Gavi Immunization Supply Chain Strategy

Strengthening Immunization Supply Chains

Increasing vaccine coverage and reducing under-five mortality through stronger immunization supply chains

In 2014, the Gavi Alliance partners developed the Gavi Immunization Supply Chains (iSC) Strategy focusing on strengthening country immunization supply chains. From the port of entry to the immunization in clinics, the supply chain is critical to ensure potent vaccines are available to the beneficiaries in an efficient manner.

The strategy is built on five fundamentals essential to strengthen the performance of immunization supply chains. The fundamentals are: Supply Chain Leadership, Continuous Improvement & Planning, Supply Chain Data for Management, Cold Chain Equipment and Supply Chain System Design.

Through the Gavi iSC Strategy, national immunization managers, implementing partners and other immunization supply chain experts will gain access to targeted technical assistance and guidance documents, tools, case stories and other material that can help them improve immunization supply chains in countries.

TechNet-21 - Forum

  • Dear all

    Routine Immunization programme is rapidly expanding in the country, more and more vaccines are included in the National Immunization Schedule [NIS] in phased manner. Rota Virus Vaccine is being introduced in Karnataka. As customary, in Dakshinakannada district, training programmes were held in 2 batches on 17th & 19th July 2019 in collaboration with WHO country office, this will be followed by training at block and planning unit level.

    With additional vaccines, additional cold space is required. Most of the multi dose vials have 10 or more doses e.g. 2mL OPV provides 20 doses, 5mL MR provides 10 doses, 2.5mL fIPV provides 25 doses. Currently supplied RVV is unique in the sense 5mL per vial after reconstitution has 2 doses of 2.5mL each. Hence the storage code is revised to accommodate Vaccine Vials if not the diluents.

    A Planning Unit in Karnataka is not having more than 30,000 populations, at 20 birth rate; estimated annual target of 0-1year children will be 600, on an average 50 per month. RVV vial requirement is 50 infants×3doses=150×1.11wmf [@90% usage] =166.5 doses +25% buffer stock=166.5+41.65 = 288.15; rounded off to 290. @ 2 doses per vial, 145 vials are needed with 145 diluents and 290 6mL oral syringes. Diluents and oral syringes can be kept outside the cold chain and required number of diluent vials need to be kept in the ILR at least 24hrs prior to the session.

    Karnataka has the luxury of having adequate planning units, majority do not have more than 350 children per year at least in the rural area. Author had revised the earlier storage code of 2012 designed for ILR’s with 2+1 baskets [140L] for 300L ILR with 3+2 baskets, submitted to the state government which issued official circular on 29 April 2018 to all the districts and planning units. Now, in view of above it is redesigned for operational use and submitting the draft to the government for needful.


    Dr Holla

  • Dear all

    During the routine visits to Medical Colleges, opportunistic proactive supportive supervision was provided which helps in updating the practices on the spot to keep pace with the current schedule.

    It also gives an opportunity to share the successful interventions through on the spot rectification and presentations.

    This being opportunistic and voluntary - it is a zero budget activity which anybody can do.

    Attached is one such example happened on 17 July 2019.

    Wish you happy reading




  • Nigeria EX-Scholars on the way to creating lasting impact

    WHO Scholar program a learning approach to bring sharing new innovations and intervention guideline to improving immunization system all over the globe has been widely received by Nigerians and other scholars in different countries across the globe.

    The WHO Scholar Program have deepen our knowledge in immunization system and how to improve in immunizations coverages in our different context and further creating lasting impact. In fact we now thinking differently outside the box towards bringing innovative ideas and strategies that will improve immunization program quality and coverage. This has been possible through having different learning methodology like the open webinars, short videos by experience course contributors from WHO, UNICEF, CDC etc, peer review process, sharing of guidelines by course team, whatsup platform, and other platform created by the Geneva Learning Foundation.

    Nigeria Ex-scholars who have completed one or more of the WHO Scholar courses have come together to meet digitally to brainstorm on the way forward towards implementation of the courses they have learn so far. They have decided to take a holistic approach towards Impact accelerators exercise, by this approach they have decided to harmonized all projects from the different courses such as Immunization coverage survey, Data Improvement plan, using Global Routine Immunization strategy practice to improve coverage, and reducing inequity and improving coverage into 4 harmonized documents with actionable recommendation and simplified strategies.

    Nigeria Ex-scholars have decided to go beyond learning, acquiring of certificate to creating lasting impact in the world of immunization in her country and globally, that will have significant impact in improving immunization coverage and strengthen Health system. This is an innovation!.

    Nigeria Ex-Scholars are leading the way for other countries’ scholars to follow, this is becoming more interesting because of high level of commitment and enthusiasm that have been seen by Nigeria ex-scholars and others towards impact acceleration. We continue to brace up until we make impact.

    Bravo to Nigerians Ex-scholars

  • Dear viewers

    KVG team wishes to share the "mini" successful story of one page with photos for information.

    Cross learning visit to an established "Demo-Site", practicing the acquired operational knowledge in the home institution on returning, retro visit for further fine tuning is one of the simplest, surest public health interventions in rapidly scaling up / replicating right practices for the successful outcome of a programme.

     Attached is "mini" example.

     Way forward: Opportunities to expand the benefit to wider geographical area in the state and the country.

     With warm regards

    Holla n Team   



  • Dear all 

    I wish to share the highlights of above CME held today (30-06-2019) by the IAP Dakshinakannad as felt need in association with District Health and Family Welfare officer, SMO WHO country office Mangaluru, KVG Medical College, Yenepoya Medical College, KVG Medical College Sullia, ~78 participants - mainly private practitioners.

    wish you happy reading



  • We are pleased to announce the launch of our new resource library available here: 

    What can you expect from the library: 

    - A faster (less than 1 second!) and more powerful search engine with more filters (type of document, category, language, disease, author...) 

