Imperatives of vaccine distribution

FILIPINO WORLDVIEW - Roberto R. Romulo - The Philippine Star

The COVID-19 crisis and the need to execute the largest mass vaccination campaign in recent history, both globally and in the Philippines, is unprecedented and complex. We are in extraordinary times – needing not only extraordinary measures – but also clarity of purpose, certainty in direction, and patient-centric focus.

Clarity of purpose

The Philippine government, including Secretary Carlito Galvez and the rest of the National Task Force against COVID-19, has done an admirable job under very daunting circumstances. The situation remains highly dynamic, but there is growing convergence between the national government, LGUs, and the private sector on a strategic and coordinated approach to mass vaccinations. Locking-in guaranteed supply of vaccines to achieve at least 70 percent inoculation of the population is on-track with commitments being built with various manufacturers, including large MNCs such as Pfizer-BioNTech, AstraZeneca and Moderna, as well as Asian players such as Sinovac and Faberco (Novovax). Funding pools, both public and private, are accessible and sufficient – whilst regulations are in place to fast-track vaccine approvals for local use through FDA’s Emergency Use Authorization (EUA) framework.

Locking in vaccine supply has been the initial and appropriate focus, but is only the beginning of the country’s mass vaccination journey. Managing the vaccine supply chain from port-to-jab and beyond requires an equally strategic and concerted effort amongst healthcare stakeholders.

Certainty of direction

COVID-19 vaccine supply chain management should drive the quickest, most orderly and most efficient distribution of COVID-19 vaccines – whilst ensuring product quality and integrity, including vaccine authenticity, handling, and temperature control throughout the process.

To achieve successful mass vaccination and the appropriate healthcare outcomes, several critical factors must be met.

Cold chain must be at scale

We will need to receive, handle, and distribute hundreds of millions of sensitive vaccines in fully validated, FDA-certified, global pharma-grade warehouse facilities capable of handling different temperature requirements of COVID-19 vaccines (i.e. two to eight degree centigrade, -20 deg C, and -80 deg C). Such storage facilities should have fit-for-purpose automation, drive efficient inventory management, and must be equipped with redundancies that include temperature monitoring devices with alarms. This will optimize inventory and protect the vaccines from spoilage due to unmonitored temperature excursions while in storage.

Logistics must be integrated

Logistics by land and air should be choreographed in a timely and organized manner. Throughout the vaccine transport from warehouses to vaccination sites across the country, there should be fully validated passive packaging methods capable of handling the different temperature requirements of the COVID 19 vaccines, with temperature monitoring devices while in transit to maintain their quality and efficacy. Equal weight must be given to provincial areas where regional warehouse and vaccination centers should have the same capabilities and capacity to store COVID-19 vaccines at required temperature like what is available in our major cities.

Healthcare delivery systems must be equipped

To achieve mass vaccination at every barangay and barrio, we will need to combine public and private healthcare capacity and re-purpose other venues to meet vaccination demand. Beyond healthcare centers, clinics, and hospitals; we must also equip other potential vaccine sites, including malls, movie theaters, retail pharmacy chain outlets, offices, and warehouses (i.e. vaccination with employees “on-site”), etc. We will need to quickly build the necessary temperature-controlled storage, trained healthcare workers, and the right systems and processes to ensure efficient, effective, transparent, and fully operational vaccination sites – both existing and re-purposed.

Digital technology must be in place

Digital health can play a critical role in facilitating equitable, efficient, and transparent access to COVID-19 vaccinations. Technology can help our taskforce on (1) planning, command and control, as well as (2) managing the whole vaccines supply chain. Technology can also help create a (3) seamless experience for every citizen (including screening, eligibility, scheduling, authentication, reminders, adverse reporting and digital passports), and (4) empower our healthcare professionals and vaccine center administrators at a national and LGU level. Our systems must be equipped with (5) data privacy and cybersecurity protocols, and leverage (6) powerful data and analytics tools so that we drive efficiencies through the process whilst ensuring a delightful consumer experience.

LGUs must be prepared

This include identification and profiling of eligible population, addressing issues on supply chain management, improving vaccine adoption, addressing the information needs of the population, and strengthening leadership and governance at the local level.

As chairman (emeritus) I know that the Zuellig Family Foundation (ZFF) is working with partner LGUs in preparing for vaccine administration. I also know the LGUs have expressed the problem of vaccine hesitancy among their constituents. Hence, assistance on risk communication and community engagement is provided to them by the foundation to increase public willingness to be vaccinated against COVID-19 to achieve herd immunity from the virus.

Patient-centric focus

We should go beyond the numbers and focus on the patients. Their safety, health, the right outcomes and proper management of any adverse effects must be of primary importance.

This requires that healthcare providers must reach all target population the soonest possible time with the active support of local leaders.

No one can do this alone. History has shown that the Philippines has been most successful against adversity in times of unity and solidarity. There is no better time than now for a collaborative, trust-based partnership between the national government, LGUs, the private sector, and each Filipino citizen to ensure integrity, transparency, safety and health outcomes for COVID-19 mass vaccinations.

These should guide the national government and LGUs as they move forward in localizing and operationalizing the national COVID-19 vaccine deployment and administration program.

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