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Zhang J, Wang K, Xu S, Chen L, Gu H, Yang Y, Zhao Q, Huo Y, Li B, Wang Y, Xie Y, Li N, Zhang J, Zhang J, Li Q. Silk Fibroin-Coated Nano-MOFs Enhance the Thermal Stability and Immunogenicity of HBsAg. ACS APPLIED MATERIALS & INTERFACES 2024; 16:8346-8364. [PMID: 38323561 DOI: 10.1021/acsami.3c16358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
Vaccines are widely regarded as one of the most effective weapons in the fight against infectious diseases. Currently, vaccines must be stored and transported at low temperatures as high temperatures can lead to a loss of vaccine conformation and reduced therapeutic efficacy. Metal-organic frameworks (MOFs), such as zeolitic imidazole framework-8 (ZIF-8), are a new class of hybrid materials with large specific surface areas, high loading rates, and good biocompatibility and are successful systems for vaccine delivery and protection. Silk fibroin (SF) has a good biocompatibility and thermal stability. In this study, the hepatitis B surface antigen (HBsAg) was successfully encapsulated in ZIF-8 to form HBsAg@ZIF-8 (HZ) using a one-step shake and one-pot shake method. Subsequently, the SF coating modifies HZ through hydrophobic interactions to form HBsAg/SF@ZIF-8 (HSZ), which enhanced the thermal stability and immunogenicity of HBsAg. Compared to free HBsAg, HZ and HSZ improved the thermostability of HBsAg, promoted the antigen uptake and lysosomal escape, stimulated dendritic cell maturation and cytokine secretion, formed an antigen reservoir to promote antibody production, and activated CD4+ T and CD8+ T cells to enhance memory T-cell production. Importantly, HSZ induced a strong immune response even after 14 days of storage at 25 °C. Furthermore, the nanoparticles prepared by the one-step shake method exhibited superior properties compared to those prepared by the one-pot shake method. This study highlights the importance of SF-coated ZIF-8, which holds promise for investigating thermostable vaccines and breaking the vaccine cold chain.
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Affiliation(s)
- Jiabin Zhang
- College of Veterinary Medicine, Jilin Agricultural University, Changchun 130118, China
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun 130012, China
| | - Kai Wang
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun 130012, China
| | - Shiyao Xu
- College of Life Sciences, Tonghua Normal University, Tonghua 134002, China
| | - Linlin Chen
- College of Veterinary Medicine, Jilin Agricultural University, Changchun 130118, China
| | - Haiquan Gu
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun 130012, China
| | - Yujie Yang
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun 130012, China
| | - Qi Zhao
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun 130012, China
| | - Yurou Huo
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun 130012, China
| | - Bo Li
- College of Veterinary Medicine, Jilin Agricultural University, Changchun 130118, China
| | - Yufei Wang
- College of Veterinary Medicine, Jilin Agricultural University, Changchun 130118, China
| | - Yubiao Xie
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun 130012, China
| | - Nan Li
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun 130012, China
| | - Jiali Zhang
- College of Veterinary Medicine, Jilin Agricultural University, Changchun 130118, China
| | - Jianxu Zhang
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun 130012, China
| | - Qianxue Li
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun 130012, China
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Suwantika AA, Zakiyah N, Abdulah R, Diantini A. Assessment of childhood immunization services at private healthcare facilities in Indonesia: a case study in a highly-populated city. Front Public Health 2023; 11:1093387. [PMID: 37575096 PMCID: PMC10415032 DOI: 10.3389/fpubh.2023.1093387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 07/07/2023] [Indexed: 08/15/2023] Open
Abstract
Introduction The need to enhance the utilization of the private sector for immunization programs in Indonesia while maintaining the high quality of services provided is evident. This study aimed to rapidly assess immunization services at private healthcare facilities in Indonesia by using Bandung, the most densely populated city, as the reference case. Methods Initially, a situation analysis was conducted by collecting data from selected healthcare facilities (n = 9). Furthermore, a qualitative study was taken into account by developing framework approaches and conducting interviews with different layers, such as mid-level managers at healthcare facilities (n = 9), professional organizations (n = 4), and public stakeholders (n = 7). Results The situation analysis showed that private healthcare facilities had provided sufficient time for essential childhood immunization services with adequate staff. Nevertheless, the number of limited staff the Ministry of Health (MoH) has trained remains a programmatic problem. Furthermore, private healthcare facilities have used the MoH guidelines and additional internal guidelines for immunization services as the primary reference, including in the efforts to provide complete and reliable equipment. Vaccine availability at private healthcare facilities is manageable with an acceptable out-of-stock level. The results of our interviews highlighted three key findings: the lack of coordination across public and private sectors, the need for immunization service delivery improvement at private healthcare facilities, and the urgency to strengthen institutional capacity for advocacy and immunization systems support. Conclusion Even though private healthcare facilities have been shown to make a modest contribution to childhood immunization services in Indonesia, efforts should be made to expand the role of private healthcare facilities in improving the performance of routine immunization programs.
