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
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[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