TED Challenge: tracking & tracing vaccines in the GAVI Alliance supply chain

I’m heading to Long Beach, California this weekend for my annual participation in the TED conference – and this year, I’m looking for help, from TED and from you.

Malawi, November 2011 – Health workers transport vaccines in vaccine carriers to keep them cool, on their way to an immunisation outreach session at a remote village in eastern Malawi (Credit: GAVI/Doune Porter/PATH/2011)

Health workers transport vaccines in cold boxes to a remote village in eastern Malawi (GAVI/Doune Porter/PATH/2011)

To do our work at the GAVI Alliance, we need to make sure that vaccines are not wasted. Vaccines are a powerful technology, but must be looked after very carefully. They have to be stored at  a certain temperature and used within a fixed period of time, or they become non-viable. I’m making this the focus of a TED Challenge, asking the smart, innovative people who make up the TED community to help us find a better way to track vaccines. That could involve existing technology like 2D barcodes or RFID tags, or there may be a whole new approach that we haven’t yet thought of.  Of course, it requires not just technology, but also appropriate hardware, systems for data transmission, and the ability to scale it up in some of the most difficult places in the world.

I want to make sure we hear all the best ideas, so I’m also asking all of you to help. Are there smart technologies that can help, or better ways to use what we already have?

Click here to read more about the TED Challenge, then post your comments or questions below.

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37 responses to “TED Challenge: tracking & tracing vaccines in the GAVI Alliance supply chain”

  1. Amy Smith says :

    Dear Seth,

    I found your blog post because Tim Julian tweeted at Magpie Sensing as a possible solution to this problem. We are doing some neat stuff with cold chain tracking, and are currently beta testing our device with the Maryland Department of Health & Mental Hygiene and Johns Hopkins, among others.

    I would love to connect and learn more about a possible partnership with the GAVI Alliance. Please feel free to reach out.

    Amy Smith
    Marketing Director
    Magpie Sensing

  2. VaccinesToday (@VaccinesToday) says :

    Hi Seth,
    Great post. The EU’s innovation directorate has launched a €2 million prize as an incentive for smarter ways to transport. Not an enormous sum, perhaps, but good to see it on the agenda.
    Vaccines Today

  3. Prashant Yadav says :


    I am so glad you are discussing this in your TED event.

    “Tracking & tracing vaccines in the supply chain” could mean different things to different people. To some of the drug and vaccine regulators it implies establishing pedigree or ensuring that the product’s handover from one party to another at any point in the supply chain was properly recorded. Their worry is more about counterfeit or poor quality products entering the supply chain. More important for GAVI and the global vaccination community is the ability to trace the flow of vaccines through the supply chain to have clear visibility of the system, enable end-user verification, avoid wastage or shortage, and ensure the cold chain is not compromised at any stage.

    Technologie such as 2D bar codes and mobile based tracking solutions could clearly be a strong enabler for achieving this. But we also have to learn from low-tech solutions for track and trace. You must have heard about the Mumbai Dabbawallahs . They deliver over a million lunchboxes every day from people’s homes to their exact office cubicle using a very simple color coding scheme on each lunch box. They never miss delivering and the right lunchbox gets to the right person each day. Wrong or missed deliveries can be very high repitational risk for the service provider i.e. the lunchbox carrier. For many Indians eating a lunch that was cooked by someone else’s wife could disastrous consequences so the lunchbox carriers have to achieve 99.9% service level. I visited the Dabbawallah operation a few years ago and discussed with their chief knowledge officer at a supply chain conference recently. What makes their track-trace ande delivery system function so well at such low cost is the fact that it leverages the professional pride of each employee, it uses simple, easy-to-understand and robust coding system, and it is organized as a cooperative. The CEOs of many large global airlines, logistics companies like Fedex, UPS visit the Dabbawallahs to see how they do it at such low costs and such high service level. The answer is the eco-system built around people, technology, and the economics of sharing rewards. Tracking and tracing in itself will not achieve the outcomes we desire till we can couple it with a system of incentives.