    - More documents as our Cold Chain Equipment documents are now also available in the library  

    - You can now mass download your search result into a zip that includes a csv file with the resources info and all the uploaded files attached 

    - It's optimized for mobile devices 

    - You can choose between two grid views or a list presentation 

    - You can easily post comments on each document page 

    - The downlaod page offers a suggestion of related resources 


    And as before, if you see there's a relevant missing document, you can upload it in the resource library to make it available to all! 

    Our resource library is one of the most exhaustive immunization-related online library, we hope you'll enjoy it!

    Please do leave a post here if you have any question! 

  • EHC is a valuable method of obtaining excess energy from an SDD refrigerator, however an autonomous solar direct system powering USB ports is a simpler, more reliable and less expensive method of providing auxiliary power.

    USB ports can be powered directly from a solar panel, no batteries are required. The conversion device is simple and reliable; these ports can be used for charging cell phones, ipads, lights and AA or AAA batteries.There are a large variety of lights available: lanterns, directional lights, headlamps and lights with motion sensors. Jump starting car batteries can also be charged by a USB port. If desired a 12 volt port could also be incorporated to power a fan and if needed a 12 Volt battery. USB charged devices typically require an average of 3 watts of charging power. Twelve watts of solar per USB port will supply reliable charging at the beginning and end of the solar day and during overcast conditions. For 4 ports a 48 watt module would provide highly reliable power. This would charge at least 8 devices each day.

    Having an autonomous system for auxiliary loads has a number of advantages:

    - With EHC’s the controller is designed for a specific brand and model of refrigerator. An autonomous solar system will work with all types of refrigerators.
    - As a consequence of working with only a specific brand and model of refrigerators the aggregate cost of testing will be very high.
    - Testing must also be carried out for each specific type of load, resistive, battery charging, etc.
    - Trouble shooting system in the field will be much simpler with an autonomous power system there will not be the possibility of interaction between the two systems.
    - The autonomous system with USB ports would be inexpensive and easy to install.
    - When solar conditions are poor the autonomous system will provide more reliable power for a greater portion of the day.

    I would be glad to discuss the pros and cons of this system further. EHC’s are a good concept because a 60 watt load is typically powered by a 300 watt array. However, I think a separate autonomous system is a more appropriate solution.

  • Dear viewers


    Learning is a continuous prosess, attached is one such example applicable for the entire country with ~28000 planning units; presenting the attachment as an evidence for continuous learning.


    With best wishes 

    Holla n Team


  • Announcing a new Topic resource page: EPI Core Reference Materials, now available on TechNet here:

    On this page, you will have accesss to a list of key reference materials published by the WHO Expanded Programme on Immunization (EPI), organized by antigen, themes, and groups. This page will continue to be updated as new global resources become available, so check back regularly! 

    Remember you can also find all documents, as well as additional immunization materials, in the Immunization, Vaccines and Biologicals (IVB) Document Centre on the WHO web.


  • Dear all

    I encountered operational challege were during SIA, specifically OBR using mOPV2 antigen. I observed that the fixed post team were given only bOPV which is the right antigen for routine while ignoring the purpose of the campaign (mOPV2 not given). They were intructed to give both mOPV2 and bOPV concurrently in other to ensure children received RI and SIA doses. When we reffered to the stakeholders it was revealed that guideline stipulated that, child should receive only mOPV2 and resheduled for bOPV next contact. i have little imformation that needs clarification from immunzation experts and/or refference materials for capacity building in support of the guideline.

    1. What is the possible consequence of given mOPV2 and bOPV at same time? any scientific justification.

    2. Weighing the risk of missed oppurtunities and combining both antigens at same, which one should i prioritised?

    Thanks alot waiting for your input.

  • Dear Sir/Madam

    Wish to share that under the aegis of  IIHMR University, Jaipur, 05 days International training program on “Procurement and Supply Chain Management of Essential Medicines & In Vitro Diagnostics”  is scheduled from 26-30 August, 2019 at the IIHMR University Jaipur, India

    The objective of the training program is to provide technical guidance for establishing a robust procurement and supply chain framework for ensuring supply of good quality essential medicines and diagnostics

    Program Contents : -

    Managing selection of essential medicines and diagnostics 

    • Selection criteria’s
    • Significance of EML, EDL, STD and Formularies

    Quantification and Forecasting

    • Methods of quantification 

    Procurement of essential medicines and diagnostics

    • Strategic objectives of good pharmaceutical procurement
    • How to formulate tender specifications
    • Tender evaluation
    • Selecting correct procurement type
    • Selection of appropriate supplier
    • Procurement laws and regulations
    • Pooled procurement mechanism 

    Warehousing, Storage and Distribution

    • Guidelines for good storage practices
    • Receiving and arranging commodities
    • Monitoring and evaluation of drug distribution system 

    Quality Assurance and Donation of medicines

    • WHO Prequalification of Medicines Program (WHO PQP)
    • Quality inspections-Sampling and survey process   
    • Combating Not of standard drugs/spurious drugs
    • National guidelines on donation of medicines

    Max-Min Inventory control

    • Types of Inventory control systems 

    Logistic Management Information System (LMIS)

    • Types of Logistics records and their significance

    Rational use of drugs

    • Role of drugs and therapeutics committee
    • Diagnosis, prescribing, dispensing and patient adherence