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Affiliation(s)
- Auliya A. Suwantika
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia
- Center of Excellence for Pharmaceutical Care Innovation (PHARCI), Universitas Padjadjaran, Bandung, Indonesia
- Center for Health Technology Assessment, Universitas Padjadjaran, Bandung, Indonesia
| | - Neily Zakiyah
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia
- Center of Excellence for Pharmaceutical Care Innovation (PHARCI), Universitas Padjadjaran, Bandung, Indonesia
| | - Rizky Abdulah
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia
- Center of Excellence for Pharmaceutical Care Innovation (PHARCI), Universitas Padjadjaran, Bandung, Indonesia
| | - Ajeng Diantini
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia
- Center of Excellence for Pharmaceutical Care Innovation (PHARCI), Universitas Padjadjaran, Bandung, Indonesia
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Kamere N, Rutter V, Munkombwe D, Aywak DA, Muro EP, Kaminyoghe F, Rajab K, Lawal MO, Muriithi N, Kusu N, Karimu O, Barlatt SHA, Nambatya W, Ashiru-Oredope D. Supply-chain factors and antimicrobial stewardship. Bull World Health Organ 2023; 101:403-411. [PMID: 37265674 PMCID: PMC10225941 DOI: 10.2471/blt.22.288650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 03/14/2023] [Accepted: 03/22/2023] [Indexed: 06/03/2023] Open
Abstract
Efficient and secure supply chains are vital for effective health services worldwide. In low- and middle-income countries, the accessibility, affordability and availability of essential medicines, including antimicrobials, remain challenging. Ineffective supply chains often cause antimicrobial shortages, leading to inappropriate use of alternative agents and increasing the risk of antimicrobial resistance. Shortages, coupled with insecure supply chains, also encourage the infiltration of substandard and falsified medicines, leading to suboptimal treatment and further promoting antimicrobial resistance. Addressing antimicrobial supply-chain issues should be considered a key component of antimicrobial stewardship programmes. We have explored the link between medicine supply chains and antimicrobial use in seven focus countries: Kenya, Malawi, Nigeria, Sierra Leone, Uganda, United Republic of Tanzania and Zambia. We explored country medicine supply-system structures, national medicine supply-chain policy documents and global study reports. Our aim was to develop evidence-based strategies to enhance the effectiveness and efficiency of the medicine supply chains in supporting antimicrobial stewardship efforts. Better management of medical supply chains involves rational selection, quantification, forecasting, procurement, storage, distribution, use and stock management of antimicrobials. Important supply-chain considerations include pooled procurement networks to ensure consistent pricing of quality-assured antimicrobials, and improved resource utilization and information exchange among relevant stakeholders. We propose adaptable recommendations for integrating medicine supply chains as an essential part of antimicrobial stewardship programmes, with a call for action at the local, regional and national levels in low- and middle-income countries.
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Affiliation(s)
- Nduta Kamere
- Commonwealth Pharmacists Association, London, England
| | | | | | | | - Eva Prosper Muro
- Kilimanjaro Christian Medical University College, Kilimanjaro, United Republic of Tanzania
| | | | - Kalidi Rajab
- Makerere University Pharmacy Department, Kampala, Uganda
| | | | | | - Ndinda Kusu
- Medicines, Technologies, and Pharmaceutical Services Program, Management Sciences for Health, Nairobi, Kenya
| | - Oluwatoyin Karimu
- National Malaria Elimination Programme, Federal Ministry of Health, Abuja, Nigeria
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Public health supply chain for iron and folic acid supplementation in India: Status, bottlenecks and an agenda for corrective action under Anemia Mukt Bharat strategy. PLoS One 2023; 18:e0279827. [PMID: 36827429 PMCID: PMC9955604 DOI: 10.1371/journal.pone.0279827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 12/14/2022] [Indexed: 02/26/2023] Open
Abstract
PURPOSE The IFA supplementation program under the Anemia Mukt Bharat (AMB) program is one of the most ambitious nutrient supplementation programs in India. The delivery of services often suffers due to frequent stock outs and shortages. It is critical to understand the bottleneck in the supply chain adversely affecting the performance and coverage of the program. The paper attempts to identify the bottlenecks of the IFA supply chain in key areas of supply chain i.e., forecasting, procurement, warehousing and inventory management, transportation, distribution, logistic information system and suggests a plan of action aimed at ensuring uninterrupted supplies to the end beneficiaries. DESIGN/METHODOLOGY/APPROACH The data source for the present paper is the nationwide IFA Supply Chain Assessment (2018-19) conducted across 29 Indian states with a total of 58 districts, 116 blocks, 232 Sub-Centres, 232 Anganwadi centres and 232 schools covered under the assessment as a multi-partner collaborative initiative. Field insights from supply chain strengthening interventions under different public health programs in India and other developing countries were taken to arrive at corrective actions and recommendations. Findings were disseminated to government and an action plan was suggested for connecting service delivery points through an app-based system, developing a micro plan for ensuring fixed distribution schedule, followed by continuous monitoring and review meetings identified for follow up. FINDINGS The average lead time across states was 35 weeks with top three performing states being Goa, Sikkim, and Telangana. The average per unit cost of procurement was Rs 0.35 for IFA Red, Rs 0.25 for IFA Blue, Rs 0.31 for IFA Pink and Rs 7.30 for IFA syrup. Out of the 704 districts in India, only 213 has IFA Red, only 140 had IFA Blue, 152 had IFA Pink and 163 had IFA Syrup available in four quarters of 2018-19. The key issues identified in the assessment were-a lack of standardized forecasting process, absence of inventory management techniques, no fixed distribution schedule, inadequate availability of transport vehicles and an absence of an integrated MIS. ORIGINALITY/VALUE The identification of bottlenecks in the IFA supply chain and its impact on the performance of the supply chain would provide policy guidelines for the government as well as development partner agencies to design an effective and efficient supply chain. It would also enable the policy planners to understand the challenges associated with managing different components of a supply chain, their interrelation and impact on the overall performance of the supply chain. The suggested recommendations would equip program managers with the tool to devise and implement field level solutions.
