Issue 14, October 2012

South Sudan deploys new mobile phone-based stock management toolby Morris Gargar, Consultant; Elly Tumwine, UNICEF; and Ryan McWhorter, Logistimo

The Government of the Republic of South Sudan is working with the United Nations Children’s Fund (UNICEF) and project Optimize to test a cloud-based logistics management information system (LMIS) that uses mobile phones to manage vaccine stock. The new system, named Logistimo, was deployed in May 2012 and is now being used in the central store, the ten state stores, and all six counties of Central Equatoria State. So far, the response from Expanded Programme on Immunization (EPI) staff to the new tool has been positive. “The procedure is very simple and it helps to accelerate our work, with timely response from national level,” says Teresa Adams Deng (EPI Manager, Jonglei State).

In recent years, the EPI in South Sudan has made substantial progress in increasing vaccine coverage rates. However, a serious barrier to further progress is the lack of reliable information on stock levels and consumption rates at all levels of the supply chain below the national level. Without this information, stockouts frequently occur because health centers are not resupplied in time.

The Logistimo demonstration project in South Sudan aims to evaluate the benefits to immunization programs of more reliable and up-to-date information on stock levels and consumption rates, as well as the feasibility of implementing a mobile-phone based LMIS in remote locations. As part of the demonstration, county stock managers have been provided with mobile phones they can use to register stock transactions and submit orders for additional stock. National or state managers can then use this information to track stock and demand in real-time and analyze consumption patterns.

There are several potential benefits to this approach. Being cloud based, the new system does not require investment in computer servers and other information technology infrastructure. This removes

ContentsSouth Sudan deploys new mobile phone-based stock management tool . . . . . . . . . . . . . . . . . . 1

EVM assessment highlights supply chain improvements in Vietnam . . . . . . . . . . . . . . . . . . . . . 3

SIVAC Initiative supports technical advisory groups on new vaccine introductions. . . . . . . . . . . 5

Optimizing the vaccine supply chain in Benin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Can UAVs be used to transport vaccines to remote health centers?. . . . . . . . . . . . . . . . . . . . . . 7

Investigating the benefits of selling vaccines in Kenya’s medicine shops . . . . . . . . . . . . . . . . . . 9

In pictures: Logistimo in South Sudan. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11

Announcements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Resources. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

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logistical barriers to implementation such as purchasing cost and equipment maintenance. Instead, the Logistimo LMIS is hosted on a remote server that can be accessed by a web browser or a mobile phone using general packet radio service (GPRS) or short message service (SMS) technology. Because of this, the system can be quickly scaled up to support additional users, new facilities, or increased stock with minimal additional work or equipment.

The Logistimo mobile phone application (LogiMobile) can be used on widely available, low-cost mobile phones, while the application itself requires only two hours of training for the operator to become proficient. Navigating a simple set of menus, county stock managers can record vaccine stock levels using only their mobile phone keypad. They can enter how much stock they have at that moment, how much they have issued to patients or to other clinics, or how much has been damaged or expired. The stock update is then sent from the mobile phone to the Logistimo LMIS using a GPRS connection or by SMS text message if GPRS is unavailable. Although it requires a network connection for the operator to register an update, LogiMobile can also work in offline mode by storing updates and sending them as soon as a connection becomes available.

It is just as easy for county stock managers to order vaccines. Requests for vaccines are immediately recorded in the Logistimo LMIS for national or state managers to review and approve. To help ensure the request is dealt with promptly, Logistimo can also be configured to automatically send an SMS message to the manager to provide notification of pending orders.

When an order is received, state managers can validate and ship those orders using LogiMobile or the browser-based component of Logistimo, named LogiWeb. The system can then notify the county stock manager by sending an SMS text message with details of the manager’s response (for example, “Your order has been processed and will be delivered on 12/12/2012”). When the shipment arrives, the county stock manager can then record the arrival on the mobile phone. Each stage of the process is recorded in the Logistimo system.

As well as being used to record stock levels and the progress of orders, the Logistimo LMIS can also be used to guard against stockouts. Should stock levels fall below a minimum level without the county stock manager ordering a new shipment, the Logistimo system can be configured to automatically warn county stock managers of low stock levels. For example, it can send an SMS message to the user with a warning that new stock needs to be ordered.

