Revised RFP for TechNet21 Electronic Forum and Website

The World Health Organization (WHO) is soliciting requests for proposals for the ongoing management and updating of the Technical Network for Strengthening Immunization Services (TechNet21) electronic forum and website. All organizations or individuals should submit proposals by 15 June 2010. This is a revised RFP and applicants are encouraged to provide complete proposals ... Further details on: http://www.who.int/immunization_delivery/TechNet_RFP.pdf

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Supply Chain Assessment Reveals Opportunities for Vietnam
by Nguyen Tuyet Nga and Joanie Robertson, PATH, and Nguyen Van Cuong, NIHE

When Vietnam’s National Expanded Program on Immunization (NEPI) and Optimize agreed to explore novel public-sector supply chain solutions for Vietnam, they started with an assessment of the current immunization supply chain system. The four-part assessment completed in March 2010 included one of the first large-scale uses of the Effective Vaccine Management Assessment Tool; an evaluation of commune-level cooling and storage practices; an assessment of the information system used to track vaccines and immunization coverage; and a study describing fee-based immunization practices, supply chains, and structures. Together, these assessments have revealed opportunities for Vietnam to develop, evaluate, and monitor an optimal public-sector supply chain for the future.

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WHO Develops a Process to Determine Programmatic Suitability of Vaccines for Prequalification
by Rudi Eggers, WHO/EPI, and Nora Dellepiane, WHO/QSS

The World Health Organization (WHO) recently convened a working group to propose a new process for assessing the programmatic suitability of vaccines for prequalification. The need for a new process has been driven by the emergence of unique vaccine presentations such as relatively large packed volumes, prefilled syringes that do not include an autodisable feature, injection device materials that require non-standard disposal methods, suboptimal thermostability profiles, and fully liquid low-multidose vials without preservative. These unique vaccine presentations require a more standardized approach for determining programmatic suitability.

Like the current process the new process would involve assessing characteristics such as vaccine presentations, labeling, information provided on package inserts, and packaging.

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Your Phone Rings; It's the Freezer Calling
by Olivier Ronveaux, WHO, and Mojtaba Haghgou, Vaccine Management Consultant

... Several countries, among them Sudan and Iran, have found a way to automate the temperature monitoring system, saving both time and money while increasing the accuracy and reliability of the monitoring system. While Sudan is a bit smaller in population than Iran, the two countries have a similarly sized number of surviving infants (1,086,000 in Sudan and 1,300,000 in Iran) and handled an almost identical number of doses of vaccines in 2007/2008 (about 108.8 million doses).

Sudan automated its temperature recording system with financial and technical support from the World Health Organization (WHO) Regional Office for the Eastern Mediterranean (EMRO) in 2007.

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First Solar Direct-Drive Refrigerator Receives WHO Prequalification
by Janos Maté, SolarChill Project, and Steve McCarney, PATH

On March 18, 2010, the World Health Organization (WHO) prequalified its first solar direct-drive vaccine refrigerator (Vestfrost model MKSO44). Ten years in the making, the SolarChill vaccine cooler operates with a compressor powered directly from sunlight. Instead of storing electrical energy in a battery, the refrigerator stores thermal energy in ice, and a thermostat maintains the temperature between the required 2ºC to 8ºC for vaccine storage. In low-sun situations or when power is completely disrupted, the insulated “ice battery” maintains acceptable temperatures for up to five days. An intelligent fan enhances the convection circulation of the cold air and is operated by a small rechargeable battery, which is recharged by solar power.

The current generation of SolarChill is prequalified for 20º to 32ºC ambient temperatures. However, in field tests the units have operated under lower and higher ambient temperatures ranges of 10º to 42ºC.

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Modeling Tools Under Development
by Tessa Tan-Torres, WHO; Linda Allain, USAID | DELIVER PROJECT; Bruce Lee, University of Pittsburgh; and Carol Levin, PATH

If developing countries are to meet their populations’ health needs, they must ensure that their supply chains are able to cope with the increased quantities, volumes, and cost of supplies. To help decision-makers understand the possible health and/or cost impacts of various supply chain design options, four different health commodity supply chain modeling initiatives are underway: (1) the logistics module of the Unified Health Model (UHM) sponsored by the United Nations (UN) Interagency Working Group on Costing, (2) the 2020 Supply Chain Model (USAID | DELIVER PROJECT), (3) the Vaccine Modeling Initiative (VMI) through the University of Pittsburgh, and (4) the Vaccine Logistics Model at PATH-World Health Organization (WHO) with project Optimize. With the desire to demystify these four different yet complementary initiatives, this article explains the purpose, application, and expectations for each model.

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Toward a Global Framework for E-health Information Systems
by David Lubinski and Jan Grevendonk, PATH

Improving health outcomes through strengthened platforms and systems has emerged as a guiding principle of donors and multilateral agencies. A key building block for this effort will be the development of integrated information systems to support a variety of products and programs.

... the Rockefeller Foundation awarded PATH a grant to develop a catalytic approach to health information system strengthening through the Collaborative Requirements Development Methodology (CRDM). The CRDM consists of three sets of activities: (1) a landscape analysis of best practices and research, (2) identification and validation of functional requirements, and (3) standardized documentation of the functional requirements and processes in non-technical language.

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Vaccine Vial Monitor Use, Policy, and Practices in Four Regions
by Julie Milstien, independent consultant

While the benefits of using vaccine vial monitors (VVMs) in immunization programs are widely known, a recently completed study of VVM use and availability shows that their use is still not universal.

... The availability of VVMs depends largely on how the vaccine is procured. Countries using the United Nations-based procurement system tend to have VVMs on all vaccines used for routine immunization programs. Countries that procure their own vaccines directly from manufacturers or use a mixed sourcing system are likely to have a mix of products, and if they use VVMs at all, are most likely to have them on the oral polio vaccine. Most countries that produce their own vaccines do not use VVMs. Notable exceptions are India and Indonesia ...

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Vaccine Prices
G Harshavardhan and others respond to Anil Varshney’s original posting

Vaccine prices, to be considered acceptable by the developing countries, will have to be at a level that would sustain the manufacture and control of vaccine under cGMP conditions in the developing countries.  Governments of the developing countries must take into account the requirement that prices and quality of vaccines must go hand in hand in order to prevent vaccine preventable infectious diseases and therefore, support their manufacturers with subsidies and exemption of various excise duties.

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