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Sethy G, Nenani Chisema M, Sharma L, Folorunso O, Haile D, Reda Berri Z, Joshi K, Ntenje M, Mitambo C, Laher B, Singhal S, Chirwa S, Damte T, Zulu F, Eleonore Ba A, Seidel M, Phuka J. Key lessons learned from the immunization supply chain of Malawi, an African country using EVM2.0. Vaccine X 2022; 12:100239. [PMID: 36407821 PMCID: PMC9668734 DOI: 10.1016/j.jvacx.2022.100239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/14/2022] [Accepted: 11/07/2022] [Indexed: 11/11/2022] Open
Abstract
Objectives A country’s immunization system's effectiveness depends on its supply chain's efficacy. To assess the challenges of maintaining an efficient vaccine supply chain, Malawi conducted its assessment using The EVM2.0 tool (Effective Vaccine Management). Methods It is a cross-sectional study in which all EVM requirements were assessed between September and October 2021. Data were collected from eighty-two randomly selected sites using the site selection tool of the EVM. Data were entered into the EVM assessment tool 2.0 version 1.12 for analysis. This tool generates performance indicators and criteria scores for assessed sites, compared with a WHO minimum score of 80%. Results Overall criteria scores across all levels of the immunization supply chain showed a statistically significant mean difference of 5.92 (t = 2.58, P = 0.02). Comparative overall mean criteria scores across different levels of the immunization supply chain showed no statistically significant difference for primary (p = 0.76), sub-national (p = 0.69), and lowest distribution stores (p = 0.12). However, a substantial gap was found in the overall mean scores of the health facility’s service point (SP) (t = 4.12, P = 0.001). The overall category scores across all immunization supply chain levels did not show a statistically significant difference. However, among individual category scores, Infrastructure (76 %), Equipment (67 %), Policies and procedures (62 %), Financial (47 %), and Resources (64 %) were found to be below the WHO minimum score. Conclusion Though the 2021 Malawi EVM assessment findings are promising, they still identified the gaps to be improved to ensure the vaccine availability in the right amount, at the right time, and at the right cost.
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Fahr S, Peña-Benavides SA, Thiel L, Sengoba C, Karacasulu K, Ihling N, Sosa-Hernández JE, Gilleskie G, Woodley JM, Parra-Saldivar R, Mansouri SS, Roh K. Mobile On Demand COVID-19 Vaccine Production Units for Developing Countries. Ind Eng Chem Res 2022. [DOI: 10.1021/acs.iecr.2c01217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Steffen Fahr
- Process Systems Engineering (AVT.SVT), RWTH Aachen University, 52074 Aachen, Germany
- Institute of Plant and Process Technology, Technical University of Munich, 85748 Garching, Germany
| | - Samantha Ayde Peña-Benavides
- Department of Chemical and Biochemical Engineering, Technical University of Denmark, DK-2800 Kongens Lyngby, Denmark
- Tecnologico de Monterrey, School of Engineering and Sciences, Monterrey 64849, Mexico
| | - Lukas Thiel
- Process Systems Engineering (AVT.SVT), RWTH Aachen University, 52074 Aachen, Germany
| | - Carl Sengoba
- Process Systems Engineering (AVT.SVT), RWTH Aachen University, 52074 Aachen, Germany
| | - Kaan Karacasulu
- Process Systems Engineering (AVT.SVT), RWTH Aachen University, 52074 Aachen, Germany
| | - Nina Ihling
- Biochemical Engineering (AVT.BioVT), RWTH Aachen University, 52074 Aachen, Germany
| | | | - Gary Gilleskie
- Golden LEAF Biomanufacturing Training and Education Center (BTEC), NC State University, Raleigh, North Carolina 27606, United States
| | - John M. Woodley
- Department of Chemical and Biochemical Engineering, Technical University of Denmark, DK-2800 Kongens Lyngby, Denmark
| | | | - Seyed Soheil Mansouri
- Department of Chemical and Biochemical Engineering, Technical University of Denmark, DK-2800 Kongens Lyngby, Denmark
| | - Kosan Roh
- Process Systems Engineering (AVT.SVT), RWTH Aachen University, 52074 Aachen, Germany
- Department of Chemical Engineering and Applied Chemistry, Chungnam National University, 34141 Daejeon, Republic of Korea
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Fadaki M, Abareshi A, Far SM, Lee PTW. Multi-period vaccine allocation model in a pandemic: A case study of COVID-19 in Australia. TRANSPORTATION RESEARCH. PART E, LOGISTICS AND TRANSPORTATION REVIEW 2022; 161:102689. [PMID: 35431604 PMCID: PMC8995313 DOI: 10.1016/j.tre.2022.102689] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 01/21/2022] [Accepted: 03/24/2022] [Indexed: 05/26/2023]
Abstract
While the swift development and production of a COVID-19 vaccine has been a remarkable success, it is equally crucial to ensure that the vaccine is allocated and distributed in a timely and efficient manner. Prior research on pandemic supply chain has not fully incorporated the underlying factors and constraints in designing a vaccine allocation model. This study proposes an innovative vaccine allocation model to contain the spread of infectious diseases incorporating key contributing factors to the risk of uninoculated people including susceptibility rate and exposure risk. Analyses of the data collected from the state of Victoria in Australia show that a vaccine allocation model can deliver a superior performance in minimizing the risk of unvaccinated people when a multi-period approach is employed and augmenting operational mechanisms including transshipment between medical centers, capacity sharing, and mobile units being integrated into the vaccine allocation model.
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Affiliation(s)
- Masih Fadaki
- Department of Supply Chain and Logistics Management, RMIT University, Melbourne, VIC 3000, Australia
| | - Ahmad Abareshi
- Department of Supply Chain and Logistics Management, RMIT University, Melbourne, VIC 3000, Australia
| | - Shaghayegh Maleki Far
- Department of Supply Chain and Logistics Management, RMIT University, Melbourne, VIC 3000, Australia
| | - Paul Tae-Woo Lee
- Maritime Logistics and Free Trade Islands Research Center, Ocean College, Zhejiang University, Zhoushan, China
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Wang W, Wang Y, Wang Y, Yan F, Wang N, Fu C. Vaccine bidding, procurement and distribution management practices in mainland China: A nationwide study. Vaccine 2021; 39:7584-7589. [PMID: 34802784 DOI: 10.1016/j.vaccine.2021.11.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 11/06/2021] [Accepted: 11/08/2021] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To conduct a nationwide evaluation of vaccine bidding, procurement and distribution management for understanding and improving the current situation well in mainland China. METHODS An institution survey was carried out to collect information on tendering, procurement, distribution and related issues to vaccines by structured questionnaires administered to 31 provinces in mainland China from April to July 2019. RESULTS In 13 (41.9%) of 31 provinces, centralized bidding of National Immunization Program (NIP) vaccines was accomplished, and others conducted independent tendering and purchasing in 2018. For non-NIP vaccines, all provinces implemented unified bidding at the provincial level and over half (18, 58.1%) of them chose provincial public resource trading platforms, but their modes varied over provinces. Then procurement was undertaken by the district-level centers for disease control and prevention (CDC) while they were unable to choose the best option of too many vaccines targeted by the province-level CDC for local populations. The distribution modes of NIP and non-National Immunization Program (non-NIP) vaccines were similar overall in a province but very different over provinces. Main mode was that CDCs at different levels delivered about two thirds (64.5%) of NIP vaccines distribution and more than one third (35.5%) of non-NIP vaccines. Another distribution mode was occupied as fully buying the service from third parties in 3 municipalities. Some provinces mixed both modes, too. The total distribution volume of vaccines was 430.7 million doses in 2018. The top five non-NIP vaccines delivered in 2018 were human rabies vaccine, varicella vaccine, EV71 hand foot mouth disease vaccine, hepatitis B vaccine and influenza vaccine. CONCLUSION The vaccine biding, procurement and distribution management varied over provinces in mainland China in 2018, especially for non-NIP vaccines. Specific policies and measures should be developed for different regions to improve the immunization management better.
