In India, it is not so cool. Reference is to the acute shortage of a cold chain for an effective COVID vaccination drive in India. The Covid-19 Pandemic has shaken up the entire world and has invoked a sense of fear, uncertainty and has brought upon immense loss. The world has been going through a very difficult phase and the pain is more evident in emerging economies which are further plagued by a host of shortages from food to adequate health centres and healthcare workers.
In India, the problems are accentuated because of the huge population and immunizing them is a complex problem based on the procurement, transportation and delivery, not to say hesitancy in taking the vaccine. The Covid-19 vaccination program an ambitious project, was launched on January 16 2021, a commendable attempt to vaccinate 1.3 billion population in a two-dose regimen of Covaxin and Covishield. While the move was applauded and seen as a ray of hope there were concerning doubts.
The current stats at the end of September states that around 87 crore doses were given and the percentage who have received the first dose stands at 29% and those fully vaccinated stands at around 16%, in comparison to the developed countries where the fully vaccinated ranges from 60 to 75%.
Source: Our World in Data
Does India have sufficient infrastructure for the procurement, transportation, storage and delivery, specially a cold chain for the COVID-19 vaccine? Does it have adequate facilities and trained officials to administer the vaccine successfully?
While the problems associated with these different verticals remain a concern, one of the major concerns are associated with the distribution and ultimate delivery of the vaccine in a proper manner. Currently, less than 16% of the people in the country have been fully vaccinated – not good, at this rate it would take more than a year to reach the entire population. Although India is believed to have a huge manufacturing capacity for domestic and export purposes, the cold chain supply infrastructure is woefully inadequate and is becoming a critical bottleneck for the vaccination of Covid-19. From a supply chain management perspective, the cold chain supply is of humungous importance in the entire vaccine delivery system.
As per reports, the vaccine temperature has to be maintained from -2 to -8 degrees or else it will hamper the efficacy of the vaccine. Many vaccines lose potency when exposed to higher temperatures and re-cooling does not help. It is going to be challenging to store vaccines in good condition using cold storage facilities particularly in India considering the geographies and problems of shortage of facilities. These vaccines can be stored using cold boxes, refrigerators, foam packs, vaccine carriers and water packs. Though researchers like the one at IISc are working on a ’warm vaccine’ that can be stored over a month at room temperatures, the current situation is that it requires refrigeration.
The existing cold supply chain for vaccine infrastructure is insufficient hence the Government of India is planning to utilize existing cold storage network of fruits and vegetables, a smart move. India’s National Centre for Cold-Chain Development has pointed out the ’synergies’ between agricultural, processed-food, and medical cold-chain infrastructure, the existing primary vaccination facilities and the fisheries industry have a lot of cold storage infrastructure, if a part of it can be used for storing vaccines then it would be highly beneficial. Another efficient way to facilitate is to increase the public-private and public-public partnerships. By sharing the load of storage and transportation through partnerships would relieve the stress on the existing infrastructure and facilitate better distribution.
Another roadblock to efficient cold chain is a shortage of uninterrupted and sometimes total lack of electricity. Away to assist in the vaccine programme is to set up solar-based cold storage facilities in remote areas where scarcity of electricity tends to be an additional hindrance. In this decade, electrical batteries have started to power our houses and cars. The current technology of storage batteries for electric vehicles is also a development that might help the cause of powering cold chains in areas deficient in electrical energy or having power cuts.
The creation of the infrastructure would not go waste. It would wipe out the current shortage that is present in the primary vaccination. This chain would help increase the access to markets and also reduce the wastage of food products that occur due to a shortage of such facilities especially in remote areas.
Help has been forthcoming from across the world. UNICEF has procured and supplied to India infrastructure for the cold chain like walk-in coolers, walk-in freezers, ice-lined refrigerators, deep freezers, solar direct drive fridges, cold boxes, vaccine carriers, etc. not only to support the COVID vaccinations but also for the routine vaccination for children in the longer term. The Government of Japan announced on June 25, 2021 that it will provide USD 9.3 million worth of cold chain equipment and related assistance to India.
At the end of it all, we might not have to vaccinate everybody- it could be that herd immunity will set in and it will not be required at all or well, the virus may just fade away. Not so cool, huh?
Dr Shetty is a Professor & Area Chairperson – Operations & Supply Chain Management at K J Somaiya Institute of Management. The views expressed are his own.