    Pricing and sustainable financing

    • Donor funding and pricing mechanism

    Monitoring and evaluation of supply chain

    • Indicators for M&E of supply chains

    Policy and legal framework for procurement and supply chain

    • National medicines policy
    • Hands on training on Noninvasive techniques and rapid detection techniques for determining drug quality (Raman handheld spectroscopy)
    • Field visit to drug warehouse   

    PROGRAMME FEE        

    • For Indian participants                : Rs 37,500 per participant plus 18% GST
    • For Foreign participants             : USD 700 per participant plus 18% GST

    The fees cover tuition fees, training material, stay in air-conditioning room (twin-sharing basis), breakfast, lunch, dinner, tea/coffee during the program and pick-up and drop from Jaipur airport/railway station/bus stand. Welcome dinner and short-trip to historical and cultural importance places in Jaipur would be offered by the University in honor of the participants. Participants would be encouraged to use library facilities. Around the clock internet facility (Wi-Fi) is available for the participants.

    The travel tickets from the country of origin to Jaipur and vice versa are to be borne by the participant/sponsoring agency.


    • Early Bird Discount: Nominations received with payments on/before 4-weeks (29th July 2019) will be entitled to an early bird discount of 10%.
    • Group Discount: Any organization sponsoring four or more participants to the program will be entitled for a discount of 20% on the total fee payable provided that at least four participants attend the program.
    • Maximum Discount: Organization can avail themselves of both the discount subject to maximum discount of 20%.

    I am sure that you will find it useful for the organization/national health system program.

    I would be grateful, if you could participate/nominate interested candidates in the training program.

    You may forward to concerned department also

    Kindly send the interest to the program coordinator at  

    Looking forward for your kind cooperation and support to make the program success.

    A word of response would be appreciated.



    Dr.Saurabh kumar Banerjee 

    M.Pharm, Ph.D., MBA

    Associate  Professor and Program Coordinator

    The IIHMR University,

    1 Prabhu Dayal Marg, Near Sanganer Airport

    Jaipur (Pin-302029), Rajasthan, INDIA

    Office: +91 141 3924700, Ext: 789, 

    Mobile +91-8890398067


  • Dear all


    A visiting officer was discussing about as to how to practically keep vaccines in the cold-chain equipment at service points / planning units. Visiting officer was also discussing as to why the domestic refrigerator is not recommended by the CDC even for keeping vaccines as alternate equipment. On completing the discussion, thought of presenting the same in the coming Academic Society Meeting for the benefit of staff nurse, medical students, interns, post graduates who may have to provide vaccination services in their profession. Hence, we made this PPT using the photos taken at different planning units in different districts and states at different times for illustration. This is the draft PPT for presenting on 24-04-2019.

    Happy viewing

    Holla n Team

  • Supply Chain Strategic Focus Area

    Advance the Market Availability of Solar Energy Harvest Control-Equipped Cold Chain Equipment

    Date of notice: April 1, 2019


    Summary: Manufacturers of World Health Organization (WHO) Performance, Quality and Safety (PQS) prequalified solar direct drive (SDD) appliances that can be coupled with a market-ready energy harvest control (EHC) option are invited to apply for new product field evaluation support. Selection of participants will be limited to funding available in 2019 with selection priority as follows:

    1. WHO PQS prequalified SDD and WHO PQS prequalified EHC; followed by:
    2. WHO PQS prequalified SDD and EHC with evidence of WHO PQS compliance; followed by:
    3. WHO PQS prequalified SDD and market-ready (i.e., post prototype) EHC.

    Application deadline: May 1, 2019, at 17:00 Pacific Daylight Time (Seattle time)

    Awards decision target date: May 15, 2019

    SDD + EHC shipping date (by manufacturers): July–August 2019

    Project completion target date: March 30, 2020

    1.0 Goals and objectives

    The primary goal of Energy Harvest Field Evaluation Support (“the Project”) is to advance the availability and uptake of WHO PQS prequalified Energy Harvest Control (EHC) systems coupled to WHO PQS prequalified vaccine refrigerators, water-pack freezers, and combined vaccine refrigerator/ice pack freezers.

    It has now been demonstrated that solar direct drive (SDD) appliances coupled with an EHC can meet WHO prequalification requirements for safely harvesting excess SDD electrical energy and provide it for other health facility uses. There is interest in market development support to accelerate uptake of EHC systems. Energy harvesting is a new technology requiring technical support for immunization stakeholders to utilize appropriately. Also, as a new technology, WHO requires manufacturers to pass both a laboratory test and field evaluation for full prequalification. The field evaluation aspect is a newer WHO PQS requirement with significant cost to manufacturers and is an obstacle to market entry.

    To support the goal of advancing the availability and uptake of WHO PQS-prequalified EHC systems, Gavi has funded PATH to: (1) provide technical assistance to immunization stakeholders including Gavi, WHO, UNICEF, and national immunization decision makers on EHC-equipped SDDs and (2) provide support to competitively selected SDD manufacturers for fulfilling the WHO PQS field evaluation requirement. This Project will assess EHC and SDD technical performance, user acceptability, and system fit per WHO PQS field test requirements, including submitting a field evaluation to WHO PQS. PATH will be working with Sunny Day LLC, owned by Steve McCarney, as part of the Project.

    2.0 Project roles and responsibilities

    Manufacturers will be required to apply per this invitation, and provide two complete SDD + EHC system kits including solar power system and any energy consuming loads (e.g., lights) included in, or loads recommended for use with, their kit. The manufacturers must provide the kits free of charge and delivered duty free (Incoterm DDF) to the PATH country office in Senegal, where Round One has been successfully completed. The kits are to include the minimum WHO PQS warranty requirements and will become the property of the host country at the conclusion of the Project, including transfer of warranty provisions to host country.