LogiWeb contains all the functionality of LogiMobile, but can also be used to report on stock availability and consumption in real-time across the country. Users can manage their orders, track inventory problems throughout the country, and report on consumption trends to aid in forecasting and procurement.

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A county stock manager uses LogiMobile to record BCG stock wastage.

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A cloud-based LMIS that uses mobile phones to register stock transactions and submit orders for additional stock has the potential to simplify stock-ordering, saving time currently spent by stock managers preparing and sending paper orders. It also has the potential to make stock data more accessible, enabling state managers to make ordering or dispatch decisions according to reliable and easy-to-understand data in real-time.

During the last two months, more than 400 transactions have been entered using the Logistimo system and the project will soon begin collecting data on stockouts, wastage, and service levels across the country. Project Optimize will publish a progress report on the project in early 2013. For more information, please contact Jan Grevendonk (jgrevendonk@path.org).

To show the Logistimo LMIS at work in South Sudan, Op.ti.mize has created a photo set on Flickr. View the slideshow here.

EVM assessment highlights supply chain improvements in Vietnamby Nguyen Van Cuong, NEPI, and Vu Minh Huong, PATH

Earlier this year, Vietnam’s National Expanded Programme on Immunization (NEPI) conducted an Effective Vaccine Management (EVM) assessment to evaluate the country’s immunization logistics systems. The results reveal that key improvements have been made since the previous assessment was conducted in 2009.

The EVM assessment and planning tool was developed by the World Health Organization to provide countries with the means to systematically assess their vaccine management processes. This can enable them to identify areas that need to be improved and focus their resources accordingly. An EVM assessment uses a structured questionnaire to evaluate a country’s supply chain at different levels using specific criteria based on good storage and distribution practices. The EVM assessment is just

LogiWeb can be used to report on stock availability in real-time across the country.

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the beginning of a continuous process of improvement, and the assessment tool can also be used as a supervisory aid to monitor and support individual facilities on a regular basis.

The 2009 EVM assessment in Vietnam, conducted by NEPI with the help of project Optimize, highlighted several areas for improvement in the country’s vaccine supply chain. These included recommendations to improve vaccine arrival procedures, prioritize and strengthen standard operating procedures (SOPs) for vaccine management, and put in place a preventive maintenance plan for refrigerators. Since then, NEPI has worked hard to strengthen these areas and the findings of the 2012 EVM assessment indicate that these efforts have paid off. They also demonstrate the effectiveness of the EVM assessment and planning tool as a means for countries to improve their vaccine management practices.

Comparing results of the 2012 and 2009 assessments, we see that the national store has made significant improvements in establishing procedures for vaccine arrival, stock management, and distribution. The national store now meets the 80 percent target in all criteria, compared to just 18 percent in 2009. At the provincial level, results have been improved in most criteria, notably in vaccine management and storage capacity. Many of these improvements are due to the efforts that NEPI has made to strengthen and reinforce SOPs in various functions within the EPI. The EVM assessment has been a useful tool to identify these problems, enabling NEPI to prioritize and direct resources and training to resolve them.

Key recommendations of the 2012 EVM assessment include the following:

• Integrate the EVM assessment tool into regular EPI supervision at all levels, and urge managers to reinforce and regularly review areas identified in the assessment as needing strengthening.

• Improve temperature monitoring by upgrading the monitoring equipment for vaccine refrigerators, cold rooms, and refrigerated trucks at the national, regional, and provincial levels with devices capable of continuous temperature monitoring.

• Work to raise awareness of the importance of preventing vaccines from freezing, retrain staff to use the “shake test” to detect freeze-damaged vaccines, and provide freeze indicators for district-level refrigerators and for transport between province and district.

• At the district level, improve the time it takes to repair broken cold chain equipment.

• Disseminate SOPs widely to all levels so that staff are provided with specific and clear guidelines for vaccine management practices.

For more information, or to request a copy of NEPI’s 2012 EVM assessment report (available in English and Vietnamese), please contact Nguyen Dac Trung (dactrungn@gmail.com).

