Delivering vaccines by drone in isolated areas, planning supply schedules thanks to mobile and satellite technologies… The private sector offers innovative solutions to extend immunization coverage in developing countries.

©GAVIA Sad Zaidi
©GAVIA Sad Zaidi

The private sector plays a crucial role in the development of the poorest countries. It generates innovations, employment and growth and, in many cases, is an essential partner for international organizations, NGOs and public institutions working in the field. For example, in the health sector, especially for immunization, the private sector is a key player in developing innovative solutions to reach children who are excluded from access to essential vaccines for geographical or social reasons.

Indeed, there is still a long way to go in terms of immunization. Child mortality has halved since 1990, and immunization rates have now reached record levels in low-income countries – immunization coverage stands at around 82% in these countries, which are priority targets for GAVI. However, despite this progress, 1.5 million children under the age of five still die every year around the world of diseases such as diphtheria, whooping cough, pneumococcal pneumonia and rotavirus diarrhea. These are diseases which can be avoided with immunization. Measles alone, which is currently prevalent in Europe, causes some 135,000 deaths every year around the world, mainly among children under the age of five.

So today, we still do not always manage to reach the “5th child” with basic vaccines, the child who remains outside health circuits. Children who are not protected by vaccines have their future destroyed by these diseases, which place a burden on the family budget and therefore, more broadly, on the economies of the countries in question. Any solution to reach these children is therefore a good solution, and this is where the private sector’s expertise is crucial, especially its technological and digital expertise.

 

Delivering vaccines by drones in hard-to-reach areas

Drones can be a solution for reaching this “5th child” and, for example, for optimizing the delivery of vaccines in the most remote areas in certain countries. While their commercial use is still under debate in developed countries, last year, Rwanda, in partnership with the American company Zipline International and with the financial support of the delivery company UPS and GAVI, launched an emergency delivery service for medical supplies by drones. For example, blood bags to meet transfusion needs are transported from the capital Kigali to the most remote areas nestled in the heart of Rwanda’s mountains. Rabies vaccines will soon be delivered, as this vaccine must be injected rapidly when someone is bitten by an infected animal. This technology is currently used in emergency situations, but could soon be tested on a larger scale, particularly in the context of the Rwandan Ministry of Health’s target of routine immunization.

 

 

Another example of innovation in delivery is to be found in Kenya, where a partnership has been forged between the logistics group DHL and Kenyan Ministry of Health to improve the provision of vaccines in the country. DHL’s expertise will make it possible to identify and remove the bottlenecks which disrupt the cold chain during the delivery of vaccines. Indeed, an efficient vaccine is a vaccine which, from manufacturing to injection, has been maintained at a constant temperature, often of about 5 degrees. This is one of the biggest challenges for immunization in developing countries. DHL’s knowledge of express deliveries will benefit Kenya’s health system and avoid the efforts made to ensure the availability of vaccines being ruined over the last kilometers of the delivery. This partnership will be extended to other countries supported by GAVI, depending on the results over the next three years.

 

Extend immunization coverage with the help of phones and satellites

Efficiently managing vaccine stocks and improving the cold chain are two critical points in immunization programs for which private expertise is essential. With 850 million users and a penetration rate of 74% in Africa, where the vast majority of children who are not reached by immunization are to be found, mobile phones provide a key tool for action on these two points. For example, by allowing parents to declare the birth of their child, they make it possible for immunization managers to more effectively plan their supply schedule and stock of vaccines. Data sent in real time is thereby collected, which ensures that there is no shortage in health centers. Phones also facilitate the transmission of information, such as epidemiological data or information on the causes of mortalities or on immunization rates.

In Pakistan, in Punjab Province, over 3,700 health staff responsible for immunization were equipped with phones called E-vacc for several months. This enabled them to collect information on the ages of children, the type of vaccine used, and the immunization coverage rate. This technology also allowed them, thanks to a satellite imagery system the phones are equipped with, to identify the exact areas where the non-vaccinated children were living and to direct immunization campaigns towards these areas. The immunization program was thus able to reach an additional 500,000 children in a year. This success can be put down to mobile technology, but also to the private companies which made it available to the Government of Punjab.

INFUSE: the business service platform

However, in order to bring private sector expertise and technologies to the field, it is necessary to be familiar with them and finance them. In 2016, the “Innovation for Uptake, Scale and Equity in Immunisation (INFUSE)” initiative was launched at the World Economic Forum in Davos. INFUSE is a platform which creates networks among innovators and financiers in order to i/ identify solutions to reduce inequities in access to vaccines; ii/ allow innovators to develop these solutions by mobilizing additional private financing.


For example, Nexleaf Analytics, one of the flagship projects selected by INFUSE last year, received assistance via the platform to establish a partnership with Google.org. The innovation lies in a wireless remote temperature monitoring system for vaccine refrigerators to ensure that vaccines have not been exposed to heat and are therefore high quality and effective. Google.org is going to contribute USD 2 million to the project (technical and financial assistance). Nexleaf and Google are now working together on this technology which could have a major impact on immunization coverage rates in the poorest countries. Building on the success of 2016, in early 2017, INFUSE launched its second call for projects for innovative projects capable of improving health services in developing countries.

 

The opinions expressed on this blog are those of the authors and do not necessarily reflect the official position of their institutions or of AFD.

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