In recent weeks and months, both positive and negative reports have appeared in the international press about the rat race for an effective Covid-19 vaccine. Almost all newspapers and magazines make a new ranking every month of which company will be the first to market an approved vaccine. To give the population a perspective and hope, governments communicate that they have already reserved millions of doses from various producers worldwide.
This article also appeared in De Tijd. Co-author: Frank Van Gelder - Secretary General Pharma.Aero
A weak supply chain can destroy the quality of the vaccine
This week, several logistics parties have cited that not only the development of the vaccine is a feat, but that rolling out the logistics chain for the distribution of a Covid-19 vaccine will be particularly challenging. IATA, the international airline federation, said this week that the transportation of the Covid-19 vaccines would require more than 8,000 747 jumbo freighters. Besides, DHL, among others, also indicated that it saw various logistical problems with the distribution of the Covid-19 vaccine. When a vaccine is finally on the market, it will be a tour de force to distribute those 800,000 tons of vaccines worldwide from the production sites. However, there is not yet a proven logistics chain that can guarantee worldwide that the vaccine will reach the patient qualitatively.
The traditional logistics chain can be divided into several parts: incoming logistics, production, outgoing logistics and last-mile distribution. We expect no real issues the pure incoming and production part. Incoming logistics mainly deals with large standard volumes of essential raw materials that are supplied on a pallet by air or sea freight, often from China or India. The pharmaceutical giants are now preparing to start producing their respective candidate vaccines in the meantime. Production of the vaccine will mainly take place at facilities in Europe, the United States, China and India.
Temperature-stable environment must be guaranteed
The challenges are mainly situated in the outbound logistics area. The pharmaceutical sector has traditionally cooperated with aviation companies for the worldwide transport of medicines and vaccines. This often involves logistics flows in which a temperature-stable environment must be guaranteed. Such an environment is comparable to the transport of fresh fruit that is often flown chilled from South America and Africa to the West. Industry specialists warn that the young vaccine, with relatively unstable molecules, will probably have to be stored at freezing temperatures of -18 ° C or below and can only defrost six hours before injection. The shoe pinches at the outbound logistics, we, therefore, foresee here four major potential obstacles:
"Aviation has solid experience with refrigerated cargo, but not with freezing temperatures and definitely not for that massive volume."
The majority of current pharmaceutical products are standard refrigerated streams that are distributed worldwide via refrigerated containers. Frozen flows are, however, relatively unknown in aviation. It is precisely the maritime sector that responds much more to frozen transports via reefer containers. But with frozen products, the pharmaceutical industry has relatively little experience in the outgoing part of the logistics chain. The dry ice, necessary to keep the cargo at the required negative temperature, also adds a tremendous amount of weight to the transport. As with the protective equipment, it will be a matter of searching to find enough air cargo capacity from the chosen production facilities, but ar bridges have shown in the past that the aviation sector can handle this.
"Only a limited number of airports worldwide are suitable to guarantee the cold chain of at least -18 ° C."
When the vaccines arrive at the destination airports, the problem of maintaining the cold chain arises. It must be guaranteed for the entire duration of the transport that the temperature of the vaccine has been at least -18 ° C. The handling from the aircraft and the placement in a deep-freeze warehouse create the main challenges. Transiting the goods on the sweltering tarmac of the hot transit airports like Dubai or Doha will be a challenge. Moreover, there are only a limited number of airports worldwide that have sufficient deep-freeze warehouses available. For example, there are only four airports in the entire African continent that have this option. In addition, pharmaceuticals and food may not be stored in the same room. The Covid-19 vaccine is likely to temporarily push out from the fridges certain fresh food and flower flows.
"There is hardly any monitoring of temperatures across the entire chain."
A logistics chain often consists of different parties, each individually responsible for specific tasks such as road transport, storage, handling, customs clearance, transport to and loading of the aircraft and air transport. As a result, there are far too few integrated logistics chains worldwide that can monitor and guarantee the stability of the temperature during all intermediate steps. It is precisely those temperature fluctuations that are crucial for the quality of the vaccine. Moreover, dry ice is not a panacea for keeping the goods at -18 ° C or below for a longer period of time. There are technological solutions on the market, such as temperature sensors that are read via beacons and smartphones. These are already in use in the local frozen food chains but are hardly used in the intercontinental logistics of pharmaceutical products.
"Last mile distribution: the potential quality killer ... "
Potentially the most complex part of the logistics chain, as is often the case, is the last mile or the distribution from the local frozen warehouses to the hospitals, pharmacies or doctors.
Here also the problem of available local warehouse capacity arises, and hence temperature stability and monitoring during distribution. Today it is assumed that there is sufficient refrigerated warehouse capacity on the market. However, this is only partly true. In Western economies, there is indeed sufficient cooling capacity available on the road, but for the frozen segment this is mainly used for pallet distribution. Examples of this are countless at the many frozen vegetable producers in West Flanders and large food retailers that operate frozen warehouses with a separate distribution chain. However, this is a problem for the pharmaceutical distribution, because it hardly transports frozen products. So either dry ice will have to be used again, with the risk that doing this a second time can reduce the quality of the vaccine. Either one will have to actively cool the last mile and to do this enter into a partnership with companies that now supply food and beverage shops and retail. Another option is passive cooling with cool boxes, as is sometimes the case with online food webshops. Passive cooling, however, means that there may be a maximum of 12 hours between departure from the warehouse and delivery to the hospitals, doctors or pharmacies. Apart from the availability of the necessary material such as sufficient cool boxes, dry ice and refrigerated trucks, this is a particularly challenging assignment in less populated areas or developing countries.
High time for clear protocols
A vaccine will probably be available in the first quarter of 2021. However, the distribution of this vaccine will be an unprecedented tour de force. A faulty approach to the logistics chain can potentially partly nullify the feat of vaccine development. It is therefore high time to start preparations that look beyond just air transport from airport to airport only. Brussels Airport and pharma-logistics federation Pharma.aero are already working hard on finding solutions to handle this volume. However, it is high time that the European Commission and national governments to establish clear protocols with the WHO for the requirements for the distribution of Covid-19 vaccines, including the last mile. We plead for the appointment of a task force with experts from the medical logistics and aviation sector now. The tour de force that the pharmaceutical industry is currently taking to develop a vaccine can also be done by the logistics industry, as long as it is clear what the possible scenarios for protocols, timing, quantities and standards could be.
Earlier, Prof. dr. Wouter Dewulf (UA) and Prof. dr. Roel Gevaers (UA) posted the blog 'The end of cheap online orders from China'.