Managing the cold room at the national store in Vietnam.

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SIVAC Initiative supports technical advisory groups on new vaccine introductionsby Kamel Senouci and Lara Gautier, AMP

Many national immunization programs rely on the professional advice of national immunization technical advisory groups (NITAGs) to help them make critical decisions on introducing new vaccines. Implemented in April 2008 by Agence de Médecine Préventive (AMP) in partnership with the International Vaccine Institute, the SIVAC Initiative supports the development of these NITAGs in low- and middle-income countries. In this article, we take a look at how SIVAC has supported the establishment and achievements of NITAGs around the world.

NITAGs work to enhance the use of evidence-based decision-making processes in the development of immunization programs and policies at the national level. SIVAC supports this valuable work by providing technical assistance in the creation of NITAGs and offering support once they have been created. This can include training, tools development, and knowledge-sharing through the NITAG Resource Center, a multilingual website that offers information, tools, and short learning modules.

The first country to receive SIVAC’s support was Côte d’Ivoire, whose NITAG—the Comité National d’Experts Indépendants pour la Vaccination et les Vaccins de la Côte d’Ivoire (CNEIV-CI)—was officially created in January 2010. As part of the development of a draft recommendation by CNEIV-CI on the management of adverse events following immunization (AEFI), SIVAC provided technical support in developing terms of reference documents for the evaluation and management of AEFI in Côte d’Ivoire. These were validated in June 2012 at the second regular meeting of CNEIV-CI.

In January 2011, the inaugural meeting of Mozambique’s NITAG—the Comité de Peritos para a Imunização (CoPI)—was held in Maputo. Supported by SIVAC, the CoPI rapidly began to issue recommendations on vaccine policies. During its first year, two meetings were held and nine recommendations were issued on topics such as the reliability of data from the Expanded Programme on Immunization (EPI), cold chain logistics requirements, and the introduction of new and underused vaccines. These recommendations were then adopted and implemented by the country’s Ministry of Health. At the CoPI’s last meeting in April 2012, three further recommendations were issued on vaccine safety issues, EPI staff training, and new mechanisms for vaccine registration. His Excellency Dr. Alexandre Lourenço Jaime Manguele, the Minister of Health, confirmed the key role of the CoPI in strengthening the country’s immunization program through an evidence-based approach. In June 2012, the minister signed an agreement extending SIVAC support through mid-2013.

During 2011 and 2012, SIVAC helped Kazakhstan, Kyrgyzstan, and Mongolia to establish their own NITAGs. Benin, Senegal, and Vietnam plan to establish NITAGs in the coming months, with SIVAC support.

His Excellency Dr. Alexandre Lourenço Jaime Manguele, Minister of Health, Mozambique (third from left), next to Dr. Kamel Senouci, Director of the SIVAC Initiative.

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While the main thrust of SIVAC activities to date has focused on establishing new NITAGs in low- and middle-income countries, SIVAC also works to strengthen existing NITAGs. This involves providing assistance to NITAGs on how to ensure greater compliance with international NITAG standards and how to help NITAGs to make evidence-based recommendations that are relevant to the national context. In this way, since 2010, SIVAC has been supporting NITAGs in Indonesia, Lebanon, Nepal, and Tunisia. For example, the Indonesian Technical Advisory Group for Immunization (ITAGI) recently issued a recommendation regarding a pilot study on inactivated polio vaccine in the country. The ITAGI is also working on recommendations related to the pneumococcal and rotavirus vaccines.

The Comité Technique des Vaccinations (CTV) of Tunisia is also very active: since the 2011 rubella epidemic, the CTV has been coordinating the adoption of the strategy for the elimination of rubella and increasing monitoring of congenital rubella syndrome. The CTV is also modifying its vaccination strategy for rubella vaccine in the EPI to reach new age targets.

SIVAC is also helping NITAGs and national immunization programs to conduct cost-effectiveness analyses of new vaccine introductions. This is being performed as part of the ProVac International Working Group established by the ProVac Initiative of the Pan American Health Organization Immunization Project, which was created to share ProVac tools and methodologies with other regions. In collaboration with World Health Organization Regional Offices, SIVAC will provide direct technical assistance for cost-effectiveness evaluations of potential new vaccine introductions in four middle-income countries: Albania, Azerbaijan, Egypt, and Iran. This work began in May 2012 in Albania with a cost-effectiveness analysis on the potential introduction of rotavirus vaccine.

