1. Local requirements:

PQS minimum norms generate a set of satisfactory cool-chain equipment choices. However, the PQS norms do not guarantee optimal equipment selection for local equipment selection. For example:

• PQS data may not actually be used by EPI teams to compare available options
• Additional reliable equipment models may be available, but not PQS pre-qualified, preventing EPI teams from accessing standardized performance data on this equipment and UN purchasing mechanisms
• PQS pre-qualified refrigeration equipment is currently regionally biased, most manufacturers are from Europe and very few from developing countries
• PQS pre-qualified refrigeration equipment list is currently too narrow to meet all the local needs of the countries and may not represent the energy consumption preferences of the countries (e.g. small-capacity (<20L) equipment is limited to one solar and one ILR model; all electric refrigerators are ILR, and; absorption equipment is abandoned in the PQS due to poor historical performance.)

As an alternative to PQS pre-qualified equipment, many countries procure equipment from local manufacturers. These domestic models may not meet international performance norms for vaccine storage and transport; some models may meet a critical subset of these international norms. However, because standardized performance testing is rarely conducted on these models, countries that use domestic refrigerators to store vaccines do so without knowing the true impact on their vaccine supply chain from this decision.

2.  Equipment prices

Procurement procedures and limited budgets of governments and partners frequently drive selection of the lowest purchase price solution. While tender specifications are written to ensure that minimum quality and performance standards are met, these parameters can only be assessed over time and tend to be overlooked in favor of lowest purchase price.

Weaknesses of selecting equipment based on the lowest purchase price solution include: 

• Performance at the time of purchase might be specified in the tender, but not a guarantee of lifetime reliability
• Quality of the equipment might be specified, but not the frequency of spare parts replacement
• Temperature control might be specified, but not the maximum energy consumption
• Lowest purchase price models may be designed as ‘expendable’; equipment that is built for a long life often has a higher price

3.  Life cycle costs

Quite simply, the overall cost – including its procurement, energy, disposal and maintenance costs – must be minimized each year in the life of a piece of equipment in order for costs to be covered by limited national budgets.

Unfortunately, in spite of the power of the logic, life cycle cost analysis is seldom performed when selecting equipment. The following observations may explain the reluctance to adopt this type of systematic analysis:

• Difficulty accessing evidence of lifetime performance differences
• Ease of purchasing equipment in the local market relative to importing
• Partners often donate equipment capital costs but not cost of spares parts and repair
• Cost of spare parts and repair is covered in a different budget than equipment capital costs
• Disposal costs and potential revenue from resale are rarely included in purchasing decisions
• Energy consumption rarely drives model selection and procurement (e.g. selecting an absorption refrigerator where an icelined refrigerator could operate, adds over 20% to the energy bill)

With electricity costs rising, by as much as 25% per year in sub-Saharan Africa over the next three years, consideration of life-cycle costs will become increasingly valuable when selecting new cool-chain equipment. Researchers estimate that Brazil would save 2.8 billion dollars (US$) in electricity costs annually (and 18 Mt of CO2 emissions) if all new domestic refrigerators in Brazil were the least life cycle cost of ownership option.