakhand, Sikkim that are in the Himalayas) and so they are prone to high rates of vaccine freezing.
I am sure this is a problem experienced by program managers of Russia, Canada, Greenland, Iceland, northern Europe, Alaska, etc and would be extremely grateful if they could share how they have managed to tackle this in their respective countries/regions.
The only resource that I have been able to find till now after an extensive search is "The Warm Chain", which suggests the use of a low ambient temperature refrigerature which provides protection upto -5 degrees Celsius.Does WHO have any guidelines regarding this?
A related question would be - how do we arrange for outreach immunization in such cold climates? What sort of ice packs should be used in such a scenario?
Warm Regards,
Dr. Tapas Sadasivan Nair

La version française de l’outil de calcul du Coût Total de Possession (CTP) d’équipements de la chaîne du froid est maintenant disponible.

Matt Morio Publié dans :
Outil de calcul du Coût Total de Possession d’équipements de la chaîne du froid
L’outil de calcul du Coût Total de Possession (CTP) d’équipements de la chaîne du froid a été développé afin d’assister les utilisateurs dans leur compréhension du coût d’achat et de maintenance des équipements de la chaîne du froid. L’outil peut être personnalisé pays par pays et calcule les dépenses en capital et en coûts d’opération pour les équipements préqualifié par le département Qualité et Sécurité de l’Organisation Mondiale de la Santé.
Pour accéder le CTP cliquez ici: https://www.path.org/publications/detail.php?i=2576

Universal, hybrid refrigerator for vaccines?

Among the TECHNET postings on cold-chain equipment there are embedded remarks pointing towards the need to make vaccine refrigeration simpler and less expensive to procure, more responsive to energy changes and easier to use and maintain. For example, to choose a refrigerator now current WHO, UNICEF and GAVI guides require that you make equipment choices according to energy availability and quality conditions. But in practice, energy availability and quality are changing, they do not remain static over the life of the equipment. The grid may arrive, or it may deteriorate; you may need a standalone refrigerator or one included in solar energy providing for a whole health facility. Solar direct drive refrigerators and Ice-lined refrigerators are starting to share the same design, both using an ‘energy buffer’. Opportunity exists to merge these two refrigerator types in a single model able to run with electrical grid electricity or solar energy or both linked together. Advantages of this hybrid include flexibility for the same refrigerator to adapt to any energy situation, greater production quantities will reduce excessive price differences between the two types and refrigerators are likely to adopt front door opening as the most usable, more compact installed and more efficient at avoiding freezing. Your opinions will be much appreciated to continue this reasoning!

PATH’s cold chain equipment Total Cost of Ownership tool now available

Matt Morio Publié dans :
PATH’s Total Cost of Ownership (TCO) tool for cold chain equipment is now available for download and use. The TCO tool is designed to help countries compare and understand the costs associated with the purchase, installation, and ongoing operation of cold chain equipment. The tool currently covers 82 cold chain equipment devices including all 72 PQS (Performance, Quality and Safety) prequalified devices from the E001 (cold rooms and freezer rooms), E003 (refrigerators and freezers), and the long-term passive devices under E004 (cold box and vaccine carriers) categories. Using local country costs such as labor and energy rates, the TCO tool calculates costs for purchasing and operating cold chain equipment over time through multiple views such as: cost over useful life, cost per liter of storage, and recurring operational costs. Additionally, the tool can incorporate facility segmentation requirements to match equipment and country needs. These features not only allow users to understand cost differentials of one technology versus another (absorption gas refrigerator versus solar direct–drive refrigerator), but they also provide the ability to drill down and compare costs on a model by model basis over a user-defined horizon from 1 to 20 years. The TCO tool can be downloaded from PATH via the following link: https://www.path.org/publications/detail.php?i=2576. After downloading, please check back regularly to ensure you have the latest version/updates. A large thank you to all who have contributed to our efforts developing the tool. The total cost of ownership tool for cold chain equipment was made possible with support from the Bill & Melinda Gates Foundation. Please send any questions or comments to Matt Morio mmorio@path.org.

Temperature Display

Dear Colleagues, Many of the prequalified refrigerators have integrated digital thermometers with digital display outside showing instantaneous temperature readings. During the field visits, I have started to notice considerable number of refrigerators with non-functioning digital display. I am curious if this is a coincidence or commonly observed problem. I would be happy to hear your experiences and suggestions. Thanks, Murat


Potency of vaccine at the time of administration to the beneficiaries is of utmost importance in preventing morbidity and mortality due to vaccine preventable diseases. Evolution of more and more vaccines against crippling and lethal diseases has made vaccination the most cost-effective and important strategy from control to eradication. Domestic refrigerators with horizontally opening vertical door is not recommended by WHO for keeping vaccines for certain reasons leading to excess“temperature excursions”.However, it appears that the storage code is not evolved enough to make the best use of the right equipment (ILR) recommended by the WHO. Since I had problems responding to some of the questions asked by the vaccine / cold chain handlers, I am sharing these questions with the cold chain specialists for addressing the same.

