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DATE SPEAKERS NAMES The 5th Global Health Supply Chain Summit November 14 16 2012 Kigali Rwanda   Optimizing the vaccine supply chains Modibo Dicko What is Project Optimize Fiveyear 20072012 collaboration between WHO and PATH funded by the Bill amp Melinda Gates Foundatio ID: 473393

supply amp health chain amp supply chain health vaccines vaccine senegal vision level costs global chains cost optimize scenario

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Slide1

CLICK TO ADD TITLE

[DATE]

[SPEAKERS NAMES]

The 5th Global Health Supply Chain Summit

November 14 -16, 2012Kigali, Rwanda 

Optimizing the vaccine supply

chains

Modibo DickoSlide2

What is Project Optimize?

Five-year (2007-2012) collaboration between WHO and PATH, funded by the Bill & Melinda Gates FoundationObjective: To shape the future of technologies and logistic systems for vaccines in low-income and middle-income countries.

Sanaipei  Kisoso, WHO Mike Wang, PATHSlide3

Vaccines & Supplies

Information

A network of

people,

equipment and well established procedures

Vaccine supply chain yesterday & today - 1

3

Simple, precise & rigid rules!Slide4

This system has served us very well for over 30 years! But it has now reached its limits!

*

Source: WHO. Guidelines on the international packaging and shipping of vaccines. 2002; WHO/V&B/01.05. ** Based on $7.50/dose for Rotarix and $0.155 per dose for polio and measles

$635.50

**$4,687.50**625 doses of Rotavirus VaccineDistrict vaccine store, Brazil4100 doses of Polio and Measles Vaccines

Rural hospital storage, Mozambique

More volumes for new

vaccines:

Depending

on packaging rota

&

pneumo

vaccines require 45% to 113% more

storage volume!Slide5

A changing environment: More, more, more

More target populations:Immunization & other programs are striving to reach new target groups with new strategies and new products.More parallel health supply chains:An increasing number of interventions establish their own supply chains to ensure reliable access to quality products.More global interdependence: Pandemic influenza, Avian Influenza, Meningococcal Meningitis, Yellow Fever, Polio, SARS

…5Slide6

A changing environment: Increased complexity

1975

1990

1995

2000

2005

2010

PEI:

GAVI 1

GAVI 2

GIVS

Measles

DoV?

+ Right Cost

Co-Financing

+ Right Quantity

+ Right Place + Right Time

4 Rights

5 Rights

UCI*

Full 6

Rights**

* UCI

= Universal Childhood Immunization. PEI = Polio Eradication Initiative. GIVS = Global Immunization Vision &

Strategies

** The right products in the right quantity,

at the right

place,

in the right condition

, at the right time, at the right cost

2 Rights: Right vaccines in Right conditions

(everywhere, all the time, in abundant

quantities as cost is low

)

EPISlide7

Underper-forming health programs and unachieved health goals

Poor availability of health commodities at facilities, wasted resources

Unqualified and disempowered staff managing public health supply chains

Supply chains poorly managed and insufficiently resourced

Source

: Kevin

Piltz

, USAID/Washington, 2010

A changing environment: unqualified staff can no longer cope with requirementsSlide8

By 2020, state-of-art supply systems enable

the right vaccines to be at the right place, in the right quantities, at the right time, in the right condition, at the right cost.

Engage key partners- within immunization and across public health Develop a joint vision and plan for the future

Partners agree on 2020 vision and action plan

Implement specific interventions with countries (Albania, Guatemala, Senegal, Tunisia, Vietnam)Model potential impactEvidence base created & lessons documentedIdentify innovative technologies and practices for future supply systemsPromote an environment conducive to innovationPolicies, guidelines and processes in placeProject Optimize Vision & Objectives INNOVATEDEMONSTRATE

FACILITATESlide9

A Vision and 5

TenetsSlide10

Controlled temperature chain

Product packagingPassive cooling

Integration and moving warehouseOutsourcingNet-zero energy supply chainTemperature monitoring

Immunization registries

Capturing last mile dataModelling supply chainsProject Optimize Activities at a glance Optimize techn. working groupsCountry collaboration projectsOperational researchChallenges to industryCCL Taskforce collaborationSlide11

S

upply chain optimization – Senegal Horiz.

integration:Integrated storage & distribu-tion from central to reg' level.Vertic

. integration

:From Reg'l Store directly to health posts using a moving warehouse. International / Manufacturers

PNA

National level

PRA

Regional level

5 Health Centres & 110 Health Posts

Distribution

Other drugs

& health

products

Vaccines & heat

sensitive drugs

Distribution

DPM Virtual Store

National level

Regional Virtual Store

St Louis Region

District Virtual Stores

5 Districts

Moving

Warehouse

A

B

C

Cold Chain

Ambient Temp Chain

Information

Post-Integration

Situation (Dakar & St Louis Region)Slide12

Supply chain optimization – Tunisia

Integrated supply chain system from the national level down to regional levels.Solarized stores at regional and district levelsSolar-powered “moving warehouse” delivery system. Slide13

Supply Chain Modelling & Costing

Collaboration with the Vaccine Modelling Initiative (VMI), University of

Pittsburg Development of a simulation supply chain model to assess scenarios for Senegal. Excel-based model and data collection tools to support country demonstration projects

Comparing baseline and various scenario logistics costs (transport and cold chain).

SC Cost componentsSlide14

Standard input deck

MODELLING & COSTING

Vaccine availability by scenarioTotal & unit costs by scenarioData on Supply Chain Structure, Storage Locations, Transport, Capacities, Personnel, etc.

Supply chain function costs

Supply chainperformance metricsDiscrete eventsimulation model of supply chainOPTIMIZE supply chain costing tool

Cost Drivers

Total

Costs

Unit

Costs

Economic

Metrics

Source

: VMI (

University

of

Pittsburg)Slide15

Vaccine Availability & Costs by Scenario Senegal (Constrained)Slide16

16

Vaccine Availability & Costs by Scenario Senegal (Unconstrained)Slide17

What

next at country level: scaling upDevelopment of a scale up strategy for successful

innovations:Using ExpandNet* methodology in Senegal and TunisiaValidation by MoH & funding

to be

sought (MoH & partners).* www.ExpandNet.net Senegal & TunisiaScaling – Up StrategySlide18

What next at global level: linking with the Decade of Vaccines GVAP

Ensure Optimize learning lives on: Action Plans developed for the 5 tenets of the global vision.Plans are online and available at: http://www.path.org/publications/files/TS_opt_action_plans.pdfThese will be reformatted and published as a vision 2020 outputs companion document to the

DoV Global Vaccine Action Plan (GVAP).Slide19

Nothing is impossible – never say never ... and trust staff (Optimize Team – Albania)

Thank you!Slide20