    Performance monitoring plan and monitoring equipment will be designed, provided, and installed by the Project in consultation with manufacturers. Installation of the SDD system including solar array will be by the manufacturer’s service provider (preferably located in Senegal or the West African region) and their costs will be covered by the Project. The Project and Project consultants will supervise all installation activities. Performance data will not be made public; however, it will be reported to WHO PQS, Gavi, UNICEF Supply Division, the manufacturer, and the Ministry of Health and Social Affairs (MOHSA) of the host country, Senegal.

    The Project will:

    1. Coordinate with the Senegal MOHSA to arrange for necessary approvals, including of sites and in-country partners.
    2. Coordinate with PATH office in country to support field evaluation.
    3. Review, comment, and approve project plan and field evaluation criteria.
    4. Communicate with SDD EHC manufacturer(s).
    5. In consultation with manufacturers, select and provide necessary health facility structural and electrical upgrades, loads, and monitoring devices.
    6. Develop evaluation protocol and obtain necessary research ethics approvals, at PATH and in-country.
    7. Coordinate all field evaluation requirement aspects with WHO PQS.
    8. Provide pre-installation site assessments, installation, and post installation support to service provider.
    9. Monitor field evaluation progress and data collection.
    10. Analyze and report field evaluation data.
    11. Review, comment on, and approve final reports to WHO PQS.
    12. Protect all qualitative and quantitative performance data as confidential, except to the parties noted above (WHO PQS, Gavi, UNICEF Supply Division, and Senegal MOHSA).

    3.0 Application requirements

    Note to repeat applicants from Round One: your applications were sufficiently complete; therefore, please highlight any new information since your Round One application. Several changes are being implemented in Round Two. Your application must include user manuals for both the SDD appliance and the EHC system. If your application is selected, the Project will hire your service provider to: (1) conduct pre-installation site assessments at two health facilities selected by the Project for your specific equipment offering; (2) complete installation at two sites; and (3) return for user training at two sites. Manufacturer to provide outline of user training curriculum at time of application. Service provider to complete manufacturer-supplied commissioning form and submit all forms to PATH.

        3.1 One-page summary of all products offered, appliance PQS code, solar array details, load options required or recommended, and delivery time (PATH office, Dakar, Senegal).

        3.2 Support materials including all installation, maintenance, and user manuals, all component specification sheets (e.g., solar module, solar array support structure, array cable, EHC, EHC battery, and loads if provided) and if the proposed EHC is not yet WHO PQS prequalified, submit test results as evidence of compliance with the PQS   specifications. The application must present SDD appliance user manual, energy harvest user manual, user training curriculum outline, and commissioning forms for both the SDD and for the energy harvest system.

        3.3 Manufacturer must agree in writing to:

    1. All terms and conditions noted in this invitation;
    2. Provide to the Project (at no cost to the Project) two complete systems delivered duty paid to PATH office in Senegal;
    3. Facilitate the contracting of your service provider for aforementioned tasks;
    4. Accept PATH-supplied energy loads (e.g., small fans, lights, fetal heart monitor operating on AA rechargeable batteries, 50 Watt hour Lithium battery packs for user selected loads, etc.);
    5. Relegate reporting responsibility to the Project; and
    6. Keep confidential all performance data, quantitative or qualitative (not to be made public).

        3.4   Firm price quotation for service provider tasks noted above. Project to contract the service support by the manufacturer. 

        3.5   Send applications to or before 17:00 (Pacific Daylight Time) on May 1, 2019. Questions also should be emailed before 17:00 (Pacific Daylight Time) on May 1, 2019, to Your questions will be answered confidentially by PATH and/or PATH consultant Steve McCarney (directly and confidentially to the requestor).

  • Recent reports [1] of counterfeit yellow fever vaccination certificates in Zambia follow reports of falsified proof of vaccination documents being used in other countries, including Ethiopia [2], India [3], Nigeria [4], Pakistan [5], Sudan [6], Uganda [7], Tanzania [8] and Zimbabwe [9]. While the World Health Organization (WHO) published guidelines in 1999 [10] to support countries in developing measures to combat counterfeit pharmaceutical products and issued a report in 2017 [11] highlighting the public health and socioeconomic impacts of falsified medical products, neither publication discussed the current problem of false or fraudulently obtained proof of vaccination documentation. Counterfeit proof of vaccination in home-based records (HBRs), particularly those issued to provide documented proof of vaccination against yellow fever virus or polio virus [12], presents a threat to the health and security of countries and their citizens and warrants further discussion and action.

    Given the imperative of preventing the spread of vaccine-preventable diseases at a time when increased air travel and globalization link communities worldwide as never before [13], efforts seem warranted to (1) understand the magnitude and impact of counterfeit proof of vaccination and (2) work with national health authorities to develop practical counterfeit-deterrent strategies as part of the Eliminate Yellow fever Epidemics (EYE) global strategy (2017–2026) [14] as well as ongoing WHO activity around protection of essential medicines and health products [15]. Efforts to combat counterfeiting are also timely and urgent as part of the Global Health Security Agenda [16] as the likelihood of deadly, cross-border epidemics increases [17] and as countries continue to require international travelers to provide proof of vaccination as a prerequisite for entry (or exit) as part of international health regulations recommended by WHO [18]. This directive combined with improved enforcement at ports of entry into a country and a global yellow fever vaccine shortage [19] could further drive the demand for counterfeit vaccination documents.

