The Medical Supply Chain Is Unprepared for a COVID-19 Vaccine
The primary focus for pharmaceutical companies around the world is on developing a COVID-19 vaccine. As of June 2020, over 140 vaccines against SARS-CoV-2 are in different stages of development. Meanwhile, several companies across the globe are working on antiviral drugs — many of which are already used to treat other illnesses — to help patients infected with COVID-19.
When a vaccine is developed and approved for consumption, the next step will be to make it available to everyone on Earth as quickly as possible. This is requires overcoming several monumental challenges before the vaccine can reach the last mile. This includes producing the vaccine on a mass scale, deploying experts amid international travel restrictions, inventing clinically approved vials and syringes for billions of doses and managing extreme storage conditions.
An Unprepared Supply Chain: Filling the Gaps
The existing global supply chain has not experienced such a rush for vaccine development in the past and any setback in the untested supply chain — stretching from Baltimore in the United States to Pune in India and Oxford in England — could lead to disruptions and delays in the complex process. Much of the global focus is on developing a vaccine, but the underlying reality is that the medical sector does not have enough capacity to make, pack and distribute billions of COVID-19 vaccine doses all at once. Special attention will be needed to scale up machinery capacity for automated filling, putting the vaccine into vials or syringes and sealing and packaging them for shipping.
Conventional borosilicate vials typically operate in the range of 60-70% efficiency at up to 450 vials per minute. A massive surge in demand for these vials once a vaccine is developed will place immense pressure on pharmaceutical manufacturers to produce at unprecedented rates. The current fill/finish has little spare capacity and manufacturers will have to rely on re-allocating existing capacities and simultaneously building new capacities to meet the demand for the COVID-19 vaccine. The former solution may lead to a shortage of other life-saving medication while the latter one would require huge investments of time and money to increase capacity.
Governments and manufacturers across the world are aware of this demand-supply gap and several collaborations have been signed in recent times to address the issue. The US Biomedical Advanced Research and Development Authority (BARDA) has selected Corning’s Valor Glass as part of the United States government’s Operation Warp Speed — an initiative to facilitate, at an unprecedented pace, the development, manufacturing and distribution of COVID-19 countermeasures.
The Lack of a Robust Cold Chain Facility
Toby Peters, an engineering and technology expert at the University of Birmingham, has described the issue as the biggest medical logistics challenge the world has ever faced. Safety and efficacy requirements during transportation of the vaccine could hinder distribution. Many vaccines that fight pandemic diseases are temperature-sensitive and must be refrigerated or frozen. A robust cold chain would be an integral part of the distribution process. Developing countries pose several challenges to maintain cold chain distribution from extreme environmental conditions to unstable or fully absent access to electricity as well as complicated logistics due to a weakened health care system.
According to the Global Alliance for Vaccines and Immunization, only 10% of the health care facilities in the world’s poorest countries have a reliable electricity supply. Meanwhile, in some countries, less than 5% of health centers have vaccine-qualified refrigerators. A survey by the Association for Accessible Medicines (AAM) found that the average cost of shipping of medicines increased by 224% due to disruptions in the global supply chain. The University of Birmingham and Edinburgh’s Heriot-Watt University are collaborating with MP Ensystems and India’s Centre for Environment Education to explore the integration of ‘Community Cooling Hubs’, where food cold chains will be integrated with other cold dependent services.
The medical supply chain would need rapid equipment modernization and advanced packaging capabilities to unlock ultra-high-speed capacity filling and efficiency. Collaboration between governments and manufacturers would be crucial to support the implementation of additional capacity and the latest technologies. Developing an off-grid cold chain solution would address logistics challenges in developing and poor countries. If a vaccine is discovered soon, the medical supply chain must be ready to ensure it reaches people across the world as quickly as possible.