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Affiliation(s)
- Wei Wang
- School of Public Health, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Yanhuan Wang
- School of Public Health, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Ying Wang
- School of Public Health, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Fei Yan
- School of Public Health, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Na Wang
- School of Public Health, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Chaowei Fu
- School of Public Health, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China.
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Bian W, Yang X, Li S, Yang X, Hua G. Advantages of 3PLs as healthcare supply chain orchestrators. COMPUTERS & INDUSTRIAL ENGINEERING 2021; 161:107628. [PMID: 34545266 PMCID: PMC8443400 DOI: 10.1016/j.cie.2021.107628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Given the expansion of the COVID-19 cases and the average infection rate globally, constructing a robust healthcare supply chain system for the crisis is highly crucial. The third-party logistics providers (3PLs), who can match the market demand with reliable manufacturers worldwide, have emerged as orchestrators. In addition to the basic transportation and storage services, some 3PLs can also provide procurement assistance to relatively small retailers. To illustrate the value of the above-mentioned business model, we build a game-theoretic model to capture participants' optimal strategy in a healthcare supply chain consisting of a manufacturer, a 3PL provider, and a retailer. We also investigate the conditions where the performance in this business model outperforms the traditional model. It is concluded that the 3PL's positive effect appears when the decentralized supply chain is characterized by high logistics outsourcing costs and high-level price sensitivity. We further design an incentive mechanism that can coordinate the supply chain. Finally, a series of numerical experiments are carried out to demonstrate the effectiveness of our model.
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Affiliation(s)
- Wenliang Bian
- School of Economics and Management, Beijing Jiaotong University, Beijing 100044, China
| | - Xiqing Yang
- School of Economics and Management, Beijing Jiaotong University, Beijing 100044, China
| | - Shichang Li
- Zhongjie Telecommunications Co. Ltd., Guangzhou 510055, China
| | - Xiying Yang
- School of Economics and Management, Beijing Jiaotong University, Beijing 100044, China
| | - Guowei Hua
- School of Economics and Management, Beijing Jiaotong University, Beijing 100044, China
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Kitamura T, Bouakhasith V, Phounphenghack K, Pathammavong C, Xeuatvongsa A, Kobayashi A, Norizuki M, Okabayashi H, Miyano S, Mori Y, Takeda M, Sugiyama M, Mizokami M, Machida M, Hachiya M. Vaccine temperature management in Lao People's Democratic Republic: A nationwide cross-sectional study. Heliyon 2021; 7:e07342. [PMID: 34307926 PMCID: PMC8258653 DOI: 10.1016/j.heliyon.2021.e07342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 05/05/2021] [Accepted: 06/14/2021] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE The objective of the study was to evaluate the duration and frequency of vaccine exposure to suboptimal temperatures during transit from the central vaccine storage in the capital to health centers in Lao PDR. METHODS Temperature data loggers traveled from the capital to the health centre storages (146) with the vaccines to monitor the vaccine temperature nationwide. One health centre per district was selected using a simple random sampling method for the first round of temperature monitoring. One health centre was selected from every forty-nine high risk districts monitor the trend of vaccine temperature at the health centre storage and during outreach sessions in several districts. Vaccines and temperature data loggers were transported using the normal vaccination transportation. FINDINGS Overall, the vaccines were exposed to temperatures >8 °C for an average of 1648 min, equivalent to 9.0% of the observational period, and to temperatures <0 °C for an average of 184 min, equivalent to 1.35% of the study period. The proportion of exposure to temperatures >8 °C was the highest during the transit from the capital to the province. The proportion of exposure to temperatures <0 °C was the highest during storage at district level. Examined by region, vaccines in the northern provinces had higher risk of exposure to temperatures >8 °C; however, the risk of exposure to temperatures <0 °C was scattered nationwide. Moreover, some health centers showed fluctuations in storage temperature. CONCLUSIONS Challenges associated with cold chain management, and the resulting deterioration of vaccines, might account for outbreaks of vaccine-preventable diseases. The government should examine and invest in suitable technologies and approaches to ensure consistency in cold chain management.