    As providing proof of vaccination for travelers is one of several important HBR functions [20], HBRs deserve particular attention. For many travelers, proof of vaccination status is provided through a duly completed version of the International Certificate of Vaccination or Other Prophylaxis [18] recommended by the World Health Organization. In June 2007, a revised international certificate of vaccination was adopted following the 2005 revision of the International Health Regulations [21]. The revised certificate replaced the International Certificate of Vaccination or Revaccination Against Yellow Fever but did not include any anti-counterfeit guidelines or recommendations.

    The prevalence and impact of counterfeit medical products highlighted in the 2017 WHO report [11] point to a very real public health problem: a counterfeit problem that is not limited to medicines [22]. In Nigeria counterfeit proof of yellow fever vaccination records have been noted since at least 2012 when travelers from the country holding alleged counterfeit documents were denied entry by officials on arrival in Ghana [23] and South Africa [24]. As a result, the Federal Ministry of Health has attempted to curb the problem by issuing documents that included additional security features; however, a November 2018 report from Lagos airport highlights opportunities for further improvement as the problem of counterfeit documentation may continue [25].

    It is far too easy to dismiss HBR counterfeit incidents as a trivial matter. Such incidents are anything but trivial. More must be done to investigate HBR counterfeiting incidents with local authorities. Additionally, we must leverage existing knowledge and explore novel approaches to combat counterfeit proof of vaccination while also exploring design-related solutions to better ensure the integrity of HBRs. The risks of spread of vaccine-preventable diseases by international travelers is a public health concern [26], placing increased importance on safeguarding HBRs as a verified source of travelers’ vaccination status.



    The author acknowledges the editorial support of Ms Stacy Young of Applied Scientific Consulting in preparing this work.



    1. “Fake Health Certificates Scam Exposed.” Zambia Daily Mail Limited. 29 December 2018. Available online at: Accessed 4 January 2019.

    2. “Ethiopia to Launch Massive Yellow Fever Vaccination.” Ethio Dailypost. 26 June 2018. Available online at: Accessed 4 January 2019.

    3. “Fake Yellow Fever Vaccine Certificates Pose Risk to Whole Indian Population.” RESET. 19 Jul 2013. Available online at: Accessed 4 January 2019.

    4. “Ghana denies Nigerians entry over yellow fever card.” Daily Post. 25 July 2012. Available online at: Accessed 4 January 2019.

    5. “India warns against ‘fake polio certificates’.” DAWN. 9 October 2014. Available online at: Accessed 4 January 2019.

    6. “Sudan’s Vaccination Card Black Market.” The Daily Beast. 31 August 2015. Available online at: Accessed 4 January 2019.

    7. “Travellers Resort to Fake Yellow Fever Cards.” TravelSafe Clinic. 28 October 2016. Available online at: Accessed 4 January 2019.

    8. “Seven in Trouble Over Fake Vaccination Cards.” Daily News. 28 January 2017. Available online at: Accessed 4 January 2019.

    9. “Fake vaccination certs sold.” The Zimbabwean. 9 January 2013. Available online at: Accessed 4 January 2019.

    10. World Health Organization. Counterfeit Drugs. Guidelines for the development of measures to combat counterfeit drugs. Geneva: World Health Organization, 1999. Available online at: Accessed 4 January 2019.

    11. World Health Organization. A study on the public health and socioeconomic impact of substandard and falsified medical products. Geneva: World Health Organization; 2017. License: CC BY-NC-SA 3.0 IGO. Available online at: Accessed 4 January 2019.

    12. Soghaier MA, Saeed KMI, Zaman KK. Public Health Emergency of International Concern (PHEIC) has Declared Twice in 2014; Polio and Ebola at the Top. AIMS Public Health. 2015;2(2):218-222. doi: 10.3934/publichealth.2015.2.218.

    13. Brent SE, Watts A, Cetron M, German M, Kraemer MU, Bogoch II, Brady OJ, Hay SI, Creatore MI, Khan K. International travel between global urban centres vulnerable to yellow fever transmission. Bull World Health Organ. 2018;96(5):343-354B. doi: 10.2471/BLT.17.205658.

    14. World Health Organization. Eliminate Yellow fever Epidemics (EYE): a global strategy, 2017–2026. Wkly Epidemiol Rec. 2017;92(16):193-204.

    15. World Health Organization. Essential medicines and health products. Available online at: Accessed 4 January 2019.

    16. Katz R, Sorrell EM, Kornblet SA, Fischer JE. Global health security agenda and the international health regulations: moving forward. Biosecur Bioterror. 2014;12(5):231-8. doi: 10.1089/bsp.2014.0038.

    17. Suk JE, Van Cangh T, Beauté J, Bartels C, Tsolova S, Pharris A, Ciotti M, Semenza JC. The interconnected and cross-border nature of risks posed by infectious diseases. Glob Health Action. 2014;7:25287. doi: 10.3402/gha.v7.25287.

    18. World Health Organization. International Health Regulations (2005). Third Edition. Geneva: World Health Organization, 2005. Available online at: Accessed 4 January 2019.

    19. “What is behind the global shortage in yellow fever vaccine?” VOA News. 5 May 2016. Available online at: Accessed 4 January 2019.

    20. World Health Organization. Practical Guide for the Design, Use and Promotion of Home-based Records in Immunization Programmes. Geneva: World Health Organization, 2015. Available online at: Accessed 4 January 2019.

    21. Gostin LO, DeBartolo MC, Friedman EA. The International Health Regulations 10 years on: the governing framework for global health security. Lancet. 2015;386(10009):2222-6.

