However, the success of immunisation programmes heavily depends on the efficiency of vaccine supply chains (VSCs). In many developing countries, these supply chains suffer from inadequate infrastructure, limited funding, logistical complexities, and data deficiencies.
Two critical studies—one analysing vaccine supply chains in Sierra Leone, Madagascar, Niger, and Guinea, and another examining the cost of sustainability in housebuilding—provide valuable insights into the challenges and opportunities in optimising VSCs.
Innovation News Network explores findings from these studies, offering strategic recommendations for strengthening vaccine supply systems in resource-limited settings.
Challenges in vaccine supply chains
Developing countries face several interrelated obstacles that hinder the efficient delivery of vaccines, including:
Outdated infrastructure and cold chain limitations
- Many vaccine supply chains were designed over 40 years ago and follow rigid administrative structures that no longer serve current immunisation demands.
- Insufficient cold chain storage, power outages, and unreliable transport networks often lead to vaccine spoilage.
- The increasing number of new vaccines with diverse storage requirements adds pressure to already strained cold chain systems.
Financial constraints and cost inefficiencies
- Government funding for vaccine procurement, distribution, and cold chain maintenance is often inadequate.
- High operational costs, including transportation and storage, limit the scalability of immunisation programmes.
- Cost-based decision-making without considering equity, feasibility, and long-term sustainability can lead to suboptimal supply chain designs.
Logistical and distribution bottlenecks
- Supply chains in LMICs often rely on multi-layered distribution systems, increasing transit times and the risk of vaccine wastage.
- Health workers frequently have to travel long distances to collect vaccines, reducing time for patient care.
- The lack of direct delivery models and reliance on manual inventory tracking create inefficiencies in supply chain management.
Data gaps and poor forecasting
- Vaccine demand forecasting is often inaccurate due to unreliable population estimates and manual record-keeping.
- Inconsistent data across different systems hinders real-time decision-making for procurement and distribution.
- Many countries lack a standardised logistics management information system (LMIS), leading to frequent stockouts or overstocking.
Geographical and security challenges
- Rural, conflict-prone, and geographically isolated regions pose significant logistical challenges.
- Traditional delivery models struggle to ensure vaccine availability in hard-to-reach areas.
- Security risks in some regions make the transportation of vaccines difficult, requiring alternative distribution models.
Findings from the studies: Lessons for optimising vaccine supply chains
The studies on vaccine supply chains in four African countries highlight best practices and evidence-based strategies to address these challenges. Key takeaways include:
Defining supply chain objectives based on local priorities
Each country should establish clear vaccine supply chain priorities to align decision-making with national healthcare goals.
For example:
- Sierra Leone prioritised reducing the burden on health workers by introducing direct delivery models.
- Madagascar, Niger, and Guinea emphasised the integration of vaccines into broader public health supply chains.
A country-specific approach ensures that supply chain strategies reflect local realities rather than applying one-size-fits-all solutions.
Engaging stakeholders for effective system design
- Consensus-building workshops involving government agencies, healthcare workers, donors, and NGOs can help identify key supply chain inefficiencies.
- Stakeholder involvement in scenario modelling ensures that proposed changes are realistic and actionable.
- Collaboration with private sector logistics providers can improve distribution efficiency.
Leveraging data and technology for smarter supply chains
- Advanced computer modelling tools (e.g., LLamasoft’s Supply Chain Guru) were used in the study to simulate different VSC scenarios and optimise decision-making.
- Digital logistics management information systems (LMIS) can improve forecasting accuracy and real-time inventory management.
- Data-driven planning enables evidence-based vaccine supply chain design rather than reliance on assumptions.
Rethinking cost as a sole decision criteria
- The study found that while cost optimisation is essential, it should not outweigh other critical factors such as equity, feasibility, and sustainability.
- For example, direct delivery models might increase operational costs but improve immunisation rates and reduce the burden on health workers.
- A multi-criteria approach ensures that financial considerations do not compromise long-term supply chain efficiency.
Smarter data collection for cost-effective analysis
Integrating new technologies to overcome last-mile challenges
- Drones were explored in Madagascar and Guinea as a potential solution for delivering vaccines to remote areas.
- Mobile health (mHealth) applications can help track immunisation coverage and vaccine stock levels in real-time.
- AI-driven predictive analytics can optimise vaccine demand forecasting and reduce stock imbalances.
Strengthening governance and accountability
- Governments must implement transparent procurement processes and vaccine supply chain monitoring mechanisms.
- A performance-based approach to supply chain funding can incentivise efficiency and sustainability.
- Partnerships with international organisations (e.g., Gavi, UNICEF, WHO) can mobilise funding and technical support.
Strategic approaches for strengthening vaccine supply chains
Building on these lessons, the following strategies can help developing countries optimise their vaccine distribution networks:
Modernising cold chain infrastructure
- Investing in solar-powered refrigeration can improve vaccine preservation in areas with unstable electricity.
- Expanding modular cold storage facilities at regional and district levels reduces dependency on central warehouses.
Scaling direct delivery models
- Transitioning from multi-tiered distribution to direct delivery can reduce vaccine transit times and minimise stockouts.
- Utilising third-party logistics providers can enhance efficiency and reduce costs.
Promoting integrated supply chains
- Combining vaccine distribution with other essential medicines (e.g., oxytocin, antibiotics) can optimise transport costs and improve healthcare accessibility.
- Integrating public and private healthcare supply chains can expand delivery networks.
Enhancing demand forecasting
- Implementing machine learning algorithms for demand prediction can prevent stock imbalances.
- Digital tracking systems using barcode scanning and RFID can improve vaccine inventory accuracy.
Adopting community-based distribution models
- Training local health workers and volunteers to manage last-mile vaccine delivery can bridge accessibility gaps.
- Expanding mobile vaccination units can reach underserved populations more efficiently.
Scaling up emerging technologies
- Drone-based delivery systems can significantly reduce transit times in remote areas.
- AI-driven logistics optimisation can identify the most cost-effective distribution routes.
Implementing transparent policies
- Governments should establish real-time supply chain dashboards to track vaccine stocks and prevent inefficiencies.
- Independent audits and performance-based funding models can ensure accountability.
The future of efficient supply chains
Optimising vaccine supply chains is a critical priority for achieving high immunisation coverage and preventing disease outbreaks in developing countries.
By integrating data-driven decision-making, modern technology, direct delivery models, and stronger governance mechanisms, countries can enhance the efficiency, equity, and sustainability of their supply chains.
The lessons from Sierra Leone, Madagascar, Niger, and Guinea provide a scalable roadmap for other developing nations.
With the right investments, policy shifts, and technological innovations, vaccine supply chains can be transformed to ensure that life-saving immunisation reaches every child, regardless of location or circumstance.