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Affiliation(s)
- Tomomi Kitamura
- National Center for Global Health and Medicine, 1-21-1 Toyama Shinjuku, Tokyo, 1628655 Japan
| | | | | | | | | | - Akiko Kobayashi
- School of International Health, Graduate School of Medicine, University of Tokyo, Tokyo, 113-8654, Japan
| | - Masataro Norizuki
- National Center for Global Health and Medicine, 1-21-1 Toyama Shinjuku, Tokyo, 1628655 Japan
| | - Hironori Okabayashi
- National Center for Global Health and Medicine, 1-21-1 Toyama Shinjuku, Tokyo, 1628655 Japan
| | - Shinsuke Miyano
- National Center for Global Health and Medicine, 1-21-1 Toyama Shinjuku, Tokyo, 1628655 Japan
| | - Yoshio Mori
- National Institute of Infectious Diseases, Murayama Branch, 4-7-1 Gakuen, Musashimurayama, Tokyo, 208-0011, Japan
| | - Makoto Takeda
- National Institute of Infectious Diseases, Murayama Branch, 4-7-1 Gakuen, Musashimurayama, Tokyo, 208-0011, Japan
| | - Masaya Sugiyama
- Genome Medical Sciences Project, National Center for Global Health and Medicine, 1-7-1 Kohnodai, Ichikawa, Chiba, 272-8516, Japan
| | - Masashi Mizokami
- Genome Medical Sciences Project, National Center for Global Health and Medicine, 1-7-1 Kohnodai, Ichikawa, Chiba, 272-8516, Japan
| | - Munehito Machida
- Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Ishikawa, Kanazawa, 9208640, Japan
| | - Masahiko Hachiya
- National Center for Global Health and Medicine, 1-21-1 Toyama Shinjuku, Tokyo, 1628655 Japan
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Kanyoma KE, Agbola FW, Oloruntoba R. Inhibitors and enablers of supply chain integration across multiple supply chain tiers: evidence from Malawi. INTERNATIONAL JOURNAL OF LOGISTICS MANAGEMENT 2020. [DOI: 10.1108/ijlm-06-2019-0161] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThis paper investigates the inhibitors and enablers of supply chain integration (SCI) across multiple tiers in the supply chains of manufacturing-based small and medium-sized enterprises (SMEs) in Malawi.Design/methodology/approachFollowing a qualitative approach, data were collected through face-to-face interviews across three supply chains, each consisting of a focal manufacturer, a major supplier and a retailer.FindingsThe research identified interpersonal relationships, supplier cost transparency and joint supply chain management (SCM) investments as key enablers of SCI. Concerning the inhibitors of SCI, the study found that a lack of external integration inhibited internal integration by acting as a source of disruption to intra-firm processes and relationships. Further, the research found weaker links between manufacturer–-retailer dyads than in manufacturer–supplier dyads, which constrained the ability to achieve multi-tier supplier–manufacture–retailer integration. The study also revealed that resource and infrastructural deficiencies, a culture of fear and intimidation within and between firms, corruption in sourcing transactions and a lack of inter-firm trust inhibited SCI.Research limitations/implicationsThe paper extends earlier evidence that internal integration is a prerequisite for external integration demonstrating that a basic level of external integration is necessary to prevent disruptions to internal integration.Originality/valueThis study is one of the few to go beyond the focal firm perspective and explore the inhibitors and enablers of SCI across multiple supply chain positions, and provides new evidence on the role of external integration in achieving internal integration.
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An inventory-location optimization model for equitable influenza vaccine distribution in developing countries during the COVID-19 pandemic. Vaccine 2020; 39:495-504. [PMID: 33342632 PMCID: PMC7833064 DOI: 10.1016/j.vaccine.2020.12.022] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/23/2020] [Accepted: 12/07/2020] [Indexed: 01/31/2023]
Abstract
The addition of other respiratory illnesses such as flu could cripple the healthcare system during the coronavirus disease 2019 (COVID-19) pandemic. An annual seasonal influenza vaccine is the best way to help protect against flu. Fears of coronavirus have intensified the shortage of influenza shots in developing countries that hope to vaccinate many populations to reduce stress on their health services. We present an inventory-location mixed-integer linear programming model for equitable influenza vaccine distribution in developing countries during the pandemic. The proposed model utilizes an equitable objective function to distribute vaccines to critical healthcare providers and first responders, elderly, pregnant women, and those with underlying health conditions. We present a case study in a developing country to exhibit efficacy and demonstrate the optimization model's applicability.
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Sarveswaran G, Krishnamoorthy Y, Sakthivel M, Vijayakumar K, Priyan S, Thekkur P, Chinnakali P. Preference for Private Sector for Vaccination of Under-Five Children in India and Its Associated Factors: Findings from a Nationally Representative Sample. J Trop Pediatr 2019; 65:427-438. [PMID: 30698773 DOI: 10.1093/tropej/fmy071] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Understanding the factors associated with private sector preference for vaccination will help in understanding the barriers in seeking public facility and also the steps to improve public-private partnership (PPP) model. METHODS We analysed the recent National Family Health Survey-4 data (NFHS-4; 2015-16) gathered from Demographic Health Survey programme. Stratification and clustering in the sample design was accounted using svyset command. RESULTS Weighted proportion of children receiving private vaccination was 10.0% (95% CI: 9.7-10.3). Children belonging to highest wealth quantile (adjusted Prevalence ratio; aPR-1.58), male child (aPR-1.07) urban area (aPR-1.11), not receiving anganwadi/Integrated Childhood Development Services (aPR-1.71) and receiving antenatal care in private sector was significantly associated with higher proportion of private vaccination. CONCLUSION Current study showed that 1 in 10 <5 years child in India received vaccination from private health facility. Preference for private health facility was found to be influenced by higher socio-economic strata, urban area residence and seeking private health facility for antenatal and delivery services.
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Affiliation(s)
- Gokul Sarveswaran
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Yuvaraj Krishnamoorthy
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Manikandanesan Sakthivel
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Karthiga Vijayakumar
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Shanthosh Priyan
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Pruthu Thekkur
- Centre for Operational Research. International Union Against Tuberculosis and Lung Disease (The Union), New Delhi, India
| | - Palanivel Chinnakali
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
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Iwu CJ, Jaca A, Abdullahi LH, Ngcobo NJ, Wiysonge CS. A scoping review of interventions for vaccine stock management in primary health-care facilities. Hum Vaccin Immunother 2019; 15:2666-2672. [PMID: 31116638 DOI: 10.1080/21645515.2019.1607130] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
One of the challenges facing the success of immunization programs is shortages of vaccines at health facilities, which could result from inadequate vaccine stock management. Several approaches have been designed by countries to improve vaccine stock management. This review summarizes currently available information on interventions for vaccine stock management.We considered both randomized trials and non-randomized studies eligible for inclusion in this review. The following databases were searched: PubMed, Embase, Cochrane Central Register of Controlled Trials, World Health Organization Library Information System, Web of Science, and PDQ-Evidence. We searched the websites of the World Health Organization, Global Alliance for Vaccine and Immunization, PATH's Vaccine Resources Library, and United Nations Children's Fund. The reference lists of all the included studies were also searched. Two authors independently screened search outputs, reviewed full texts of potentially eligible articles, evaluated risk of bias, and extracted data; resolving disagreements through consensus.Four studies met our inclusion criteria (three before-after studies and one randomized trial). Three studies were conducted in low- and middle-income countries while one was conducted in Canada (a high-income country). All the studies had various limitations and were classified as having a high risk of bias. Study findings suggest that the use of digital information systems to improve information and stock visibility, coupled with other interventions (such as training of health-care workers on the use of innovative tools and redesign of the supply chain to tackle certain bottlenecks), has the potential to increase vaccine availability, reduce response times, and improve the quality of vaccine records.