    Also, we shouldn’t select a technology (or fund) for this purpose but rather help create a “market” for providing tracking and tracing service for vaccines. We should set clear quality requirement on the tracking and tracing services we need (kind of like the TPP in AMC). This would enable small innovators in GAVI eligible countries, and large innovators in corporate and academic labs to think of solutions for tracking and tracing vaccines and providing that as a service.

    In the process we would not only have helped make the tracking and tracing of vaccines in GAVI eligible countries possible, but perhaps we may even end up discovering something new e.g. a new business model or a new eco-system of “technology-people-economics” that may later become useful for Fedex, UPS, DHL, the airlines and everyone else to use in their developing country operations.

    My best for the TED event.

  4. Joel Selanikio (@jselanikio) says :


    I run DataDyne (www.datadyne.org), the maker of the Magpi mobile data collection system (www.magpi.com, formerly EpiSurveyor) and a recent TEDx speaker (http://tedxtalks.ted.com/video/Shining-The-Light-In-Data-Dar-2).

    Magpi is already have the most widely-used mobile data collection system in the development sector, with close to 16,000 registered users from organizations like WHO, UNICEF, JSI, Abt, the World Bank, IFRC, and many others — the vast majority of whom pay nothing at all for the service.

    We’ve been up and running with this service since 2009 — which means we are not just a bright idea or a pilot or project, but a robust and tested system, which is self-supporting and scaling ever more widely as we speak. And it’s already been used by JSI and others for supply-chain management with great success.

    I know that this system could be easily adapted to your purposes, and just as importantly that it could be done at exceptionally low initial and ongoing costs — our specialty.

    Would love to brainstorm about this.


  5. Flavia Guidetti says :

    Has others have pointed out, the ownership by the Government at all levels is crucial for the sustainability of the new initiatives. For that the introduction of new technologies should be accompanied by a sound marketing and advocacy programme. The quality of the communication component is crucial for the success.

  6. Lasher Consulting says :

    I think it’s extremely encouraging to broaden the discussion on exciting potential technologies like RFID tags and barcodes. Even better would be to share the broader context of challenges and solutions facing vaccine supply systems. Project Optimize has worked with a large range of partners to facilitate discussion around a global vision for Vaccine Supply and Logistics Systems. This exercise has revealed a lot of exciting ideas and a lot of need–engaging the many bright minds within and outside of the field of immunization is a step in the right direction. If you haven’t already seen Optimize’s video on vaccine supply chain problems and potential solutions, here’s the link: http://youtu.be/JVe9eLoauTQ

  7. Ted Prusik says :

    VVMs are used on most vaccines in developing countries through UNICEF, GAVI and self-procuring governments. The combination of VVMs and 2D barcodes can be read with an application on a smart phone. This allows data capture of the barcode information for track and trace purposes and provides an additional level of product integrity verification by measuring the extent of heat exposure of each vial. These data are transmitted to a database for timely reporting of vaccine supply, status, and use. This powerful combination will make the health care worker’s job easier, will establish electronic health records and provide needed data on a timely basis to a localized or centralized database. The smart phone application is currently under development.

  8. Nate says :

    It’s Complicated…

    A couple of weeks ago a man named Curtis Cooper, utilizing 360,000 computers, found the new largest prime number. It is over 17 million characters long. After the initial discovery it took an additional 39 days for a computer to prove the number was in fact prime. Whether you have an appreciation for math or not, I think the sheer volume of numbers, variables and computing power is enough to impress almost anyone.

    Stories like these somehow make us think that almost any problem, no matter the variables or complexity is solvable. You just have to throw enough money at it, enough man power, enough computing power… and out comes the answer.

    There are countless scenarios out there where this is true… but if there was any one thing that will mess up the wonderful world of math it would be the introduction of a human being as a variable. Most of the time a person doesn’t represent a single variable but instead a countless subset of variables. Ironically when people are in groups it is much easier to predict their behavior over time yet when it comes down to one person at any one point in time it is impossible to account for the set of variables that they are capable of setting off.