NITAGs in low- and middle-income countries have demonstrated their value by issuing important recommendations on new immunization policies and vaccine introductions. However, NITAGs can further improve the decision-making processes, and SIVAC is working hard to provide tailor-made support to countries by promoting evidence-based processes that can improve their immunization policies and programs.

For more information, please visit the SIVAC Initiative website.

Optimizing the vaccine supply chain in Beninby Hamadou Modibo Dicko, Philippe Jaillard, and Benjamin Schreiber, AMP; Bruce Y. Lee, University of Pittsburgh; and Heidi Lasher, consultant to project Optimize

To improve immunization program performance, the Government of Benin is using cutting-edge modeling tools to better understand how changes to the vaccine supply chain impact vaccine availability and cost. If successful, this approach could be replicated in other countries wishing to optimize their supply chain.

Like many countries, Benin has seen its immunization coverage stagnate or even decrease in recent years in spite of efforts to improve performance. An external review conducted in 2008 by the Expanded Programme on Immunization (EPI) suggested that supply chain and logistics problems could be inhibiting vaccine availability and access. To address the problem, the government sought support from the LOGIVAC project, a joint effort of Agence de Médecine Préventive and the World Health Organization to optimize the vaccine supply chain in Benin.

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In July 2012, the government and partners worked through the first phase of the optimization process, which involved several assessments and analyses, including a Cold Chain Equipment Manager inventory, Effective Vaccine Management (EVM) assessment, and an analysis of supply chain costs. Considering goals of the EPI, including planned introduction of new vaccines, the government then discussed and selected several different optimization scenarios they wished to model.

Between July and September, the HERMES team at the University of Pittsburgh and Pittsburgh Supercomputing Center, funded via the Vaccine Modeling Initiative, populated its HERMES (Highly Extensible Resource for Modeling Supply Chains) software with data from Benin to generate a simulation model of the entire Benin supply chain, including virtual representations of each storage location, refrigerator, freezer, vehicle, personnel, route, vaccine vial, and vaccine product. Once populated, the model serves as a virtual laboratory with millions of different vaccine doses flowing through the model simultaneously to simulate how the supply chain would perform in each scenario.

In September, partners gathered again in Benin to review the results of the HERMES simulation model and determine which scenarios result in higher vaccine availability and increased access to vulnerable populations. A parallel costing effort by Optimize, working in collaboration with the HERMES team, provided cost comparisons for each scenario compared to the baseline system that currently exists in Benin.

Following the September workshop, the government of Benin will have an opportunity to evaluate EVM results and the feasibility of different optimization scenarios modeled by HERMES. From there, the government can develop a detailed optimization plan and implementation roadmap.

The supply chain optimization approach used in Benin is noteworthy because it is systematic and potentially replicable in any country wishing to embark on supply chain optimization efforts.

Over the next several years, nearly all developing countries introducing new vaccines into their EPI systems will be assessing the performance of their vaccine supply and logistics system and determining how to address deficiencies. By applying a similar model of assessment and by making use of modeling tools like the HERMES software and PATH’s costing methodology, countries can more easily determine which scenarios might make the most sense in their country.

Can UAVs be used to transport vaccines to remote health centers?an interview with MIT’s UAV vaccine delivery team

Earlier this year, Dr. George Barbastathis and five graduate students—Nikhil Vadhavkar, Adam Pan, Vyas Ramanan, Andrew Warren, and Justin Lee—from the Massachusetts Institute of Technology (MIT) were awarded $100,000 by the Bill & Melinda Gates Foundation through its Grand Challenges Explorations initiative. The team hopes to demonstrate that vaccines can be transported to remote health centers using unmanned aerial vehicles (UAVs). Op.ti.mize spoke to the team about their proposal and the challenges they face.

What gave you the idea for your proposal?