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Affiliation(s)
- Chinwe Juliana Iwu
- Division of Health systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Anelisa Jaca
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | | | - Ntombenhle Judith Ngcobo
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa.,Independent consultant, Pretoria, South Africa
| | - Charles Shey Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa.,Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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15
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El Baz J, Laguir I, Stekelorum R. Logistics and supply chain management research in Africa. INTERNATIONAL JOURNAL OF LOGISTICS MANAGEMENT 2019. [DOI: 10.1108/ijlm-09-2017-0242] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe purpose of this paper is to review the literature on logistics and supply chain management (SCM) in Africa over the last few decades. It provides a comprehensive assessment of theory application regarding the research articles published between 1994 and 2016.Design/methodology/approachIn this structured systematic literature review, a set of 110 articles on SCM research in Africa is assessed.FindingsThe authors present the state-of-the-art review on logistics and SCM research in Africa. Extant literature shows that most research works focused on operational aspects of logistics and SCM and that papers drew heavily on theories inspired by strategic management, marketing, micro/macroeconomics and organizational behavior theories. Also, most of the papers with theoretical background can be categorized into theory matching and theory dressing and only a minority of theoretical papers belongs to theory suggestion category. Furthermore, based on the findings, the authors present a framework to characterize the peculiar aspects of Africa-based SCM and logistics practices and provide research propositions related to underexplored aspects of logistics and SCM in Africa.Research limitations/implicationsThis study has a number of implications. Practitioners and researchers will gain a greater understanding of how logistics and SCM are carried out in Africa and the type of issues that have been addressed. Furthermore, researchers will be able to identify areas that need greater research attention in Africa.Originality/valueThis study is one of the first literature reviews of publications on logistics and SCM in Africa. It presents an overarching map of the research to date and a series of propositions to inform future research.
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16
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Vouking MZ, Mengue CMA, Yauba S, Edengue JM, Dicko M, Dicko HM, Wiysonge CS. Interventions to increase the distribution of vaccines in Sub-Saharan Africa: a scoping review. Pan Afr Med J 2019; 32:14. [PMID: 31143319 PMCID: PMC6522164 DOI: 10.11604/pamj.2019.32.14.17225] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 01/05/2019] [Indexed: 11/11/2022] Open
Abstract
Achieving universal access to immunization, as envisioned in the global vaccine action plan continues to be a challenge for many countries in Sub-Saharan Africa. Weak immunization supply chain (iSC) has widely been recognized as a key barrier, hindering progress towards vaccination targets in this region. These iSCs, which were designed in the 1980s, have become increasing fragile and are now considered outdated. The objective of this review was to assess the effectiveness of system redesign and outsourcing to improve outdated iSC systems in sub-Saharan Africa. We searched the following electronic databases from January 2007 to December 2017: Medline, EMBASE (Excerpta Medica Database), the Cochrane Library, Google Scholar, CINAHL (Cumulative Index to Nursing and Allied Health Literature), WHOLIS (World Health Organization Library Database), LILACS (Latin American and Caribbean Literature on Health Sciences) and contacted experts in the field. Our search strategy yielded 80 records and after assessment for eligibility, seven papers met the inclusion criteria. Five studies evaluated the experiences of system redesign in three countries (Nigeria, Benin and Mozambique), two assessed outsourcing vaccine logistics to the private sector in Nigeria and South Africa. According to these studies, system redesign improved vaccine availability at service delivery points and reduce the cost of distributing vaccines. Similarly, outsourcing vaccine logistics to the private sector reduced the cost of vaccines distribution and improve vaccine availability at service delivery points.
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Affiliation(s)
- Marius Zambou Vouking
- Center for the Development of Best Practices in Health, Yaoundé Central Hospital, Henri-Dunant Avenue, Messa, Yaoundé, Cameroon.,Central Technical Group of the Expanded Program on Immunization, Yaoundé, Cameroon
| | | | - Saidu Yauba
- Clinton Health Access Initiative, Country Office, Cameroon
| | | | - Modibo Dicko
- Health Supply & Solar Systems (H3S), Systèmes Solaires & Logistique de Santé, Cité El Farako, Bamako, Mali
| | | | - Charles Shey Wiysonge
- Cochrane South Africa, South African Medical Research Council, Tygerberg, South Africa
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17
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Peckham R, Sinha R. Anarchitectures of health: Futures for the biomedical drone. Glob Public Health 2018; 14:1204-1219. [DOI: 10.1080/17441692.2018.1546335] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Robert Peckham
- Centre for the Humanities and Medicine, The University of Hong Kong, Hong Kong
| | - Ria Sinha
- Centre for the Humanities and Medicine, The University of Hong Kong, Hong Kong
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18
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Akbari M. Logistics outsourcing: a structured literature review. BENCHMARKING-AN INTERNATIONAL JOURNAL 2018. [DOI: 10.1108/bij-04-2017-0066] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to provide a structured literature review (SLR) and systematic insight into logistics outsourcing research, in order to identify gaps in knowledge, and provide future research direction in the logistics outsourcing discipline.