    Why am I talking about this?

    With the TED Challenge to improve the global vaccine supply chain. a lot of people are talking about the problem like there is a “Holy Grail” solution. If we could just figure out 2D bar codes or RFID… If we could get better thermal trackers or refrigeration… we need better data… Still others are focusing on a few human variables like in-country human resources or cultural stigmatisms. Through all the confusion and campaigning for our individual pieces of the problem it seems to be missed that we are dealing with a variable set so big not even 360,000 computers and 39 days of checking our work is going to ever be able to solve anything.

    I think we are asking the wrong questions – anytime there is a problem afflicting the human race throughout history we can almost always look back and see we were asking the wrong questions. The answer isn’t faster horses, it’s the automobile. Don’t buy more slaves, invent a cotton gin… In fact don’t buy slaves at all, instead kick off the industrial revolution. You get the point.

    In this case the question is simple: If there is no one-size-fits-all solution for these issues how do we come up with one answer that will solve them all independently. Seems a little contradictory…

    The good news is our premise isn’t all wrong… if you throw enough money and man power at any one problem it will probably get solved… IF you are addressing the real problem. The global vaccine market is expected to hit $23B by 2015 and $32.21B by 2017 yet kids in northern Nigeria are still getting Polio… a disease eradicated in the US in 1979. My point is simple, our failure is not due to lack of funding. It is not due to lack of passion and it is not due to lack of subject matter experts. It is due to execution and lack of focus on a solution that solves for everything…contextually. We can’t afford to continue to all campaign for our individual pieces of the problem. We have to attack this problem as a whole, country by country, region by region.

    There is a reason SWAT teams exist and there is a reason they don’t have 200 people in them and two to three organizations instructing them as well as two to three others that fund their tools and still several other foundations they have to appeal to for continual funding. Analysis paralysis exists but for the sake of wanting to accomplish something I am not going to argue that point.

    My second point is simple: A properly funded small team that represents a diverse set of subject matter experts that can assess a country based on its actual infrastructure, culture and needs and recommend and implement contextual, properly funded, sustainable solutions seems unattainable yet surprisingly relevant and necessary.

    Now imagine if all the disjointed funds we spend and sometimes waste as the Global CCL community could go into financing several of these teams and the infrastructure improvements they identify. The difference is simple, don’t look for the “Holy Grail” it doesn’t exist, it never did. It represents an idea and the idea is possible through highly contextual, country driven solutions. Building a CCL SWAT Team and financially backing it is an answer, not because it solves all the problems at once… it is an answer because it solves the problems independently, listening to the people, listening to the context… hearing, seeing and solving for the all important human and cultural variable sets.

    My 3rd and final point: The solution exists, all the pieces are currently available, we just have to accept that each time the solution is implemented it will use a different subset of the available resources. It is our job to build teams of people capable of piecing this together hand-in-hand with local governments and properly financing these solutions to get them off the ground in a sustainable fashion, properly recognizing sovereignty and culture.

    Solving only part of a problem in fact does not solve the problem at all – call me idealistic or call it a reach but this doesn’t get solved till someone solves for everything in each context. The good news is we will get better with it as we go.

  9. Andrea Coleman says :

    New technology can play a big role in improving tracking of vaccines, along with lots of other areas of health care and development. But the failure to create strong health systems up to this point isn’t a lack of new technology; it is a failure to properly manage the technology we have had for 100 years.

    No matter how good the tracking system for vaccines is, if they do not reach the people who need them in the time they are viable, they are simply wasted. Health care isn’t just technology, it is physics. It is negotiating the physical world and reaching down to the last mile. This requires transport fleets. Transport fleets that work day in, day out. Well maintained vehicles that deliver vaccines to the smallest, most isolated village, and being there when you said you would.

    In seven countries in Africa, Riders for Health is managing fleets of motorcycles and ambulances so, for the first time, they are being used for what they were designed for: delivering vaccines and other health care to rural communities rather than sitting, broken, at a rural clinic.

