As the covid-19 pandemic began to spread, India, like most other countries, found itself looking for protective equipment and medical equipment to control the crisis. As the world prepares for the rollout of vaccines to end the pandemic, India may be better prepared, at least in one respect. As the world’s leading vaccine manufacturer, India may also have greater access to vaccines than many other parts of the emerging world. The Serum Institute of India (SII) alone produces more than 1,500 million doses. of vaccine each year and is expected to produce one billion doses of the Novavax vaccine through 2021.
Still, distributing vaccines as part of India’s first mass adult vaccination campaign can prove to be a daunting task. This will require a meteoric expansion of the capacity of India’s existing health chain, especially in some of the most densely populated areas of the country, where such infrastructure is very limited. It will also be to address the shortcomings in India’s existing vaccine distribution network, which became known a few years ago through a report by the Ministry of Health.
India’s health minister said the government aims to vaccinate three hundred million of the most vulnerable people by August 2021. This translates to six hundred million doses through August, a goal that may be difficult to achieve, given the state of India’s bloodless garage infrastructure. , such as tanks and cold rooms. Vans.
It would conceivably be possible to administer between 550 and 600 million doses during 2021 alone, given bottlenecks in India’s bloodless chain infrastructure, Credit Suisse’s Anubhav Aggarwal and Sayantan Maji wrote in a report on India’s vaccination plan last month.
The estimates are based on the assumption that the infrastructure of the country’s existing vaccination program will be used for the covid vaccination plan, even if the normal vaccination program continues. In addition, bloodless personal chain corporations will be asked to distribute approximately part of the necessary dose (300 million over the next year). These estimates seem reasonable, said Sunil Nair, CEO of Snowman Logistics, India’s largest chain of ride-hailing companies. Snowman himself could arrange for the storage of 100 million doses, he added.
India’s vaccine distribution network is managed through four government medical depots (GMSDs) in Karnal, Mumbai, Chennai and Kolkata, which procure vaccines from manufacturers. Approximately 53 state-owned vaccine retail outlets source from those GMSDs or directly from manufacturers. Retail sale of vaccines Then, the points of sale in the state distribute the vaccines to cold chain units at the regional, district and subdistrict levels in isolated vans.
India currently has around 27,000 blood chain points, 76,000 blood chain kits, 700 refrigerated vans, 55,000 blood chain handlers and 2. 5 million fitness machines as part of its vaccine logistics network.
To reach the goal of the first phase of the Covid vaccination campaign, the distribution capacity of the public sector will need to be multiplied from 2 to 3. Increasing this capacity is not the only challenge. Gaps in the existing supply chain are a similar challenge. significant challenge. Vaccine control in India has improved over the years thanks to a real-time source chain control formula known as the Electronic Vaccine Information Network (eVIN). As of August 2020, it had been implemented in 32 states and union territories. , and the vaccination campaign against covid will be useful.
However, the most recent audit of the vaccination chain conducted through the Ministry of Health in 2017-2018 shows that bottlenecks still exist. 26% of eVIN bloodless chain issues reported that they were out of stock during the evaluation period. More than one-fifth of services reported vaccine waste.
India ranks in the 51-75th percentile of diversity among 89 countries in effective vaccine control, according to a 2018 WHO-UNICEF global analysis. Its functionality has been poor in terms of compliance with the procedures required for the arrival of vaccines and the use of vaccines. MIS formula for effective vaccine control. Estimation of demand for vaccines, syringes, etc.
Adding to the challenge of vaccination is the disparity between states in the distribution of bloodless chains across the country. For example, about four bloodless chains serve another 100,000 people in Gujarat, while there is only one bloodless chain for the same number of other people. Jharkhand, Uttar Pradesh and Bihar are among the underserved states in terms of public chain infrastructure.
It may not be easy to fill those shortfalls given that most of the private-sector blood chain network is concentrated in major cities, said Gagandeep Kang, a virologist at Christian Medical Center in Vellore.
A union official at the Ministry of Health in charge of managing the vaccine control campaign declined to comment on the issue. A senior official at Jharkhand’s Ministry of Health said the state has known 30 new distribution chain problems to expand its distribution network. It also expects to obtain 148 ice coolers and 57 freezers from the central government by the end of this month, the official said, speaking on condition of anonymity. The government plans to allocate as much of the existing resources of the universal vaccination program as possible to the covid vaccination crusade, but without disrupting the normal vaccination crusade, he said. Despite this expansion, Jharkhand will continue to lag behind more urbanized states such as Gujarat and will have to make do with its limited resources.
Uttar Pradesh, another state with a limited blood chain, plans to increase its garage capacity 2. 5 times, according to Rakesh Dubey, director general of the state’s family policy department. The central government has created blood-chain apparatuses such as cold rooms, bloodless rooms, ice coolers, freezers, etc. And they are settling in, he said. The state government is investigating the feasibility of refrigerated vans recycled from other industries, he added.
The unique needs of the upcoming vaccination campaign pose another facet of the distribution challenge. Identifying recipients, making sure they show up on the day of vaccination, and administering a second dose after a month would require a lot of micro-level planning. said Neeraj Jain, country director for India at PATH, a global nonprofit that works with countries around the world on immunization and public health.
In addition to distribution and delivery challenges, two key issues will be vaccine adoption and tracking, Kang said.
“Vaccine acceptance demands to be accepted as true in vaccines and in the distribution system, and it seems that we are moving from the vaccine level to the ultimate solution (which arguably would not be) for vaccines that evolved so temporarily and with many shortcuts that they will necessarily have to be harmful and harmful. Untested (which is not true),” Kang said. In addition, vaccination documentation and monitoring and investigation of vaccine protection moments are critical parts of surveillance that have historically not been done well. “It would therefore be useful for external monitoring or support mechanisms.
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