#VaccinesWork, but require effective and efficient cold chain infrastructure
Distributed renewable energy solutions can power SDG3 for last mile delivery of immunization
India organizes nine million immunization sessions each year, targeting infants and 30 million pregnant women for routine immunization. Although the last few years have seen significant improvements, India still accounts for more than 20 percent of child mortality worldwide.
Immunization is a critical intervention aimed at protecting children against preventable life-threatening conditions, and its benefits go beyond just improving health and life expectancy, and even impacts social and economic indicators. An effective, evenly targeted immunization program reduces the disease burden and contributes to achieving Sustainable Development Goal 3 or SDG3 — good health and well-being.
However, nearly 20 percent of India’s poorest children are not fully immunized. Globally, many rural areas that don’t have reliable power face low immunization rates. Vaccines require specific temperature for storage in order to retain their efficacy. Cold chain conditions are impossible without power. A cold chain is a temperature-controlled supply chain that runs from the time the vaccine is produced until its administered. A power outage can break this cold chain and result in the vaccine losing its effectiveness. The World Health Organisation (WHO) estimates that more than 50 percent of vaccines may be wasted globally every year because of temperature control, logistics, and shipment-related issues. This highlights the urgent need to integrate distributed renewable energy (DRE) solutions such as solar-powered refrigerators for achieving universal, decentralized healthcare for all at every level.
Here are a few examples of these solutions:
Doctors for You: Model Immunization Centre
Bihar is one of the worst performing states when it comes to immunization coverage. In response to this, Doctors for You has established a model rural immunization centre in Bihar within the campus of Vistex Hospital in Masarhi, Patna, using DRE to ensure effective cold chain management of the vaccines. This initiative aims at improving access to health services in the region by providing immunization services in coordination with existing government programs and promote awareness regarding the benefits of immunization.
Reliable energy is important for not just effective cold chain management but also for the overall functioning of health facilities. Doctors for You has partnered with SELCO Foundation to design and implement this model rural immunization centre and will also document learnings, demonstrate guidelines, and assess the impact of the project for further replication and evidence building for the health and sustainable energy sectors domestically and internationally.
Emvolio: Active Vaccine Carriers
Many communities in rural and remote areas lack awareness about the need and importance of immunization. The location itself can be challenging in terms of accessing required healthcare services. This makes it necessary to improve this access by providing doorstep immunization by trained health workers. Active vaccine carriers play a crucial role in making this happen. While ice-lined carriers are used in certain regions, these are effective only for a few hours. Some communities in hilly, densely forested regions could take longer to access, which makes vaccine spoilage a serious concern even with ice-lined carriers. Moreover, with these carriers, it is not possible to monitor and maintain the internal temperature which makes it difficult for health workers to ascertain the efficacy of the vaccines upon arrival.
Emvolio is a portable, battery-powered refrigeration device, by Blackfrog Technologies, designed in accordance with WHO PQS E003 specifications (pending certification), to strictly maintain a pre-set temperature (between 2°C and 8°C), for up to 12 hrs for last mile transport of vaccines. Further device capabilities will include continuous temperature monitoring, location tracking, state of charge indication, and communication with headquarters via live tracking and vital statistics for improved coverage. According to Blackfrog Technologies, this device will reduce the economic burden of wasted vaccines and optimize human resources in vaccine delivery by nullifying the need for repeated immunization visits to account for the administering of unviable vaccines.
SELCO Foundation: SDG7 for SDG3
As per the Rural Health Statistics (RHS) 2018–2019, 26.3 percent of the rural sub-centres and 4.8 percent of rural PHCs lack access to electricity supply and the ones which do receive few hours of supply experience voltage fluctuations and frequent interruptions. As a result it often affects the cold chain and results in the vaccine wastages. According to the Immunization Technical Support Unit (ITSU) under the Ministry of Health and Family Welfare,around 25 percent of all vaccines supplied to health facilities get wasted during storage and transportation. Weak links in the current cold chain in remote areas or in places with intermittent power supply result in millions of dollars’ worth of spoiled vaccines each year. In the wake of COVID epidemic, cold chain has taken many fold importance for deployment and administration of vaccines for the people dwelling in the last mile connectivity.
SELCO Foundation has worked with close to 150 public health facilities across the country to implement decentralized renewable energy solutions, including solutions focused on improving cold chain, resulting in these centres being able to provide better health care services to their communities.
These solutions include solar power of ice-lined refrigerators (ILR) and deep freezers in primary health centres (PHCs) and community health centres (CHCs) to improve cold chain at the required temperature of 2 to 9 degrees celsius for the management of vaccines. In addition, there has also been a focus on replacing existing ILR and deep freezers with energy efficient appliances.
Technologies such as Godrej Sure Chill don’t need a constant power source and have the ability to maintain the temperature for more than seven days. This ensures reliability of the power back up and energy efficiency, that is, reducing energy consumption and making a transition to a green cold chain for immunization that is economically viable as well.
#VaccinesWork
Last week, the World Health Organisation celebrated World Immunization Week themed #VaccinesWork, aimed at raising awareness around the importance and benefits of immunization, but it’s important to also recognize that the success of immunization drives are dependent on effective infrastructure and cold chain management that can be addressed by implementing cost-effective decentralized renewable energy technologies.