    It requires spanners, oil and monkey wrenches. It isn’t as sexy as a smart phone, it is just more fundamental. And a system that delivers drugs one way is perfect for sending information on stock levels back up the chain.

    But I think the most important thing to remember is that the world has singularly failed to use this existing technology effectively in the developing world. As well as ensuring existing technology at last forms the fundamental platform that is required, we also have to think about what we need to do to make sure we don’t make the same mistake again.

    New technology needs systems engineers, telecommunications experts, software programmes and data analysts. And, back to the fundamental, a reliable supply of electricity to keep it all working. Just as Riders for Health has shown that for vehicles to work properly they require technicians, parts suppliers, logistics experts, data clerks and a supply chain.

    New ideas should never be stifled by worries about practicalities, but practicalities should never be ignored by a desire to chase what is new.

    • ck says :

      Such an interesting challenge!

      If governments were into mobile phones and internet, while the private sector had the responsibility for vaccines, safe water and toilets, how different would the scene be?

      I am personally of the view that what a government backed program takes 20 years to achieve, a profit driven initiative will achieve between 2-5 years. Without being uncharitable to governments and people in the public sector, but I think that for far too long we have known the problem, but have not done enough to fix it.

      The issue of vaccines needs an integrated solution; – creative and effective management, people, technology, political commitment, and of course funding.

      Perhaps its time for vaccine management [end to end] is outsourced to a special agency with just quality assurance oversight?

  10. SILVE - Chairman POEPLE THAT DELIVER INITIATIVE // www.poeplethatdeliver.org says :

    Hi Seth,
    I would like to draw your attention on the importance of Human Resources. Please refer to the optimize 2020 vision tenet 5 at http://www.path.org/publications/files/TS_opt_vision_2020_tenet_5.pdf and to the “People that Deliver” Global Initiative.
    People that Deliver (PtD) is a broad coalition of organizations from around the world that strives to improve the health supply chain workforce in developing countries, notably immunization supply systems. This Initiative is based on global recognition that without trained professionals to manage the health supply chains, vaccines, drugs and other health supplies does not reach the patients who need them. Indeed, rapid increase in health assistance from multilateral and bilateral donors has resulted in huge increases in the quantity, value, and complexity of supplies flowing through public health supply chains. The health supply chain workforce plays an essential role in achieving global health goals, such as improving maternal health, reducing child mortality, and combating other diseases. However, the health supply chains of middle- and low-income countries are often unable to respond reliably to existing demands, putting both health supplies and health outcomes at risk. Limitations on supply chain performance stem, in part, from the lack of a competent, recognized, and empowered health supply chain workforce.
    PtD improves the impact of its member organizations by:
    • Coordinating and aligning activities of member organizations in support of countries
    • Endorsing and promoting relevant technical solutions developed in collaboration with its member organizations
    • Facilitating advocacy and information sharing.
    PtD has more than 70 member organizations, including country governments, international agencies, implementing partners, nongovernmental organizations, and private companies.
    Benoît Silve, Chairman of the “PoepleThatDeliver” initiative and coordinator of tenet 5 2020 vision (connect on LinkedIn)

    • sethberkley says :

      Thanks Benolt: This is great and congratulations for putting together the People that Deliver Initiative. Of course, you are absolutely right. We are working to stregthen the supply chain for livesaving vaccines. That supply chain is managed by the same person managing supplies for many of the other health interventions, so if we can strengthen the vaccine one, we will also be building the pyramid that will support other health interventions. Of course, with the proliferation of new vaccines (the basic WHO globally recommended vaccines for children have grown from 6 to 11) the supply chain has become even more stressed. This is why our partners are working with countries to evaulate supply chains through the Essential Vaccine Management system and to strengthen these systems. We look forward to working with your initiative.

