With the initial phase of trials of the Covaxin underway, the logistics and supply chain industry faces the Herculean task of maintaining the potency of the vaccine while distributing it across the country to serve a population of a whopping 1.33 billion people. As vaccine manufacturers prepare themselves to run the race against time, we look at India’s ability to handle the logistics of the much-awaited COVID-19 vaccine.
With the novel coronavirus taking over the reins of the world, the quest for a potent COVID-19 vaccine is being undertaken like never before. In such times of adversity, scientists across the world are grappling and racing against time to find a cure to alleviate the virus and the havoc that the pandemic has unleashed upon us.
As we inch closer every day towards the development of the vaccine, the real victory against the viral disease will only be won when steps are taken to ensure that it reaches every corner of the country.
On Saturday, Bharat Biotech International Limited (BBIL) informed that the first phase of testing has begun on 375 people, as per a report. This Hyderabad-based pharmaceutical company has jointly developed the vaccine with the Indian Council of Medical Research (ICMR) and National Institute of Virology (NIV).
Although scientists are now relentlessly striving to obtain results in months that usually takes years to achieve, vaccine manufacturers are speculating whether India is geared up well enough to produce numbers of doses sufficient enough to reach its 1.33 billion population. Thus, India’s cold chain system will play an indispensable role in ensuring that the proper logistics of the COVID-19 vaccine takes place and that its potency is uncompromised.
The cardinal quest of Last-Mile Delivery
Last-mile delivery will prove to be a litmus test for the Indian cold chain industry. Highlighting one of the most successful vaccination programmes, Vickram Srivastava, Head of Planning – Supply Chain Management, Ipca Laboratories Ltd shares his valuable insights on the importance of last-mile delivery for ensuring the reach of the vaccine. “It’s just not going to be about how the logistics industry or Logistics Service Providers will play a part on it, it will also depend on the process innovations – on how we can look at it to connect to the last-mile, by understanding the criticality and the cold chain integrity in place. Also, various policies are there to ensure that the trucks reach every corner of the country”, he shares.
The development of the vaccine has led to people revisiting the importance of India’s cold-chain like never before. Although there have been massive efforts to accelerate the entire process, it will take substantial amount of time to reach the corners of the country.
“By the time it reaches every nook and corner of India, it will take four to six months, given the geography and the criticality. As the vaccine is still under the process of development, its temperature sensitivity is yet to be ascertained. For example, efficacy of polio vaccine reduces beyond a certain temperature if the cold chain criteria are not met.”~ Vickram Srivastava
Mr Srivastava underlines the importance of efficient last-mile delivery for India’s far-flung corners. He talks about focusing on “people logistics” rather than just relying upon vehicular logistics
“Reaching far nooks and corners of India’s villages is challenging; one has to make use of small reefer vans and trucks, small cooler bags, MRs etc. So, logistics will have to move from vehicles to people. To facilitate proper distribution, small bags will have to be considered so that people can carry it [the vaccine] themselves-we have to look at people logistics more than just the transportation. In my opinion, moving the goods across India will not be a problem, since we are well connected through road, rail and air throughout the span of the country”, he says.
“To ensure cold chain integrity throughout the supply chain, it will be important to look at the logistics of the vaccine, how it reaches a village, reaches the pharmacy, how the doctors store the vaccine, because as a supply chain professional, our job is not finished when the vaccine reaches the doctor, the doctor can keep it safe and ensuring that the temperature is maintained even at the last mile and before being administered to the patient, the efficacy is not compromised”, says Mr Srivastava.
While offering his insights on whether India has a robust infrastructure in place for creating a Green Corridor for COVID-19 vaccine and if the Indian air cargo sector is prepared enough to cater to the spike in demand, Sunil Arora, President, Air Cargo Agents Association of India (ACAAI) during a LinkedIn Live Interview with Logistics Insider says, “Firstly, our Indian infrastructure is absolutely prepared and sufficient to handle any such situation. Green corridors will definitely come up. If you recall, a few months ago when the pandemic broke out, a panic situation had emerged on whether PPE and other safety essentials like gloves can be delivered but very efficiently, our industry and infrastructure had managed it.”
“This pandemic has brought an absolute emergence of various industries like glove manufacturing, pharmaceuticals etc and at the same time, their import/export has also been managed. Not only are we prepared for the logistics of the COVID-19 vaccine, but we are also ready to get into the distribution networks as well. We have very efficient distribution networks and it will be done very smoothly.”~ Sunil Arora
Government support will play a critical role
The role of the government will be paramount in assuring that the vaccine reaches every corner of the nation in an uncompromised condition.
“Apart from the service providers, process innovation has to be in place. We will need government support tremendously right from manufacturing to the last mile connectivity at far flung places, since basic infrastructure will have to be there to ensure that the safety and quality is not comprised”, remarks Mr Srivastava.
Mr Srivastava reflects on India’s successful polio mission over the years-made successful through relentless government support and monitoring. “India has managed to transport polio vaccine throughout the country for so many years. Sustained government intervention has been there to ensure to make India polio-free. We’ll need active government support as well if we have to make India COVID-free.”
“Government infrastructure will be needed to ensure that the vaccine is made and the Medical research will have rounds of polio dosage for administering the vaccine to ensure that the virus is killed. So logistics, infrastructure and policy have to go hand in hand. Only the logistics infrastructure or the process will not suffice, you have to redesign the basic infrastructure to make sure that the safety and the quality are not compromised”, he shares.
He also shares how polio makes use of more than a single dosage to ensure that in case the first dose is not effective, the later doses make up for it in a way that the virus is killed in the end. He draws a similar fate for the COVID-vaccine trials as well.
Walking the tightrope between risks and a greater call for humanity
Coordination between regulatory approvals and manufacturing has intensified in these months in ensuring that the road to developing an effective vaccine soon, is unhindered. While massive support is being lent to provide a strong backbone to clinical trials, many vaccine manufacturers are already planning and designing large-scale manufacturing upfront, expressing their eagerness to take massive financial risks, even before completely knowing whether or not the vaccine will work.
How are companies managing to tread on such a tightrope between taking massive financial risks while not being fully aware of the efficacy of the vaccine yet?
“It is a once-in-a-century call for humanity.The last time a human race faced a pandemic like this was in 1918 during the Spanish flu and now, it is after a century that something like this has happened. So, more than a business call, it is a question of the human race. Companies have to be fully prepared in case the vaccine turns out to be effective, so that they are able to start the process of distribution.”~ Vickram Srivastava
The phase 1 trials are on, after which we have the phase 2 and phase 3 trials, before a vaccine can get approved successfully. By the time this happens, the best case scenario that the industry overall is looking at is between October to December 2020. Only after that will the manufacturers start producing it. Since India is the largest manufacturers of vaccines globally, it has to be done in huge numbers. It is not just about producing the vaccine, we have to look at the entire value chain. If we look at the value chain of producing a vaccine, starting from injecting the vial, getting the rubber stoppers, getting the injections-nobody in the industry was geared up to manufacture at that. But now, everybody is gearing up.”
He also comments on how the prospective benefits that will emerge once the vaccine turns out to be potent will outmatch the underlying financial risks involved, should it turn out to be ineffective. “Apart from this, there is a business call – should the vaccine turn out to be effective and the company or industry gets the first mover advantage, the profit that it would be bring in will be enormous. Thus these organisations are taking a bigger call – if the vaccine works, it will bring a huge fortune for their company”, he comments.