The developed world takes cold-chain delivery of drugs for granted. Companies and distributors have invested hundreds of millions of dollars in high-tech warehouses and systems to make sure drugs arrive safe and sound. But in much of the undeveloped world, cold chain means ice packs, freezers and kerosene-powered generators. Now the World Health Organization (WHO) has shown that when vaccines are freed from the cold chain, the financial savings and health benefits are enormous.
In 2011, the Meningitis Vaccine Project and WHO experts projected that using the MenAfriVac meningitis A vaccine in 7 highly endemic countries could save up to $300 million over a decade and prevent 1 million cases of disease. The vaccine, made by Serum Institute of India, costs 50 cents per dose. After determining that the vaccine remained safe and effective without refrigeration for up to four days, WHO decided to see how much further it could spread its use.
WHO, along with nonprofit PATH, tested delivering MenAfriVac outside of cold storage for up to four days during a 10-day vaccination drive in Benin in 2012. Vials had a heat-sensitive sticker that would alert healthcare workers if the vaccine got too hot. Despite temperatures that reached 102°F, no vials were lost to the heat. Without the need for cold storage, the campaign was able to vaccinate more people and the results were impressive. The report notes that in 2013, the year following the program, there were no cases of meningitis A in the country.
The financial implications of not having to rely on a cold-chain distribution system are great for those who pay the costs of vaccination programs as well as for the companies trying to make these drugs available at low prices. WHO had conducted a separate study in Chad in 2011 to determine the cost savings of keeping MenAfriVac outside of the cold chain for four days during a vaccination sweep. It determined that the logistics cost per dose dropped by half, to 12 cents from 24 cents, mostly because of the reduced manpower required to keep vaccines cold.
- here's the PATH release
- view the WHO study (PDF)
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