NV: We were taking a class in global health innovation and had the good fortune to hear some really far-out ideas. After the class, we discussed how interesting it would be to do something like that. Our idea was sparked by one of those “wouldn’t it be cool if…?” discussions, and so we started refining this idea of using UAVs to transport vaccines to remote villages. UAV technology is advancing very quickly right now, and decreasing in price all the time. For example, communities such as DIY Drones have been successful

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in designing and building low-cost UAVs using open-source software and off-the-shelf parts. We wanted to tie this back to global health and really take advantage of the UAV revolution.

Have UAVs been used in health care contexts before?

AP: There have been a few health care projects that have made use of UAV technology. One of them was basically the reverse of our project: health care workers in the field, without access to complex testing equipment, using UAVs to fly blood samples back to a central health clinic where the tests could be performed. There have been other examples where UAVs have been used in emergency situations such as search and rescue, and by law enforcement, but we don’t have any knowledge of UAVs being used to transport vaccines.

How will your plan work?

AW: When a health care worker at a remote location needs more vaccines, they send an SMS text message to the UAV with details of what they require and when they need it. The system then forwards this information to the relevant health care worker at the central clinic, who loads the UAV with the requested vaccine stock. After loading and refueling the UAV, the central clinic health care worker sends a launch command SMS to the UAV. The UAV then takes off, flies fully autonomously to the preloaded GPS coordinates associated with the remote health care worker’s phone number, drops off the vaccines, and then returns to the central clinic.

What are the advantages of using UAVs to distribute vaccines?

VR: Last-mile distribution of vaccines is a critical issue in much of the developing world. In mountainous areas, in places with rainy seasons that make rivers impassable and wash out roads, delivering vaccines to remote health centers by a car or truck is a real challenge. Delivering vaccines by air is a simple way to alleviate these geographical problems.

AW: Also, when you send a vehicle on a long and difficult journey, you need to make a pretty large shipment to justify the high transport costs. When you send a UAV, you can deliver the exact amount of vaccine that the health care worker needs, so there is much less chance of overstocking or associated vaccine wastage. This is really useful if you are vaccinating only a small number of children each week, in a location where you cannot store vaccines for long periods. Having the ability to regularly transport small amounts of vaccines—whenever they are needed—is a big advantage.

What are the limitations?

NV: One of the biggest limitations is distance. We envisage building a simple UAV that is small and robust, that can deliver payloads of up to a kilogram about 40 kilometers. But if you want to fly 150 kilometers and make multiple or larger deliveries, you need to build a bigger, more expensive UAV and a more complicated system.

AW: We see our UAV as being used in particular scenarios, such as when the road to a remote health center in the mountains is washed out in the rainy season, and road delivery becomes impossible. So we don’t see the UAV completely replacing other distribution methods in the vaccine supply chain, but we do see it as having very useful applications in specific contexts. In places such as the Democratic Republic of the Congo, where villages are scattered and separated by very large distances, traditional forms of transportation may be better.

How will you customize your solution to work in the developing world?

AP: One of the things we are working on is enabling health care workers to control the UAV using SMS messages. We’re hoping that this will help to make the system as straightforward to use as possible,

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and that all health care workers will need to do is state in the text message the amount of vaccines they require and when they need them to be delivered. Aside from loading up the UAV at the central health clinic, very little technical expertise will be required to operate the UAVs.

How will you test your proposal?

VR: A lot of our initial testing is being done on airstrips here in the USA. Once we have a working system, we’re going to field-test the UAV in a more realistic scenario so we can see how it performs and how successfully health care workers can be trained to work with it. We will also use this opportunity to collect data regarding cultural and governmental challenges to be considered when implementing a full-scale version of our solution. One challenge might be that countries are resistant to using UAVs because they associate them so strongly with their military uses. I think a lot of what we are going to do is build trust in this sort of system; having a working proof-of-concept will go a long way towards this.

The team aims to complete their project by October 2013. For more information, please email Dr. George Barbastathis (gbarb@mit.edu).