    22. Hamisu Hassan, Kate Kolaczinski, and Angela Acosta. Preventing, identifying, and mitigating the impact of fraud, theft, and diversion of insecticide treated nets: A summary of experience and best practices from country programs. VectorWorks Project, Johns Hopkins University-Center for Communication Programs (JHU-CCP), and Tropical Health LLP. 2016. Available online at: Accessed 4 January 2019.

    23. “Ghana denies Nigerians entry over yellow fever card.” Daily Post. 25 July 2012. Available online at: Accessed 4 January 2019.

    24. “On Yellow Fever, Yellow Cards, Nigeria And South Africa.” Nigeria Health Watch. 6 March 2012. Available online at: Accessed 4 January 2019.

    25. “Investigation: Inside Nigerian airport where cleaners, touts issue fake yellow cards to travelers.” Premium Times. 10 November 2018. Available online at: Accessed 4 January 2019.

    26. Gautret P, Botelho-Nevers E, Brouqui P, Parola P. The spread of vaccine-preventable diseases by international travellers: a public-health concern. Clin Microbiol Infect. 2012;18 Suppl 5:77-84. doi: 10.1111/j.1469-0691.2012.03940.x.

  • The BID Initiative is featured in the most recent issue (December 2018) of the MMS Bulletin #148 "Digital Health - A Blessing or Curse for Global Health."

    • "Marrying engineering with health policy to bring digital health to scale," by Steven C. Uggowitzer, Sima C. Newell, Dykki Settle, Alice Liu and David J. Hagan. 

      Just as medical doctors take the Hippocratic Oath as they graduate into their profession, so do many engineers solemnly promise to carry out work to the highest quality, recognizing that any errors may put lives at stake. Given this sharing of fundamental values, engineering is a profession that could be leveraged even further towards public health information systems to address opportunities created by the fusion of the early and relatively informal eHealth and mHealth paradigms into the more mature and complex one that is Digital Health. Recently, the World Health Assembly (WHA) adopted a key resolution on Digital Health, urging member states to assess and prioritise the scale-up of the implementation of digital technologies towards the “universal access to health for all”(WHA 71.1, 2018). For the full article, visit the MMS Bulletin.

    • "The challenges of implementing a data use culture," by Hassan Mtenga, Dr. Alex Mphuru, Dawn Seymour, and Laurie Werner. 

      To increase coverage and equity of routine immunization services, the government of Tanzania is strengthening the data use culture through the implementation of a package of data quality and use interventions, including an electronic immunization registry, for immunization service delivery. Three key phases for achieving scale as a government-owned model emerged during the implementation: user-centered design and testing, PATH-led implementation, and government-led implementation with scale-up. A combination of factors contributed to achieving a government-owned model of implementation and ultimately showed significant time and cost savings, as well as greater ownership and ability to sustain and scale the interventions. For the full article, visit the MMS Bulletin.

    Other articles in the MMS Bulletin #148 can be found here.


  • Hello,

    I am brand new to TechNet-21 so this will be my first posting. 

    I am trying to find an SDD (Solar Direct Drive) freezer which will maintain -10C and below. The product I need to store in Nigeria is surfactant (injected into the lungs of premature babies with collapsed lungs to give them life) which must be kept at that cold temperature to maintain a shelf life of 3 years. The electricity supply throughout the country in Nigeria is erratic and undependable, thus I would like to install an SDD freezer with a distributer (in Lagos) which would be independent of grid power. Surfactant is a very high value and low volume product so a smaller (50-100 liters) SDD freezer would be ideal.

    My understanding is the freezers designed for freezing ice packs may not maintain -10C and colder thoughout a 24 hour cycle which includes night.

    The only other solar option I am aware of is to revert back to older technology that relies on solar charged batteries to either operate a 12 or 24 volt DC freezer of use an inverter to power an AC powered freezer. I was hoping to eliminate the weak link in the system, the battery.

    To date I have not been able to identify an SDD freezer among the mainline manufacturers -- Dulas, SunDanzer, SureChill, Vestfrost, Haier.

    Thanks for any advice!


  • Dear TechNet-21 community,

    Further to the publication of the English and French versions of the Decommissioning and safe disposal of cold chain equipment guidance earlier this year (available here, we are glad to share with you that the Arabic and Russian versions of the document are now available in the TechNet-21 Resource Library.

    To access these documents, please click on the following links:
    1. For the Arabic version:
    2. For the Russian version:

    On behalf of UNICEF and WHO, I wish you an insightful reading and look forward to interesting and fruitful discussions with the TechNet-21 community!

    Michelle Seidel,

    Cold Chain Specialist - Immunization Supply Chain, UNICEF Programme Division (UN City Copenhagen)


  • New materials are available on the "Coverage Surveys" page of TechNet-21 ( on the "17 Steps to do a Coverage Survey".

    This collection contains a series of documents & presentations outlining the basic steps of a vaccination coverage survey, as well as some presentations on commonly asked questions and variations on a coverage survey. This also contains links to resources (templates, models, examples, etc).

    This link takes you to the drop box folder with all the materials.
  • A new issue of Vaccine is now available:

    Rotavirus Surveillance, Safety and Economic Data before Vaccine Introduction: a Global Perspective from the World Health Organization Global Rotavirus Surveillance Network 
    Edited by Adam L. Cohen, Negar Aliabadi, Fatima Serhan, Jacqueline E. Tate, Patrick Zuber, Umesh D. Parashar

    This can be accessed from:

  • A textbook from lectures we used to give at the “Ciro de Quadros Vaccinology Course for Latin America” just got published by the Sabin Institute:

    The book is available in English and Spanish.

