UNICEF Malawi Supply Update on Coronavirus Disease (COVID-19) Response:
Prepositioned and locally procured supplies provide critical input to Malawi response in combating COVID-19
The COVID-19 outbreak around the world has imposed enormous pressure on global supply markets and brought unprecedented challenges to UNICEF’s global supply operations. Restrictions on international transport are having an impact on freight operations globally, disrupting supply chains and causing bottlenecks, delays and higher costs in the delivery of lifesaving supplies for humanitarian and development programmes.
Despite these countless challenges, including extreme supply shortages for personal protective equipment (PPE), UNICEF Malawi and its partners are working around the clock to come up with agile solutions to ensure the safeguarding of children and their families in Malawi. One of the solutions includes procuring supplies not just through the offshore UNICEF’s Supply Division but also from the local and regional market. Such locally procured supplies will provide initial relief to the high demand for PPEs in the country. Opportunities for domestic production of PPEs and equipment are also being explored by UNICEF and partners as a way of improving access, cost, sustainability, and boosting the local economy.
UNICEF Malawi is actively involved in supporting the Government of Malawi to mitigate the impact of the virus on children’s survival, health, well-being and education; and in stopping the spread of the virus. As a leading UN agency for supply chain, UNICEF has initiated procurement actions worth over US$10 million for essential and strategic supplies on behalf of the Government of Malawi and other partners.
Update on Procurement and distribution of PPEs [Offshore and Local]
- For the reporting Period Jan to June 2021, with funding from the Health Services Joint Fund (HSJF), World Bank (WB), GAVI, and FCDO / UK Aid, UNICEF has procured and received Personal Protective Equipment (PPE), medical supplies and medicines worth about US$ 6.190,850.51 as follows: HSJF-$448,925.73, GFATM- 4,399,285.70GAVI- $20,886.49, FCDO-$718,837.68, WB PEF- $106,166.87, WB IDA-$496,748.04. The PPEs include coveralls and protective aprons, protective headgear, safety boots, goggles, gloves, respirators, and masks.
- During the 6-month period from January to June 2021, UNICEF undertook local procurement for Personal Protective Equipment including face cloth masks and heavy-duty boots. In addition, mobile plastic portable toilets were procured for Health facilities as well as chlorine bleaching powder, tarpaulins, buckets, and soap. The total value of locally procured supplies during the period under review was US$154,000.
- UNICEF has undertaken two major distributions of supplies to all 29 districts by December 2020 using the distribution plans prepared by the MoH/HTSS.
- Monitoring of COVID-19 supplies is being undertaken by the MOH.
- Weekly meetings are held with the MOH/HTSS to discuss and strategize on funding availability, procurement progress, distribution status and supplies utilization monitoring.
- The global supply portal, managed by UNICEF, continues to facilitate requests by national authorities and humanitarian partners for strategic and critical supplies for COVID-19 response. By June 2021, about US$2.732 million worth of COVID supplies have been submitted through the supply portal for procurement.
- UNICEF Malawi, as part of its COVID-19 support to the Ministry of Health, procured TaqPath COVID-19 CE-IVD RT-PCR Kits for use on Applied Biosystems 7500 Real-Time PCR Systems.
- Capacity building provided by SD to MOH in the use of TaqPath to the existing RT-PCR platforms through calibration enabled the country to expand PCR testing from the initial five to sixteen sites.
- The availability of automated Polymerase Chain Reaction (PCR) tests kits remain a gold standard for diagnosing COVID-19. Overtime Antigen Rapid Diagnostic Tests (Ag-RDTs) are available and being used widely for testing asymptomatic suspected cases and contacts. They include Panabio and Biosensor that have improved on access to testing in district hospitals and Points of entry. Additionally, Antibody Rapid Diagnostic Tests remains critically limited in application to mini sero surveys in Malawi.
