Preparations beyond only setting up logistics are needed to ensure on-time availability of the vaccine!
The vaccine is coming, are Supply Chains ready?
With a large number of COVID19 vaccines in Phase II or III of clinical trials, it’s a race against time for the world to scale supply chains and implement policies to ensure vaccines availability!
Over the past couple of days, the daily count of COVID19 in India has been dwindling. While it may appear things are getting better, and the situation is in control, there is a likelihood of a second wave hitting India, post the festive season that runs for around 20 odd days, between 22 October to 15 November.
People do not fear the virus-like they did. They are out and about, flocking the streets, shopping, socializing, etc. And who can blame them? The past 8–10 months have been the longest the entire world has been confined to their houses!
Most people I speak to about the virus feel that: “If I’ve already got the virus, I have antibodies and I will not get it again.” While it is not scientifically proven that you cannot be reinfected, chances are one in a million. There are 32 known cases of reinfections in the world, from over 40 million known cases worldwide.
As the world opens up and people resume lives in the ‘new normal’, they eagerly anticipate the arrival of the vaccine to get back to their pre-COVID lives. While there are over 250 vaccines in clinical trials, we do know when the first vaccine will be approved and available to the mass market.
A few searches from Google indicate that a normal vaccine could take anywhere between 8–10 years to develop. In the case of COVID-19, within a few months, a few of the vaccines: AstraZeneca/Oxford, Pfizer, and Moderna are already in Phase III or pre-approval trials, while most other have begun Phase II. While experts still believe that a few of them would be available by early 2021, India and the world together have to address a host of issues, if we are to be ready for the virus.
The biggest unknown variable: when will the vaccine be available?
World Economic Forum data indicate that 15,000 flights, 200,000 pallets, and potentially 15 million cooling boxes, with the corresponding amounts of cooling bricks or dry ice, would be required to transport the virus across the globe within a year to two.
The other problem is, the timeline of vaccine approvals and availability, so while the demand is there, without supply, demand forecasting and supply chain planning could be a real challenge for major cargo carriers across the globe.
“But we know it is going to be available soon! Donald Trump and India’s Health Minister, Harsh Vardhan, have said it.”
Yes, agreed, but without data, nothing can be said. While speculations are rife that it will be available, it all depends on the success of the ongoing human trials for the vaccines. About 50% of the trials in Phase III fail.
Supply Chain
There is a very high likelihood that a few drugs would be approved and available by Q1 2021 (March-end). Challenge then becomes the need for a robust and falter-proof supply chain integration and an unprecedented air cargo capacity, right from the get-go. Meaning: considering the vaccines would require express and quick transportation, there will be a need for large cold storage facilities, at transit points and most international gateways like airports.
Many have already begun preparations. Emirates, for instance, has set up a dedicated anchor hub at Dubai World Central, for cold chain storage and distribution of the vaccine.
Still, even considering ‘Public Private Partnerships’, supply chains around the world are not prepared to handle the scale vaccine distribution would need.
Apart from the infrastructure, technologies and processes need an overhaul as well, if things are to move fast.
1. COVID vaccine needs special handling — Normal polio vaccinations are stored between 15–25 degrees Celsius. Most COVID vaccines need to be stored at 2–8 degrees Celsius, some even at -80 degrees, meaning special handling requirements. That means more number of configured cold storages, WITHOUT disrupting the supply of other vaccines!
2. Jets — large aircraft (777s/747s) can carry up to 10–30 tonnes of cargo, while the narrowbodies (737s) 2–6 tonnes. And these aircraft would have to be highly temperature controlled. Over 15,000 flights, as anticipated by the WEF, would be needed to meet vaccine requirements.
3. Security of vaccines — Protection against pilferage, robbery, and tampering during transit has to be controlled. Vaccine movements would be in lines of the movement of goods like currency, gold, etc.: secured and safeguarded throughout its movement.
4. Transparency — Technology will play a pivotal role. For the world to move fast, there have to be data-sharing platforms, like those in forwarding industries — where data about potential risks are shared. It is essential to properly judge supply and demand and identify potential bottlenecks that may slow the transport and distribution of vaccines. Blockchain-enabled global supply chains would’ve been ideal, but alas, it’s still in adoption across the globe.
5. Paperwork — if you know a shipper or have been in the Supply Chain team of major FMCG or eCommerce outlets, you know how cumbersome paperwork can be!
Is India ready?
Supply Chain
In December 2019, the Hindu mentioned that India has a total cold storage capacity of 226.7 lakh tonnes (lt) vs the 350 lakh tonnes required. Considering the lockdown bought India to a standstill, the number may have improved only slightly.
According to Pawanexh Kohli, CEO of India’s National Centre for Cold-Chain Development (NCCD), India’s public health network is limited in capacity. While most vaccines are expected to be distributed under the Centre’s Universal Immunization Programme (UIP) mechanism, the government will have to rope in private players, if the goal to inoculate 25 crore people by July 2021.
Two other hindrances for India could be the amount of paperwork that the government requires and the lack of temperature controlled wide-body jets to move vaccines within India.
Budgets
Prime Minister Modi announced ₹50,000 crores has been set aside to give the vaccine to the entire country.
Assume the government acquires AstraZaneca’s doses from Serum Institute of India for ₹450, if the target is to inoculate 25 crore people by July 2021, this alone could cost about ₹11,000 crores. Add other charges of transportation, logistics, etc. That means the budget set aside may not be enough.
Coordination between the central government and state governments
Considering the recent GST impasse between the centre and the states, coordination for the supply of vaccines has to be there, to ensure all Indians get it. Who gets the vaccination first should be left for the state governments to decide.
Vaccine decision
Which vaccine may work and which may not work, depending on the mutation of the virus in India’s conditions remains a mystery, till Phase III data is available for analysis. Whether Pfizer’s, Moderna’s, or Russia’s Sputnik V, it will depend on the levels of efficacy, safety, and even costs.
Procurement
India needs to order the vaccines from now itself, instead of waiting for vaccine approvals and then placing orders. By then, the world may have placed orders with suppliers across the globe, even institutes in India.
While Russia will sell 100 million doses of Sputnik V to India, orders with Serum Institute or other developers: ICMR (Indian Council of Medical Research) and Zydus should be placed now, instead of creating export restrictions later and forcing them to increase domestic supply.
The latter may leave the Indian government and PM Modi red-faced again, considering India banned hydroxychloroquine towards the end of March, but had to lift it after pressure from the US.
Even the way of government procurement needs to change. Instead of inviting tenders, they need to retain the flexibility to be able to use various vaccines at various times.
We may talk about export curbs working, considering India has one of the highest vaccine manufacturing capabilities in the world. However, everything mentioned above can be overcome if the world does it through a coordinated global strategy.
What do you think, are the supply chains in India and the world ready to take on the vaccine supply? Should India government do more, maybe even allow private players to administer approved vaccines, at a charge, to those who can afford to pay, to reduce pressure on them?
Share your thoughts below!
