In December 2020, the UK became the first western country to approve the COVID-19 vaccine from Pfizer. Since then, efforts made by the NHS, community workers and volunteers on its roll-out have been nothing short of heroic. But while it’s easy to focus on the successes taking place at home, the scale of the pandemic means the fight to protect communities extends internationally.
Overseeing the international coordination of vaccine delivery are organisations including the WHO, the Centre for Epidemic Preparedness (CEPI) and the Gavi Vaccine Alliance, whose leaders know there are several potential threats to vaccine distribution across the world.
Unequal access to supplies, security risks in transporting goods, local unrest and a lack of public compliance – all must be taken into account, monitored and planned for. But in sharing information on disease management and national vaccination programme successes, countries can learn from each other as they go.
Entering emergency mode
Israel has been held up as a shining example for the rapid rate of its roll-out of the Pfizer vaccine: within a month, more than 80 per cent of people over 60 had received their first jab, putting the nation far ahead of the UK and other European countries.
Professor Eyal Leshem, a director at Sheba Medical Centre, says this impressive speed was made possible thanks to clever negotiations from the Israeli government.
“They were able to meet with Pfizer early on, suggesting to them that we will share the data publicly from our vaccination programme. All of this played to our advantage, as Pfizer probably wanted the natural experiment of one country getting to a high coverage rate to be able to measure vaccine impact. Israel fit this definition.”
The success can also be attributed to the country’s strong national healthcare system, which has similarities to the UK’s NHS. “There is existing logistical capacity which could be built on quickly, but Israel is also used to emergency operations and military-led thinking – we are familiar with the need to go into an emergency mode of logistics,” says Leshem.
We’re all in this together
Crucially, both Israel and the UK have benefitted from being able to buy large supplies of vaccines in advance – the UK has ordered 407 million doses for its population of just 65 million, for example, ensuring that there will always be enough coming in regardless of delays within individual manufacturers’ own supply chains.
But the fact richer countries are able to buy such great quantities is unethical and unproductive in terms of global recovery, says Jenny Ottenhoff, senior policy director at the ONE Campaign: “There is a huge risk of unequal distribution of the vaccine. That will almost certainly lengthen the impact of this pandemic on everyone, including those in rich countries.”
Ottenhoff oversees the charity’s projects on global health outreach – and a key part of her job is leading campaigns urging fairer access to vaccines for poorer countries. “The real challenge at this point is ensuring that the vaccine gets into the arm of everyone who wants it, starting with the most vulnerable people across the world, and I think that’s the space that we are not doing so well in.”
Supporting fairer distribution
There are some international mechanisms in place to help level the playing field, in particular the COVID-19 Vaccines Global Access group (Covax). Covax leaders are campaigning to get richer countries to donate their own supplies instead of stockpiling. This will help to ease pressures on the supply chain and enable world leaders to be better prepared to manage future spikes and even future disease outbreaks.
Supporting fairer distribution in this way not only gives wealthier countries a better return on their investment – ending the pandemic faster, helping economies to recover more quickly – but also reduces the security risks involved in transporting vaccines across continents.
“Project managers will be aware that organised crime groups are looking to steal these products… but with COVID-19 the risk is more elevated because we know there are issues of inequality with global distribution,” explains Amy Shortman, director of product marketing at the logistics company Overhaul.
For these reasons, each shipment is extensively tracked and traced, and new technologies are helping to monitor cargo even better, she says. Sensors inside vaccine boxes are installed to measure light and temperature during transit, “so if thieves open the door there’ll be an alert. Companies are already using digital tools like blockchain to make sure that any system can share track and trace information, and all these different data points mean that if anything is not what it should be, we can act,” says Shortman.
“It’s these real-time corrective actions that make the supply chain more efficient, and ultimately get the world vaccinated quicker,” she says.
For a more in-depth analysis of the global challenges around vaccine distribution, look out for the spring edition of Project journal in March.
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