Investigating the benefits of selling vaccines in Kenya’s medicine shopsan interview with Lisa Ganley-Leal and Pauline Mwinzi, Epsilon Therapeutics

Earlier this year, Lisa Ganley-Leal and Pauline Mwinzi were awarded $100,000 by the Bill & Melinda Gates Foundation through its Grand Challenges Explorations initiative. They hope to demonstrate that selling vaccines in medicine shops across Africa can improve vaccine availability among hard-to-reach populations, and that doing so can be profitable for both vaccine manufacturers and small business owners in disease-endemic regions. They spoke to Op.ti.mize about their proposal and the challenges they face.

What are medicine shops?

PM: Medicine shops are ubiquitous in developing countries. They sell a wide variety of painkillers, antipyretics, antimalarials, antihelminthics, antihistamines, antiprotozoals, and cough and stomach ache remedies.

Up to 80 percent of children in Kenya are treated with health products purchased at medicine shops, which are usually much closer to their homes than government facilities such as community health centers. In coastal Kenya, for example, more than 80 percent of rural households live within one kilometer of a medicine shop, but only about 30 percent live within two kilometers of a government dispensary or private clinic.

What gave you the idea for your proposal?

LGL: I was listening to a presentation from a student at Boston University on using medicine shops to distribute medical devices. She talked about a pharmaceutical market pyramid where most of the money is spent by the primary consumers at the base of the pyramid. NGOs were in the middle and the Ministry

A medicine shop in Kisumu, western Kenya.

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of Health was at the top. It reminded me of the time I was in Kenya and needed to visit a medicine shop—I was in a remote location and had a headache—and I was able to buy some ibuprofen. It struck me that these medicine shops at the foundation of the pyramid could also be used to distribute vaccines and that this might even help to encourage greater investment in vaccine development. As people who visit medicine shops are prepared to pay for their drugs, might they also be prepared to pay for their vaccines as well? If so, might this stimulate investment in vaccine development?

Is this a neglected area of study?

PM: Using the private sector to distribute vaccines is a neglected idea because vaccines are typically distributed by governments or international organizations for free. In countries with limited resources, vaccinating children under five has been the top priority. But vaccinating adults is important as well, so we need to ask whether the methods that have worked for young children also work for other age groups. This is particularly important when you consider the new vaccines that are in the pipeline. Medicine shops are already an extremely popular way for people to obtain treatment for various diseases (malaria, for example). These types of shops or kiosks have already been wildly successful in bringing cell phones to every corner of Africa. We suspect that vaccine distribution has the potential to become a similarly profitable business in emerging markets through local medicine shops, to the owners of medicine shops as well as vaccine manufacturers and investors.

What are the advantages of distributing vaccines in medicine shops?

LGL: Because medicine shops are everywhere—most villages have two or three, and they’re usually pretty well stocked—it would be great if we could somehow utilize this huge existing network that so many people are just steps away from.

PM: Unlike the vaccines that governments distribute for free to children under five, we can explore ideas where others can benefit as well, that are not just charity. There are employment opportunities here for small-scale businesses throughout the developing world, where large numbers of people who might otherwise be jobless could be employed.

How will you test your theory?

LGL: For two weeks, ten medicine shops in Western Kenya (in both rural and urban locations) will sell typhoid vaccine for US$1. We will station a trained nurse in each shop, who will educate patrons on the importance of vaccines, collect data on who visits the shop, and administer the vaccine to those who purchase it. The nurse will manage cold storage of the vaccines and safe disposal of needles. If there is any indication that the vaccine suffers degradation during the trial period, distribution at that medicine shop will cease. Afterwards, we will have focus groups to find out why people did or did not purchase the vaccine. The owners of the medicine shops will keep any money from the sale of vaccines.

What will be your biggest challenges?

PM: The vaccine cannot be administered by medicine shop owners themselves, so for our trial, we will station nurses in every medicine shop selling vaccines. We are testing whether people come to the medicine shop to buy vaccines, not the actual logistics of delivering today’s vaccines in these settings. In the future, it’s possible that some vaccines may have less strict storage requirements or may even be able to be administered by nonclinical personnel, but for now, we will have a nurse in each medicine shop.

If your demonstration project is successful, what will you do next?