      • SILVE - Chairman POEPLE THAT DELIVER INITIATIVE // www.poeplethatdeliver.org says :

        Thank your for taking the time and for the positive feedback. I would think (if not demonstrate :)) that the only way to stengthen the vaccine SC is to build the pyramid that also support other interventions. Indeed, the HR issue has to be addressed in a systemic manner. Also I have a WHO slide showing the 5 and 25 fold increase of new vaccines in terms of volumes and cost, I would be happy to foward it in case you have not the slide, though I am quite sure that the fact is not new to you.

  11. Naomi Wasserman-Reitz says :

    We have the technologies and experts. It’s about reinventing the way public and private sectors collaborate to ensure affordability and hence, sustainability of operations. The best support we can give to Health and Finance Ministers is to help them develop viable business models and investment strategies that their counterparts in Energy, Water, Internet, and Telecommunications have been doing for years…

    • sethberkley says :

      Agree Naomi, but one needs political will here. Vaccines are among the most cost effective preventive health interventions that exist. Yet often, they are not locally prioritized and given the resources–in cash or human resources necessary to do the job. GAVI is trying to help, but at the end of the day, it has to be a country responsibility.

  12. Terry Hart says :

    Tracking and tracing is fine, and of course essential. A multitude of technologies are rapidly leading us to improvements and eventual solutions. Before we can track and trace, we need to “deliver” however, and here there seems to be a black hole especially across Africa except for a few isolated examples. Riders for Health offer an excellent solution in the Gambia, but scaling and replication is slow. Slow because of the absence of innovative financial solutions. Partners for the most part are not structured to share risk in commercial models. Governments need support and are locked into grant mindsets with little incentive to operate on a business platform. There are a multitude of well proven, commercially attractive financial models commonly practiced in the transport and equipment supply world. (Leasing, HP, Fee for service etc). There is no obvious reason why these cannot be applied to enable vaccine delivery mechanisms (transport and service) and even equipment supply and maintenance. Perhaps the TED Challenge can “front end” this issue to its “Tracking and Tracing” reflections. After all efficient distribution, minimises wastage, ensures good temperature management and stock control.

    • sethberkley says :

      Terry: All important issues. The fact is we are delivering. Global coverage for DPT3 is over 80%. However, there are major equity problems and we need to reach that fifth child whom as Chris Elias has said, is often not standing with the other four. Interestingly, we do not know exactly what percentage of children are fully immunized with all of the recommended antigens, but it is low say 4-5% so our work is cut out for us…

  13. Allen Wilcox says :

    These ideas will excite a TED crowd who will walk away thinking “problem solved.” It will be another example, however, of a technological solution presented in room full of the latest technology to those who are proficient in using that technology. With sufficient external resources, it is often possible to implement such a solution in a pilot project in a low-income country and show some success. The challenge is always scale and sustainability. These solutions flounder in low-income countries due to the infrastructure vacuum (e.g., information systems, communications and human capacity) that is particularly acute at the lower levels of the supply chain. Bar codes and RFID tags weren’t introduced into high-income countries in a vacuum, but on top of decades of incremental improvements in an infrastructure that can now support such solutions. Without a supporting ecosystem of information systems, communications and human capacity, bar codes and RFID tags will be just another great idea that is well ahead of its time for low-income countries.

    We believe the solution lies in starting with the infrastructure that is currently available in low-income countries and building simple supply chain systems that are proven to work at scale and in a sustainable manner. Granted these initial systems won’t have the level of sophistication of the supply chain systems currently operating in high-income countries, but over time they can be enhanced, often quite quickly. As the sophistication level rises, it is then possible to introduce new technologies, such as bar codes and RFID tags, which can thrive given the greater capability of the supply chain system and supporting infrastructure.

    A word of caution: The siren song of a quick technological fix will sound particularly enticing on the state-of-the-art sound system in the TED auditorium; it won’t sound so good on an old transistor radio in rural Africa.

    • sethberkley says :

      Alan: As you know, I agree. As a former Board Member of Villiage Reach, I am proud of the practical on the ground work you have done in places like Mozambique. But we also need better tools. In an era where most places I visit have and value mobile phones, the fact that we have no idea what the stocks of supplies are and when we do, it is six months after the fact, using the paper based systems from when EPI was launched in 1974 means we have to do better. Our children deserve it.