Design/methodology/approach
This paper identifies and synthesises information from academic journals and examines research designs and methods, data analysis techniques, geographic locations, industry engagements, year of publication, publishers, university and author affiliations. A collection of online databases from 1991 to 2016 were explored, using the keywords “third-party”, “logistics” and “outsourcing” in their title and/or abstract, to deliver an inclusive listing of journal articles in this discipline area. Based on this approach, a total of 263 articles were found and data were derived from a succession of variables.
Findings
There has been a significant increase and concentration by researchers over the past 25 years focussing on logistics outsourcing. A need to implement best practice has been universally identified, owing to increasing global supply chain complexity. This analysis shows that only seven literature reviews were published in the logistics outsourcing discipline. Additionally, this study revealed that 42 per cent of the work in this field was found to be survey based and this trend in research indicates the development of the structural equation modelling and multi-criterion decision-making methods. Investigations between 2010–2012 and 2015–2016 accounted for 151 of the total 263 articles published. Finally, reverse logistics is an area that requires special attention.
Research limitations/implications
This paper is limited to a review of academic articles obtainable from online databases, containing the words “logistics” and “outsourcing” in the title and/or abstract. Additionally, only papers from high quality, peer-reviewed journals were evaluated. Other academic sources such as books and conference papers were not included in this study.
Originality/value
This review will provide an increased understanding of the existing state of current research, trends and future research directions in the logistics outsourcing discipline.
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Songane M. Challenges for nationwide vaccine delivery in African countries. INTERNATIONAL JOURNAL OF HEALTH ECONOMICS AND MANAGEMENT 2018; 18:197-219. [PMID: 29047019 DOI: 10.1007/s10754-017-9229-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 10/09/2017] [Indexed: 06/07/2023]
Abstract
Vaccines are very effective in providing individual and community (herd) immunity against a range of diseases. In addition to protection against a range of diseases, vaccines also have social and economic benefits. However, for vaccines to be effective, routine immunization programmes must be undertaken regularly to ensure individual and community protection. Nonetheless, in many countries in Africa, vaccination coverage is low because governments struggle to deliver vaccines to the most remote areas, thus contributing to constant outbreaks of various vaccine-preventable diseases. African governments fail to deliver vaccines to a significant percentage of the target population due to many issues in key areas such as policy setting, programme management and financing, supply chain, global vaccine market, research and development of vaccines. This review gives an overview of the causes of these issues and what is currently being done to address them. This review will discuss the role of philanthropic organisations such as the Bill and Melinda Gates Foundation and global partnerships such as the global alliance for vaccines and immunizations in the development, purchase and delivery of vaccines.
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Affiliation(s)
- Mario Songane
- McGill Life Sciences Complex, McGill University, 3649 Promenade Sir-William-Osler, Montreal, H3G 0B1, Canada.
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20
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Kitamura T, Bouakhasith V, Phounphenghack K, Pathammavong C, Xeuatvongsa A, Norizuki M, Okabayashi H, Mori Y, Machida M, Hachiya M. Assessment of temperatures in the vaccine cold chain in two provinces in Lao People's Democratic Republic: a cross-sectional pilot study. BMC Res Notes 2018; 11:261. [PMID: 29703228 PMCID: PMC5924473 DOI: 10.1186/s13104-018-3362-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Accepted: 04/18/2018] [Indexed: 11/10/2022] Open
Abstract
Objective All childhood vaccines, except the oral polio vaccine, should be kept at 2–8 °C, since the vaccine potency can be damaged by heat or freezing temperature. A temperature monitoring study conducted in 2008–2009 reported challenges in cold chain management from the provincial level downwards. The present cross-sectional pilot study aimed to assess the current status of the cold chain in two provinces (Saravan and Xayabouly) of Lao People’s Democratic Republic between March–April 2016. Two types of temperature data loggers recorded the temperatures and the proportions of time exposed to < 0 or > 8 °C were calculated. Results The temperature remained within the appropriate range in the central and provincial storages. However, the vaccines were frequently exposed to > 8 °C in Saravan and < 0 °C in Xayabouly in the district storage. Vaccines were exposed to > 8 °C during the transportation in Saravan and to both > 8 and < 0 °C in Xayabouly. Thus, challenges in managing the cold chain in the district storage and during transportation remain, despite improvements at the provincial storage. A detailed up-to-date nationwide analysis of the current situation of the cold chain is warranted to identify the most appropriate intervention to tackle the remaining challenges.
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Affiliation(s)
- Tomomi Kitamura
- Bureau of International Cooperation, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku, Tokyo, 1628655, Japan.