PM: We want to highlight to vaccine manufacturers that their products might eventually end up being sold in medicine shops, and so they should start tailoring their manufacturing practices towards vaccines

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that can be delivered in such settings. Pharmaceutical companies are often reluctant to spend more on research and development for new vaccines, partly because current vaccines are not great revenue generators. We’d like to change that so we can start seeing manufacturers excited about developing new vaccines and investors wanting to support innovation in vaccine technology—such as increased vaccine stability, for example.

LGL: Selling vaccines in medicine shops is a just starting point, in terms of moving vaccines from where they are distributed now—which is at the hospital or on large immunization campaigns—to where they can be more easily distributed, even without a functioning cold chain or reliable electricity. If the demand is created from the bottom up, then other avenues will open.

Lisa and Pauline aim to complete their project by November 2012. For more information, please email Lisa Ganley-Leal (lisaganley@comcast.net) or Pauline Mwinzi (pnmutie@irsk.or.ke).

In pictures: Logistimo in South Sudanby Ryan McWhorter, Logistimo, and Dan Brigden, PATH

To accompany the article “South Sudan deploys new mobile phone-based stock management tool” in this month’s newsletter, project Optimize has published a photo set on Flickr that reveals how the new logistics management information system created by Logistimo is being used by health staff in South Sudan.

The photo set illustrates how county stock managers can use the Logistimo application on their mobile phones to review and update vaccine stock levels, order new vaccine stock, and record its arrival. It also

A county stock manager receives training in how to use the LogiWeb mobile phone application.

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shows how state and national managers can use Logistimo to respond to orders submitted by county stock managers, and view vaccine stock availability and consumption data.

Access the photo slideshow directly. You can click “Show info” in the top right corner to view/hide photograph descriptions, and click the following button in the bottom right corner to view the slideshow in full-screen mode.

AnnouncementsNew global health journal now accepting submissions

Global Health: Science and Practice, an open-access, peer-reviewed online journal launching in late 2012, is now accepting submissions for new articles. The journal aims to improve health practice, particularly in low- and middle-income countries, and is especially oriented toward practical knowledge related to how to implement programs in the field. Submit your manuscript, volunteer to be a reviewer, and subscribe to updates about the journal at www.ghspjournal.org.

5th Global Health Supply Chain Summit

Registration is now open for the 2012 Global Health Supply Chain Summit to be held from November 14 to 16, 2012, in Kigali, Rwanda. To register and access information about the event, please visit the Summit website.

TechNet Consultation

The next TechNet Consultation will be held in Dakar, Senegal from February 5 to 7, 2013. Further details will be posted on TechNet21.org.

ResourcesSummary of vaccine stability data

These updated PATH publications provide the latest stability data from current research on commonly used, licensed vaccines as well as novel, investigational vaccine formulations. Data are sorted by vaccine in a table format.

Outsourcing evidence brief

Project Optimize has published a document that provides an overview of the potential benefits of outsourcing components of vaccine logistics systems to the private sector. Intended for supply chain managers in low- and middle-income countries, the document also provides practical advice on determining whether outsourcing is a viable option. Read the document here.

OptimizeBatiment Avant Centre, 13 chemin du LevantFerney Voltaire 01210 FRANCE+33.450.28.43.75 | technet21.orgwho.int/immunization_delivery | path.org/vaccine-delivery.php

New EVM website

The Effective Vaccine Management (EVM) Initiative provides materials and tools needed to monitor and assess vaccine supply chains and help countries to improve their supply chain performance. The EVM Initiative website has recently been rebuilt and new content has been added. For example, the EVM standard operating procedures and updated EVM report template and improvement plan are now available for download.

Supply Chain Management Newsletter

The USAID | DELIVER PROJECT publishes a quarterly newsletter on supply chain management issues. Sign up here.

HuffPost blogs: Robert Steinglass and Orin Levine

The Huffington Post hosts blogs from two prominent immunization experts: Dr. Orin Levine, Director of Vaccine Delivery at the Bill & Melinda Gates Foundation, and Robert Steinglass, Immunization Team Leader at John Snow, Inc.

Optimize: Demonstrating innovative health supply chain solutions in Albania and Senegal

Project Optimize has published updated factsheets on their work with the governments of Albania and Senegal to demonstrate innovations in the vaccine supply chain.