      • Allen Wilcox says :

        Agreed. We use mobile phones and for the 50% of health centers we serve which have no cellular coverage we use physical movement of products to carry data. Presently we can show you the actual vaccine stocks by vaccine in 40% of the health centers in Mozambique online by health center with no more than a month’s latency. Mobile phones are only a tiny part of that solution. It is the entire system of “tools” that the others on this conversation are mentioning (trucks, people, technology, even businesses) that the Mozambique Ministry of Health and VillageReach use to provide that level of visibility into vaccine distribution performance.

        Our children deserve a well thought out comprehensive solution that works – that solution involves people, trucks, training, managment, information, private sector engagement and maybe a cell phone or two.

  14. Oz Mansoor says :

    The question is framed on technology, but the answer lies in human behaviour -as pointed out by Philippe Jaillard.

    As noted by Seth and others, we have many potential technologies to explore, but must do do so using participitory approaches of user-centred design, and understand the human motivations and sociocultural barriiers and incentives that can work against these technologies.

    The elements of what is needed are also clear: (1) cloud-based infrastructure to manage and analyse data (2) automated data capture tools that reduce or at least do not add to hath woker burden (3) use of data by management aslo systematically captured and reported (4) Key perfomance indicators to compare perforamnce within and between countries to benchmark and encourage improvemetn thourhg comparison

    But the main issue here is political – do governments want to have systesm that

    We need to learn to embrace failures as the best teaching tools, and to plan for itThe key is to ensure that whatever we design is bottom-up and based on user-needs and effectively addresses any

    but even basic temperature monitoring is not yet implemented in most countries which stil use simple tehrmometers in most fridges, instead of the WHO-recommended 30-day temperatture loggers.

    • sethberkley says :

      Fully agree Oz. It is for us…the Alliance to work with our countries to generate the political will and to help them with the tools that will ease their workloads whilst allowing us to use our resources (and vaccines) better. We look forward to working with UNICEF on this.

  15. Asad Zaidi says :

    Of the various tech innovations available, the pervasiveness of the mobile-phone makes it the ideal tool to combat disease and to provide healthcare in the most difficult of settings. Combining smart technologies with existing knowledge from other disciplines such as behavioral economics may hold a promising approach with which to implement them. In low-income neighborhoods of Karachi, Pakistan, poor tracking of immunizations using paper-based registries at EPI centers meant that vaccines became less effective due to poor immunization completion and timeliness outcomes. We setup a mobile-phone based vaccine registry that utilizes RFID tags on EPI cards to track infants as they receive immunizations, whilst also utilizing SMS Reminders and a lottery-based incentive program to ensure vaccination regimens are completed; and at the right time. Having a well-functioning system is critical, however, our major lessons learnt involve facilitating adoption of such technologies at the grass-roots level through collaborative peer-learning, demonstrating impact through regular stakeholder engagement and carefully geared communication strategies, which at times have been in “vaccine-hostile” environments. Whether such technologies can be scaled-up and made sustainable using social business models is a question we hope to answer using catalytic support from the UN Innovation Working Group:


  16. maeve says :

    A holistic view has to be taken, as mentioned above, having the appropriate skills and expertise to support these systems is just as critical as the technology/gadgets, while ensuring the right processes are in place to support the technology solutions (and the discipline in following those processes).

    We are at the point in the development space to where we need to be focusing on sustainable solutions (real sustainability!) which requires a holistic approach.

    Given what we are trying to achieve here is not new (the enviornment maybe but not the concept), there is alot of expertise that can be tapped into especially from the private sector. While CSR/CSI efforts are a consideration, the sustainability of these actvities are uncertain.

    Other key roles, private sector actors can play include the provision of funding, technology, access to their expertise (lessons learned/successes etc) or provision of services (data hosting, data analytics, logistics services etc).