- Since March 2020, UNICEF has been supplying COVID-19 tests for low- and middle-income countries including Malawi as shown below:
- Abbott RealTime SARS-CoV-2 assay by Abbott
- Xpert® Xpress SARS-CoV-2 test by Cepheid
- cobas® SARS-CoV-2 assay by Roche
- TaqPath COVID-19 Combo Kit Life Technologies by Thermo Fisher
- Real-time fluorescent RT-PCR kit for detecting 2019-nCoV
- Smart Detect SARS-CoV-2 rRT-PCR Kit
- Novel Coronavirus (2019-nCoV) Real Time Multiplex RT-PCR Kit (Detection for 3 Genes)
- COVID-19 genesig CE IVD Real-Time PCR assay
- STANDARD M nCoV Real-Time Detection Kit
- Malawi received the first batch of COVID-19 vaccines (AstraZeneca) - 360,000 doses on the 5th of March 2021. In addition, Malawi received 102,000 AstraZeneca doses from AU and 50,000 AstraZeneca doses from the Government of India.
- Under the COVAX facility, UNICEF has received a total of 3,420,000 syringes and 34,225 safety boxes out of which we provided 360,000 syringes and 3625 safety boxes (for the safe disposal of syringes) to be used in the COVID-19 vaccination. The balance of 3,060,000 and 30,600 safety boxes are currently being warehoused in the National Vaccine Store at CHSU.
- The country utilized all the 512,000 doses of COVID-19 vaccines before 27th June 2021. Currently there is a stockout of COVID-19 vaccine and vaccination is currently not taking place.
- In total, Malawi used 492,390 doses (360,000 from COVAX, 50,000 from the Government of India and 82,390 from AU) for both first and second dose. Vaccine from AU had only 3 weeks shelf-life. Out of these 19.2% expired before use.
- Only 43,165 people received both first and second Dose.
- The following COVID-19 vaccines are coming from COVAX and some are donated by US and French Govt as follows:
- 360,000 doses of Astra Zeneca (AZ) vaccines: All regulatory approval documents provided to COVAX and shipment planning is ongoing. It is expected in Country by August 2021.
- 192,000 doses of AZ vaccine (donated by French Govt): All regulatory approval documents provided to COVAX and shipment planning is ongoing. It is expected in Country by July 2021. The manufacturer located in Sweden.
- 165,000 doses of Johnson &Johnson vaccine (donated by Govt of USA): All regulatory approval documents provided to COVAX and shipment planning is ongoing.
- 37,060 doses of Pfizer vaccine: Ministry of Health received the information from COVAX recently and regulatory approval process is ongoing.
- Pfizer vaccines are challenging in that the temperature requirements are different from what Malawi has, and the syringe size is also different and AD 0,3ml syringes with RUP2ml for dilution and safety boxes would need to be procured. UNICEF is procuring Ultra-Cold Chain Equipment globally and Malawi can procure through UNICEF the Ultra Cold Chain equipment.
- The global supply of vaccines is presently constrained, which impacts country access. This constraint is due to multiple factors including company related production delays, shipping challenges, and increasing demand. Participating countries and economies of the COVAX facility are particularly affected.
Oxygen therapy is critical as supportive treatment of COVID-19 cases and preventing patients suffering from severe lack of oxygen (Hypoxemia) in the blood. Such complications may be caused by a range of common conditions including pneumonia, COVID-19, complications from pregnancy, and premature birth among others.
UNICEF with support from FCDO, World Bank, Health Sector Joint Fund (HSJF), Irish Embassy and other urgencies procured 176 Oxygen Concentrators, 10 Ventilators, patient monitors, Pulse Oximeters, Oxygen Cylinders and installation and transportation of a Pressure Swing Adsorption (PSA) plants from South Africa to Lilongwe at Kamuzu Central Hospital that is capable of producing over one million litres of oxygen per day. UNICEF efforts to establish an Oxygen Task Force Chaired by MOH and use of the SPRINT tool to forecast has proved helpful in addressing the oxygen gaps and consumables.
For Frequently asked questions related to COVID-19 supply and equipment, click here.