Abstract
BackgroundWhen addressing the urgent task of improving vaccine supply chains, especially to accommodate the introduction of new vaccines, there is often a heavy emphasis on stationary storage. Currently, donations to vaccine supply chains occur largely in the form of storage equipment.MethodsThis study utilized a HERMES-generated detailed, dynamic, discrete event simulation model of the Niger vaccine supply chain to compare the impacts on vaccine availability of adding stationary cold storage versus transport capacity at different levels and to determine whether adding stationary storage capacity alone would be enough to relieve potential bottlenecks when pneumococcal and rotavirus vaccines are introduced by 2015.ResultsRelieving regional level storage bottlenecks increased vaccine availability (by 4%) more than relieving storage bottlenecks at the district (1% increase), central (no change), and clinic (no change) levels alone. Increasing transport frequency (or capacity) yielded far greater gains (e.g., 15% increase in vaccine availability when doubling transport frequency to the district level and 18% when tripling). In fact, relieving all stationary storage constraints could only increase vaccine availability by 11%, whereas doubling the transport frequency throughout the system led to a 26% increase and tripling the frequency led to a 30% increase. Increasing transport frequency also reduced the amount of stationary storage space needed in the supply chain. The supply chain required an additional 61,269L of storage to relieve constraints with the current transport frequency, 55,255L with transport frequency doubled, and 51,791L with transport frequency tripled.ConclusionsWhen evaluating vaccine supply chains, it is important to understand the interplay between stationary storage and transport. The HERMES-generated dynamic simulation model showed how augmenting transport can result in greater gains than only augmenting stationary storage and can reduce stationary storage needs.
Highlights
When addressing the urgent task of improving vaccine supply chains, there is often a heavy emphasis on stationary storage [1]
To guide the assessment and improvement of vaccine supply chains, the World Health Organization (WHO) created the Effective Vaccine Management (EVM) tool and PATH collaborated with the WHO and the United Nations Children’s Fund (UNICEF) to develop the Cold Chain Equipment Manager (CCEM) tool [2,3]
Data to construct this network came from direct field observations in Niger and personal communications with members of the following organizations: the WHO in both Geneva and the Niger country office in Niamey, the Niger Ministry of Health (MOH), the UNICEF Niger country office, the Niger National Geographic Institute (NGI), and the Expanded Program on Immunization (EPI) in Niger
Summary
When addressing the urgent task of improving vaccine supply chains, there is often a heavy emphasis on stationary storage [1]. To guide the assessment and improvement of vaccine supply chains, the World Health Organization (WHO) created the Effective Vaccine Management (EVM) tool and PATH collaborated with the WHO and the United Nations Children’s Fund (UNICEF) to develop the Cold Chain Equipment Manager (CCEM) tool [2,3]. While both tools are helpful in assessing a country’s supply chain, both focus more on stationary storage rather than transport aspects of supply chains. When addressing the urgent task of improving vaccine supply chains, especially to accommodate the introduction of new vaccines, there is often a heavy emphasis on stationary storage. Donations to vaccine supply chains occur largely in the form of storage equipment
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