    There is even an opportunity to make this the vaccine manufacturers responsibility, asking them to deliver to regional, district or facility level knowing they will ensure the vaccines are stored and transported at the appropriate temperatures and provide the visibility in terms of products delivered.

    • sethberkley says :

      Sustainability is the critical component in all we do. But before we can sustain, we must work with countries to deliver and know where we are not delivering. Agree that many of the solutions will come from the private sector.

  17. Geoffrey Glauser says :

    Seth, I’ve too many ideas to list so, but I’ll start with: Case quantity 2D bar codes that upload to a central web-based application to track large quantities. It is easy to apply those labels after-the-fact and gives a broad volume solution that could be enacted quickly from manufacturer to case point-of-use in a quickly implemented way. The data needs to be able to be stored locally as web connections may not be available 24/7.
    Next step; utilize unit-of-sale 2D bar codes which are being implemented already by vaccine manufacturers as the next level of track and trace. The cases and inventory system would need to handle inference from the case quantity to the unique unit-of-sale 2D bar code on each package. No one wants to break apart a case to scan each unit. Through time all vaccine “touch points” would need to have unique locator numbers to show where it was handled. The database would need to handle each much higher number of transactions.
    Next step; Follow the lead of manufacturers as they shift to RFID to incorporate temperature monitoring data through to expiry data, light exposure, shock data, vibration data, in a passive RFID micro-chip located on each vial label that would contain all vaccine information (Lot#, expiry date, serialization #, GTIN) and perhaps even the entire Package Insert.

    • sethberkley says :

      Geoffrey: Some big visions here. I will take it to the group. Of course, we would love RFID technology that did temperature monitoring as well as expiry and other functions. I suspect that is a second generation solution in our countries…but we have to start somewhere…

  18. Ian says :

    This is a really important topic with a very high percentage of vaccines subjected to dangerous and damaging tempertures in the cold chain. You would think that its the high ambient temperatures that pose the biggest risk but in fact freezing is much more common and more dangerous. By recording temperatures at every stage of the cold chain we can expose the weak links in the chain. Since a large number of storage devices are top opening its important that we monitor more than one temperature – In this type of device very cold air pools at the bottom of the storage space and temperature differences between top and bottom can be huge. We need fixed sensors that at very least give temperatures at the top and bottom of the ‘safe vaccine storage area’. Small, stand alone devices will not give a representative and consistent picture of the temperatures in a cooling device – they will be moved around to suit the device manufacturer or user – they can be separated from the device altogether. Fixed sensors are essential as they enable comparisons to be made and individual devices to be identified.

  19. Philippe Jaillard says :

    Smart and new technologies are certainly part of the solution. But it can be smart or old fashion ways of tracking the vaccines, the more important is to provide the good people at the right place with the right skills and motivation to do the job in the field. without investing in peolple, all investment in technology will be unefficient.

    • sethberkley says :

      Agree Philippe: As said above, we need political committment from countries to be sure to provide the human resources of high quality and retain and motivate them so that they can support the system. Given them tools to help their work load will help.

  20. Bruce Y. Lee says :

    Important topic. You can combine tracking technologies such as bar codes or RFIDs with information systems with computer modeling and simulation, just as in other industries (e.g., manufacturing, air traffic control, and retail). The tracking technologies provides the location of each vaccine vial at given times throughout its delivery, which can be stored in the information system. The modeling and simulation (e.g., hermes.psc.edu), which can pull such data from the information system, will then help you anticipate where the vaccines will and should be going and the potential effects. This can help you make the appropriate changes to ensure the vaccines get to where they are supposed to go and are used. Models such as HERMES can serve as “virtual laboratories” to test strategies to improve vaccine delivery and also project what is and will happen throughout the delivery system.

  21. Mohamed says :

    Use major consumer brands (Coca Cola, Unilever, etc)’s distribution networks to reach areas that are difficult to reach for vaccine distribution organisations. Some of them are claiming huge “development” and CSR credentials while their investments are mostly navel-gazing – they need to be held up to their commitments, and their CSR investments better spent.

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