Considering a Max/Min range for Vaccine Storage Capacity in refrigerators

The percent difference between the gross refrigerator (ILRs and SDDs) volumes quoted in the PQS Catalogue and the net vaccine storage volume varies from 29.6% to 88.6 %. This is a wide variation for front opening fridges, due to space for air-circulation. Increasingly, new models of ILR and SDD are emerging with cooled internal walls and cooled ceilings. Some of these models maintain a satisfactory internal temperature distribution whether they are packed according to the test procedure (with air spaces) or when the vaccine load fills the whole gross volume (without air spaces). The impact of this finding is that the storage capacity of a new model of ILR or SDD may be double or even treble the catalogue figure. The difference in capacity at intermediate levels of storage in-country will affect the economic decision to procure a cold room or maintain a bank of ILRs or SDDs. Running costs will be affected. Cold-chain equipment planners be made aware of this issue when they choose new equipment and when they re-equip stores. What about these next steps – just my own suggestion? we maintain the method of loading by the test laboratories that uses 1.0 and 0.5Lt. boxes and we maintain the 'net vaccine storage capacity' measured by the laboratory. But I suggest that this parameter be titled 'Minimum vaccine storage capacity'. we maintain the manufacturer's gross capacity, but we add a 'Maximum vaccine storage capacity' that is measured by the laboratory as the maximum vaccine load (represented by the dummy load) without airspaces, without baskets or shelves IF this extra loading step is done (Optional, requested by client) then: ◦ the Maximum vaccine storage capacity is reported by the lab. and entered in the catalogue ◦ the rest of the testing that requires a dummy load would be loaded according to the Maximum capacity IF it is not done, the Maximum capacity will be the same as the minimum and the Minimum capacity will be loaded for the rest of the testing. the country clients for cold chain equipment would be informed that the laboratory reports generate a range of capacity (Min./Max) for each refrigerator and that, within this range and according to the vaccines they use, the country managers can choose a value for the Vaccine storage capacity in that country. The consequence of this approach is that ILRs and SDDs with satisfactory temperature disitribution performance even when fully loaded, will be more efficiently loaded, less numerous in larger stores and less energy and space consuming. Usually, this would result in lower cost of procurent and maintenance. Also, the coldchain manager has an opportunity, even an obligation, to check the capacity that he/she will use when equipping stores to better correspond to the vaccines in use. Finally, if an equipment model requires airspaces to assure a correct temperature range, then the manufacturer does not invoke the additional measuremnt during testing - the dummy vaccine load simply reverts to the current procedure.

Ice-lined refrigerators: Time to rethink this product?

Icelined refrigerators have become a dominant standard worldwide for the safe storage of vaccine in areas of unreliable electricity supplies. In the 35 years since the start of the Product Information Sheets not a single upright, domestic compression refrigerator has been posted in the pre-qualified catalogue of WHO for a sustained period. Yet upright, domestic refrigerators that are used to store vaccines are far more numerous than the Icelined refrigerator in spite of the published risks of exposing vaccines to heat and freezing. Industrialized countries with multi-national manfacturers of refrigerators use domestic refrigerators in immunization clinics or pharmaceutical refrigerators in larger facilities. Even low to middle income countries are increasingly commercialising their own domestic refrigerators under license from the multi-nationals. Countries such as Morocco, Tunisia and Algeria use domestic refrigerators bought on the local market and only a few Icelined refrigerators in larger stores. Looking forward to the near future, two changes are likely to alter procurement preferences for Icelined refrigerators. First, there is a new acceleration of demand for storage of vaccines and for medicines for non-communicable diseases classified for refrigeration or controlled room temperature. Not only are quantities and volumes increasing but the diversity of presentations of vaccines is also growing. Until now the icelined refrigerator has been top opening due to the original parent, the chest freezer. Managing stocks of meat is easy in a chest freezer but as vaccines and presentations increase managing stocks becomes increasingly difficult. Front opening refrigerators provide better access to shelving where vaccine containers can be arranged for better identification. A recent trend may make it possible to improve vaccine management and swtich more domestic refrigerators to Icelined. Motivated by the recent market popularity of American double-door domestic refrigerators, European manufacturers are offering their biggest refrigerators and freezers in pairs with identical external casing at prices far lower than the US counterparts. Converting the heavily insulated freezer of this pair to an icelined refrigerator for vaccine should be practicable by using an icebank situated at the top of the appliance. In this way the high prices of pharmaceutical refrigerators can be avoided and the Icelined refrigerator could be incorporated into the assembly lines of european and other international manufacturers product lines. A voltage regulator and highspeed circuit breaker should be incorporated as standard and a set of thermal sensors to link with proprietary temperature monitoring instruments procured separately. Two more stimulae to the use of the Icelined refrigerator worldwide would be first to regulate the vaccine refrigerator as a medical product to steer procurement away from standard doemstic refrigerators. The second would be to organise regional pooled procurement of the Icelined, front-opening refrigerators to assure a big enough market to interest manufacturers.
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