UNICEF on equitable distribution of vaccines

The Vaccine Challenge

This episode of The Vaccine Challenge is hosted by Priyanka Asera and features Jean-Cedric Meeus, the Chief of Global Transport at UNICEF. UNICEF plays a KEY role in ensuring that low income countries get access to vaccines and medicines. This is something they’ve been doing for decades and are one of the biggest buyers of vaccines globally. Today, we will be talking about various things include what challenges COVID posed when the lockdowns first kicked off, what are the challenges in purchasing and procuring vaccines given that they’re having to compete directly with governments around the world that are procuring vaccines from manufacturers directly, distribution challenges when it comes to getting the vaccines in low income countries, as well UNICEF’s relationship with WHO and GAVI.

SUMMARY OF THE PODCAST INTERVIEW:

Could you describe the scope of work that UNICEF does and its relationship with WHO and GAVI?

• UNICEF was founded in 1946 after WW2 in order to care for the children. UNICEF has bought over 1.4 billion doses of COVID vaccines. But does 2 billion doses of other routine immunization vaccines globally.
• UNICEF is essentially the procurement and delivery partner. WHO is the regulatory framework, and will certify every vendor for specific supplies and specific packaging
• We also work with the different governments’ Ministers of Health, to make sure they have the proper equipment which we help procure, ship and install. We essentially work on immunization and consultative activities, to support low income countries to make sure that they have derived commodity at quality and price for caring about the population and mostly the children

What were some challenges that UNICEF faced in 2020 directly as a result of the lockdowns?

• Used to have 14000 shipments on commercial airlines on a daily basis, and this was essential commodity that could not be interrupted - such as medication used to support malnutrition, fight malaria etc. But when the lockdowns happened, commercial airlines stopped flying and countries blocked airspace. Had to choose other means - such as sea trade, increased partnerships with airlines to prioritize COVID shipments.
• One of the biggest problems in the early days was obtaining protective equipment from Asia.
• But we had 5 year agreements with global freight forwarders that enable massive flexibilty in our supply chain so it wasn’t very bad from the lockdowns itself

What are some general supply chain and distribution challenges when it comes to vaccines in even a non-pandemic world?

• Forecast. We do a growth forecast every 5 years for five years ahead so we can inform the industry how much of specific vaccines are needed in order to make sure we’ve accounted to every country the right amount needed
• Shipments. Usually happens on commercial airlines and have cold chain requirements but this is pretty routine.
• Supporting material such as syringes and devices needed for immunization can be very voluminous and are often shipped via sea, whereas vaccines are shipped via air. So knowing having the right forecast of when all the material is needed by the governments for the immunization efforts is important because everything has to arrive at the same point of entry in a timely manner

Let’s talk about what the commitment has been for COVID vaccines and the challenges:

• The GAVI and COVAX alliance has committed to more than 2 billion vaccines procurement for the 52 low income countries.
• In general, introducing a new vaccine to a country takes 10 years because need to look at specifications, capacity, temperature requirements, regulatory framework etc. But for COVID, we had to prioritize and get it out in under a year which is unprecedented.
• We are competing with other governments that are procuring the vaccines from the same limited suppliers. So while we’ve committed to purchasing 2 billion, we were at 111 million at 5 months. We’d have even liked to procure more if more vaccines were available so that’s a major challenge.
• Another huge challenge is the ethical distribution of vaccines. Nobody is safe until everybody is safe and vaccinated. So we try to ship to as many countries as possible. The aim was to cover 20% of the population so as soon as quantities are available with different suppliers we work on on understanding how many dozes different countries have received and are able to receive and use.
• Sometimes, for example, 5% of the population of Nigeria is easy to manage because it is large volumes. But 5% for a small island country that might need 20 or 50 kilos, that’s a challenge. Sending 50 kilos can be more complex than sending 500 tonnes.

What are the factors that go into deciding which countries or regions get prioritized and why? (In addition to externally changing factors that might need to be considered in addition to regular equitable distribution).

• Readiness capacity, capacity of storage and distribution, readiness to absorb and organize administrative campaigns as soon as possible because a lot of the vaccines have short shelf lives
• Situation in the various countries with respect to how the pandemic is shaping up and who is at bigger risk of spread
• Multiple factors go into deciding through a formula how it will be distributed and allotted. The WHO makes these decisions thought. UNICEF’s role is to execute.

About Jean-Cédric:

Jean-Cedric Meeus work focusses on improving supply chains with UNICEF since 2001. He is currently the Chief of Global Transport at UNICEF Supply Division covering off shore and in land transport. Since 2001, Jean-Cedric performed in different Supply chain functions based in Mozambique, HQ NY (Supply Emergency Response Officer), HQ Copenhagen (Chief Emergency Supply Manager), Dakar Regional office of Western and Central Africa as regional (RO Supply Chain manager) to finally take his current position in Copenhagen.Prior to UNICEF, Jean-Cedric performed as Supply and Program Technical Specialist with MSF for 9 years in different countries.

Jean-Cedric has led and managed emergency operations and Supply chain teams in a wide range of global humanitarian crises and development programs over the past three decades. Constantly seeking new challenges, and through humanitarian and private sector networks, he strives to improve delivery of humanitarian aid by influencing and implementing practical, innovative changes. Through Jean-Cedric’s different positions he managed pharmaceuticals, immunization, health, education and WASH commodities to be delivered from origin to beneficiaries in support to UNICEF and government program activities.