    My chapter on information systems for EPI (part of section 3) is attached.

  • A new article Expenditures on vaccine-preventable disease surveillance: Analysis and evaluation of comprehensive multi-year plans (cMYPs) for immunization, recently published,  is available here:

  • The article Considerations for the development and implementation of electronic immunization registries in Africa, published this year, can be found here:

  • Herein lies the external evaluation results of the Smart Paper Technology Solution (aka MyChild Solution) in The Gambia which has assessed data quality, efficiency gains, operational costs, and the users’ experiences and perceptions associated with the intervention.

    In 2017, Shifo Foundation (Shifo), the Ministry of Health & Social Welfare (MoH&SW) of The Gambia, Gavi, the Vaccine Alliance, Action Aid International The Gambia, IKARE, Swedish Postcode Foundation, and Jochnick Foundation started working together to implement The Smart Paper Technology Solution (SPT) in The Gambia. To date, the SPT is implemented in the Western Regions 1 and Western Region 2, two out of seven regions in The Gambia. The real-time progress of work in The Gambia can be seen here.

    Since the inception of the programme in The Gambia, partners have identified key criteria to evaluate the effects of the programme and make informed decisions. This article summarises the results of the external evaluation conducted by Umeå University in May of 2018. The goal of the external evaluation was to assess four main attributes of the SPT in The Gambia, including 1) the data quality, 2) the annual operating costs, 3) the time efficiency gains for frontline health workers and 4) the users’ experiences and perceptions associated with the intervention.

    Data Quality Assessment

    The WHO Data Quality Review Toolkit was used as the framework to asses the data quality of the SPT over the course of three months. Data quality dimensions including 1) completeness and timeliness, 2) internal consistency and 3) external consistency were measured with this toolkit. The results indicated that completeness and timeliness of health facility reports were at 100%. The data was found to be internally and externally consistent. Moreover, the consistency between the reported data and the original records was at 99,95%. Lastly, the recording errors were between 0.7% to 1.5%. Therefore, the SPT scored highly in all of the data quality dimensions and it was concluded to generate high-quality data.

    Administrative Time Efficiency

    With the SPT, the frontline health workers’ administration time was reduced by 60% for each child who was fully immunised, receiving Vitamin A and deworming supplements.

    Annual Operating Costs

    The operating costs were measured by comparing the annual national cost of the current HMIS forms with the SPT in two different scenarios: excluding and including the monetary value of reduced time which is achieved with the SPT. When the monetary value of reducing the administration time with the SPT was excluded, the SPT (11,675.95 USD) was more expensive than the current HMIS (8,792.54 USD). When the monetary value of reducing the administration time was included, the SPT (3,944.10 USD) was cheaper than the current HMIS (8,792.54 USD).

    Users’ Experiences and Perceptions

    Interviews were conducted with frontline health workers and the regional health directorate staff to assess their perceptions of the SPT. The interviewees expressed how the SPT was user-friendly, how this solution delivered benefits to their health facility, and how the workload was less with the SPT when it was compared to the current HMIS. The health workers acknowledged the value of SMS messages sent to parents which remind them of vaccination due dates. The health workers also confirmed the importance of improving data quality. However, the interviewees also expressed how the initial registration of patients was time-consuming during the introduction of the intervention. The health workers also recommended that other health facilities adopt the SPT. In conclusion, the participants’ perceptions of the SPT were overall positive except for the initial registration of patients.


    The external evaluators provided a number of recommendations such as better planning and projection of the necessary human resources required for the initial registration of children. They also recommended the MoH&SW staff to work more closely with data verification. It may also be beneficial to return the Smart Paper Forms to health facilities after they have been scanned for the purposes of increased ownership. The evaluators expressed that scaling-up the SPT would be beneficial and they recommend it.


    The full reports and additional information about the Smart Paper Technology Solution (aka MyChild Solution) can be accessed using these links below:

    1. Assessment of MyChild Solution in The Gambia: Data quality, administrative time efficiency, operation costs, and users’ experiences and perceptions:
    2. About Smart Paper Technology Solution:
    3. Project progress in The Gambia:
  • The underground classic that explains how authentic activities help learners explore, discuss, and meaningfully construct new knowledge, GO AUTHENTIC: ACTIVITIES THAT SUPPORT LEARNING is now available for free download.

    When Risintha from Sri Lanka told me that he would never be the same again because he had discovered a life beyond PowerPoint, I thought that I had to share our approach to creating transformational value through authentic learning.

    The course activities that I share in this book have transformed people into change agents and helped them excel in their performances.

    The activities shared in this book work because they are well thought-out and aligned with all other elements of the course. They work because we do not lecture. They work because we believe that every single participant brings a wealth of experiences to our course environment. We respect each and every one of them as a “more knowledgeable other”. This is what makes the collaborative learning so valuable to all of us, including mentors. The activities described in this book work because they are part of a long learning journey, where we believe the end is nothing, but the road is all. They also work in eLearning programmes, because it is never “me and the computer screen”, there is always a human face, a mentor who supports learners whenever they need. They work because instead of shoveling information into learners’ brains and asking them to regurgitate it later, we focus on critical thinking, communication, collaboration, creativity, and, most importantly, on conation. They work because we view failures as an opportunity to learn. They work because we understand that creativity and innovation is a long-term, cyclical process of small successes and frequent mistakes. They work because we do not stop the clock and distribute a test. Instead, assessment is embedded in all of our authentic tasks. This is what makes the biggest difference. Nothing is abstract - all activities are based on authentic learning principles, just like how things work in real-life. These activities help learners to explore, discuss, and meaningfully construct concepts and relationships in contexts that involve real-world problems and projects that are relevant to them.