| | - Viraneth Bouakhasith
- National Immunization Program, Ministry of Health, Lao PDR, Simuang Road, Vientiane, Lao People's Democratic Republic
| | - Kongxay Phounphenghack
- National Immunization Program, Ministry of Health, Lao PDR, Simuang Road, Vientiane, Lao People's Democratic Republic
| | - Chansay Pathammavong
- National Immunization Program, Ministry of Health, Lao PDR, Simuang Road, Vientiane, Lao People's Democratic Republic
| | - Anonh Xeuatvongsa
- National Immunization Program, Ministry of Health, Lao PDR, Simuang Road, Vientiane, Lao People's Democratic Republic
| | - Masataro Norizuki
- Bureau of International Cooperation, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku, Tokyo, 1628655, Japan
| | - Hironori Okabayashi
- Bureau of International Cooperation, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku, Tokyo, 1628655, Japan
| | - Yoshio Mori
- Laboratory of Rubella, Department of Virology III, National Institute of Infectious Diseases, Murayama Branch, 4-7-1 Gakuen, Musashimurayama, Tokyo, 208-0011, Japan
| | - Munehito Machida
- Department of Global Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, 9208640, Japan
| | - Masahiko Hachiya
- Bureau of International Cooperation, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku, Tokyo, 1628655, Japan
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Walwyn DR, Nkolele AT. An evaluation of South Africa's public-private partnership for the localisation of vaccine research, manufacture and distribution. Health Res Policy Syst 2018; 16:30. [PMID: 29587777 PMCID: PMC5870219 DOI: 10.1186/s12961-018-0303-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 03/05/2018] [Indexed: 11/28/2022] Open
Abstract
Background Public–private partnerships (PPPs), widely used as a means of leveraging the skills, expertise and resources of the private sector to mutual advantage, were similarly adopted by South Africa to support public sector delivery. This study has evaluated one such partnership, namely the Biovac Institute, which was established in 2003 to cover vaccine research and development, manufacturing, and supply. The initiative was highly unusual given that it attempted to combine all three aspects in a single PPP. Methods The research has followed a concurrent mixed methods approach. In the quantitative study, data for prices and product volumes were extracted from secondary data sources and used to calculate the economic cost and value-for-money of the PPP. Simultaneously, a qualitative study was undertaken in which a number of key stakeholders were interviewed using a semi-structured questionnaire on their perceptions of the PPP’s value. Results The institute earns a premium on the procurement cost of a broad range of vaccines required by the South African National Department of Health for its immunisation programme, the net value of which was US$85.7 million over the period 2010 to 2014. These funds were used to finance the institute’s operations, including vaccine research, distribution and quality control. Capital expenditure to support the establishment of facilities for laboratory testing, packaging and labelling, filling, formulation and, finally, active pharmaceutical ingredient manufacture, approximately US$40 million in total, had to be secured through loans and grants. According to the respondents in the qualitative survey, the principal benefit of the PPP has been the uninterrupted supply of vaccines and the ability to respond quickly to vaccine shortages. The main disadvantages appear to have been a slow and ineffectual establishment of a vaccine manufacturing centre and, initially, a limited ability to negotiate highly competitive vaccine prices. Conclusions Overall, it is concluded that a positive value-for-money has been achieved and the institute has been of significant public benefit. Relationships of this nature can be used to achieve public health goals, but need to be realistic about timeframes, costs and the limitations of relational governance in ensuring that complex programmatic outcomes are achieved. It is recommended that a more incremental approach, with clearer contractual goals, penalties and incentives, is adopted in attempting initiatives aimed at the localisation of manufacturing technology by leveraging public procurement.
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Affiliation(s)
- David R Walwyn
- Department of Engineering and Technology Management, University of Pretoria, Private Bag X20, Hatfield, Pretoria, 0028, South Africa.
| | - Adolph T Nkolele
- Department of Engineering and Technology Management, University of Pretoria, Private Bag X20, Hatfield, Pretoria, 0028, South Africa
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Hanson CM, George AM, Sawadogo A, Schreiber B. Is freezing in the vaccine cold chain an ongoing issue? A literature review. Vaccine 2017; 35:2127-2133. [PMID: 28364920 DOI: 10.1016/j.vaccine.2016.09.070] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 09/12/2016] [Accepted: 09/14/2016] [Indexed: 10/19/2022]
Abstract
Vaccine exposure to temperatures below recommended ranges in the cold chain may decrease vaccine potency of freeze-sensitive vaccines leading to a loss of vaccine investments and potentially places children at risk of contracting vaccine preventable illnesses. This literature review is an update to one previously published in 2007 (Matthias et al., 2007), analyzing the prevalence of vaccine exposure to temperatures below recommendations throughout various segments of the cold chain. Overall, 45 studies included in this review assess temperature monitoring, of which 29 specifically assess 'too cold' temperatures. The storage segments alone were evaluated in 41 articles, 15 articles examined the transport segment and 4 studied outreach sessions. The sample size of the studies varied, ranging from one to 103 shipments and from three to 440 storage units. Among reviewed articles, the percentage of vaccine exposure to temperatures below recommended ranges during storage was 33% in wealthier countries and 37.1% in lower income countries. Vaccine exposure to temperatures below recommended ranges occurred during shipments in 38% of studies from higher income countries and 19.3% in lower income countries. This review highlights continuing issues of vaccine exposure to temperatures below recommended ranges during various segments of the cold chain. Studies monitoring the number of events vaccines are exposed to 'too cold' temperatures as well as the duration of these events are needed. Many reviewed studies emphasize the lack of knowledge of health workers regarding freeze damage of vaccines and how this has an effect on temperature monitoring. It is important to address this issue by educating vaccinators and cold chain staff to improve temperature maintenance and supply chain management, which will facilitate the distribution of potent vaccines to children.
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Aina M, Igbokwe U, Jegede L, Fagge R, Thompson A, Mahmoud N. Preliminary results from direct-to-facility vaccine deliveries in Kano, Nigeria. Vaccine 2017; 35:2175-2182. [DOI: 10.1016/j.vaccine.2016.11.100] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 09/21/2016] [Accepted: 11/14/2016] [Indexed: 11/28/2022]
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Agrawal P, Barton I, Bianco RD, Hovig D, Sarley D, Yadav P. Moving Medicine, Moving Minds: Helping Developing Countries Overcome Barriers to Outsourcing Health Commodity Distribution to Boost Supply Chain Performance and Strengthen Health Systems. GLOBAL HEALTH: SCIENCE AND PRACTICE 2016; 4:359-65. [PMID: 27688714 PMCID: PMC5042692 DOI: 10.9745/ghsp-d-16-00130] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 08/26/2016] [Indexed: 11/23/2022]
Abstract
Senegal and other developing countries are improving access to health commodities by outsourcing supply chain logistics to private providers. To achieve broader, lasting reform, we must support further adoption of the outsourced model; assist country-led cost-benefit analyses; and help governments build capacity to manage contracts and overcome other barriers.
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Affiliation(s)
- Priya Agrawal
- Merck & Co., Inc., Kenilworth, NJ, USA. Merck & Co., Inc. is known as MSD outside the United States and Canada
| | - Iain Barton
- Imperial Health Sciences, Gauteng, South Africa
| | - Roberto Dal Bianco
- Merck & Co., Inc., Kenilworth, NJ, USA. Merck & Co., Inc. is known as MSD outside the United States and Canada
| | - Dana Hovig
- The Bill & Melinda Gates Foundation, Seattle, WA, USA
| | - David Sarley
- The Bill & Melinda Gates Foundation, Seattle, WA, USA
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