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EDITOR IN CHIEF- ABDULLAH BIN SALIM AL SHUEILI

COVID-19 vaccines raise hope but the ‘last mile’ challenge looms

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Thin Lei Win and Naimul Karim -


The start of mass vaccinations has raised hopes that COVID-19 can be beaten, but ending the pandemic hinges on tackling a plethora of “last mile” challenges - from a lack of fridges to vaccine hesitancy and fraud, according to specialists.


In order to tame a disease that has killed more than 1.6 million people and battered the global economy, billions of vaccine doses must be shipped to people in every corner of the world, including war zones and remote, poverty-stricken areas.


Accessing such regions and finding suitable cold storage for vaccines during the journey and on arrival will be a huge task. “No one’s ever done this before. It’s not about trying to vaccinate all the children, all the pregnant women. It’s about saying we’ve got to vaccinate everybody,” said Toby Peters, professor of Cold Economy at the University of Birmingham.


“And until we do it, the economy will not restart,” said Peters, a global expert on cold chains - storage and transport facilities that maintain the safety and quality of perishable goods like food and medicine.


Among the three vaccines for which efficacy results have been announced, those from Pfizer/BioNTech and Moderna need to be kept at temperatures far below normal fridges, which would complicate their distribution in poor nations. The sheer scale of the inoculation campaign will also magnify the “last mile” challenges, experts said, noting even smaller immunisation programmes struggled to meet their goals.


Since 2000, the GAVI vaccine alliance has vaccinated more than 760 million children, but achieving COVID-19 herd immunity would mean vaccinating up to 5.5 billion people, Ben Hartley, from the UN-backed initiative Sustainable Energy for All, told a recent webinar.


As of last year, 85 countries had failed to reach a 90 per cent target rate for diphtheria, tetanus and pertussis vaccinations, Hartley said, adding that a global COVID-19 campaign would need “concerted efforts” from all stakeholders.


Shahrzad Yavari, who works for a technology non-profit that produces a wireless solution to monitor temperatures in vaccine fridges in rural clinics, said the “last mile” would not only be an issue in areas that lie far from urban centres. “It’s the under-reached and under-served communities that could very well be in urban settings, or in countries in conflict,” said Yavari, Director at Nexleaf Analytics.


“It’s actually a large percentage of the population worldwide,” Yavari said. At least 60 million people live in areas controlled by armed groups, adding extra obstacles, said Esperanza Martinez, global head of health for the International Committee of the Red Cross. The need for travel permits and frequent power cuts or a lack of electricity can make access to vaccines in conflict zones especially tricky, she said. — Thomson Reuters Foundation


To tackle such challenges, researchers are trying to design a sustainable cold chain system for mass immunisation, using Bangladesh, a low-lying, disaster-prone nation, as a case-study.


The South Asian nation has a thriving pharmaceutical and vaccine industry, but most of its 160 million people live in rural areas without reliable cooling infrastructure. The first draft of a strategy, which could be applied to other low- and middle-income countries, should be ready in early 2021, said Peters, who developed the project.


Ijaz Hossain, dean of engineering at Bangladesh University of Engineering and Technology, a project partner, said data was being collected on the number of fridges, back-up generators and medical assistants available in different towns. - Thomson Reuters Foundation


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