    I licensed this work under Creative Commons (CC) Attribution-NonCommercial- ShareAlike 4.0 International License (CC BY-NC-SA 4.0) so that it can be reproduced, remixed, tweaked or built upon non-commercially. Through this license, I continue offering a hand in support of open knowledge and free culture as I did with my previous two books.

    My dear friend Thomas Reeves in his foreword says that the design and implementation of learning environments must be acts of “authentic creation” more than ever before: “Go Authentic: Activities that Support Learning is, as Camus put it, a “gift to the future.” A future when learning will be active rather than passive, collaborative learning will be commonplace, tasks will be as authentic as possible, and assessment will be cherished rather than dreaded. In that hopefully near future, learning events will be as well-aligned as a precision racecar, and learning outcomes will be personally and professionally empowering. Ultimately, we hope that even participants in online versions of these authentic courses will shed tears when the courses are over just as they do now on the last day of the face-to-face courses.

    The need for transformational learning opportunities is evident in many fields beyond public health and pharmaceuticals. Enhancing human performance is absolutely essential if we are to meet the challenges facing humankind with respect to climate change, poverty, war, corruption, and the like. Arguably, we live in a time when education and training opportunities across all disciplines must become as transformative as the courses described in this book. To do this, the design and implementation of learning environments must be acts of “authentic creation” more than ever before. Please join us.”

    When it comes to helping learners, you cannot waste their time.

    Go authentic!

    For free download please visit

    The book is available both in interactive PDF (38.1 MB) and ePUB3 (13.3 MB) versions.

    216 pages, including a detailed review of 44 learning activities and games and 30 icebreakers and warmups..

    Happy downloads...



    Extensio et Progressio

  • Hereby to share a new resource on IIS produced by the Vaccine-preventable diseases at ECDC in collaboration with partners globally:

    Designing and implementing an immunisation information system. A handbook for those involved in the design, implementation or management of immunisation information systems

    We would like to hereby acknowledge the contribution of a number of experts in contributing to this report and providing case-studies based on their experience in Immunisation information systems. We hope this document will prove relevant in further informing decisions and discussions at National Level.

    The handbook proposes strategies that build on the experiences of IIS experts; provides case studies from actual programmes to highlight particular aspects of IIS practice, including functionalities, benefits, challenges, and implementation. It aims to share experiences and explore ideas that IIS experts consider valuable for developing a new IIS or upgrading an existing system,. 

    The handbook is intended for all those involved in the design, implementation, management or continuous improvement of IIS, such as immunisation programme managers and operational IIS staff; and also public health experts and policymakers.

    For more information please contact Tarik Derrough, Senior Expert VPD team, ECDC 

  • 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.

  • 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: 

    For more information, please contact: 


     HR country support package

  • People that Deliver Launches a New Resource for Health Supply Chain Practitioners: the Human Resources for Supply Chain Management Theory of Change

    Like all chains, supply chains are no stronger than their weakest link. Although hundreds of millions of dollars in commodities flow through the health supply chain (SC) system, the critical, strategic function of the supply chain within health systems is rarely acknowledged—and the SC workforce seldom has the right technical and managerial competencies to perform optimally or the empowerment to affect supply decisions and policies. Insufficient numbers of competent staff can cause breakdowns in supply chain systems and lead to poor system performance. The Human Resources for Supply Chain Management Theory of Change (HR4SCM ToC) analyzes the conditions needed to ensure that workers at every level are performing optimally, in order to fulfill all the necessary functions of an effective supply chain system.

    A theory of change (ToC) describes how a desired change is expected to occur. The HR4SCM ToC provides a useful basis for strategic planning, by providing a foundation for developing strategies—such as to manage the quantity, type, and capacity of human resources required to operate health supply chains. It also serves as a foundation for monitoring and evaluation, by specifying how to measure activities undertaken to make change. The HR4SCM ToC resource also captures complexity in a concise form and allows users to understand how a number of program activities link to one another and lead to program goals.

    PtD has developed two resources for the HR4SCM ToC - a two-page brief provides a high-level overview of the HR4SCM ToC describing the four pathways to success, our long-term outcome, and our foundational principle as well as a  longer narrative that covers the HR4SCM in more detail, with a full description of the critical assumptions, an explanation of the ToC diagram, and an indicators and interventions catalog. All HR4SCM ToC materials are available for download on the People that Deliver website ( The HR4SCM ToC’s official launch will take place at the Global Health Supply Chain Summit in Lusaka, Zambia on 27 November, 2018 ( HR4SCM ToC co-author Dr. Andrew Brown will facilitate a pre-conference workshop on Using a Theory of Change and whole of SCM labor market approach to catalyze country investments to improve HR for SCM: A practical toolkit. If you are attending GHSC and would like to participate in the workshop, please fill out this online form:

    The HR4SCM ToC can be found here:

    About People that Deliver
    The People that Deliver (PtD) Initiative was established in 2011 as a global partnership of organizations focusing on professionalization of supply chain personnel by advocating for a systematic approach to human resources (HR) for supply chain management (SCM) at the global and local level. It is based on the global recognition that without trained professionals to manage the health supply chains, drugs and other health supplies do not reach the patients who need them.

    Alexis Strader, Project Officer
    Tel: +45 45 33 57 99

  • New article on "Global Routine Vaccination Coverage - 2017" was recently published in the CDC MMWR.

    Article can be accessed here:

  • 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: Interested in contributing to the subsite? You can find guidance on the iSC topics page here:

Gavi Bill & Melinda Gates Foundation WHO Unicef