No cold chain, no immunization

UNICEF's long-running efforts to assess, expand and strengthen Nepal’s cold chain capacity are proving crucial to the delivery of vaccines around the country as part of the ongoing COVID-19 vaccination campaign

UNICEF Nepal
This image shows COVID-19 vaccines arriving at the District Vaccine Store in Jumla
UNICEF Nepal/2021/LPNgakhusi
17 March 2021

“Getting the vaccines themselves is one part of the work, but without proper storage and transport systems, it’s not possible to take them to the community.”

This image shows a UNICEF staff and government official inside a vaccine cold room at the Central Vaccine Store in Teku, Kathmandu
UNICEF Nepal/2021/PShrestha
Bade Babu Thapa (right) with UNICEF cold chain consultant Nawaraj Khadka (left) in a cold room at the Central Vaccine Store under the Department of Health Services in Kathmandu.

That is Bade Babu Thapa, Senior Pharmacy Officer at the Central Vaccine Store in Kathmandu, under the Government of Nepal’s Department of Health Services, talking about the importance of a strong cold chain – which refers to a series of precisely coordinated events in temperature-controlled environments to store, manage and transport vaccines – in ensuring the success of any immunization campaign. The Central Vaccine Store is the national-level facility responsible for storing and dispatching vaccine supplies across the country for use in immunization programmes at the community level.

This image shows a hospital staff at the District Hospital in Jiri in Dolakha opening a vaccine refrigerator provided by UNICEF
UNICEF Nepal/2021/LPNgakhusi
Mitthi Jirel, staff at the District Hospital in Dolakha District in northeastern Nepal, puts vaccines into a refrigerator provided by UNICEF in the hospital's vaccine store room.
This image shows Jiri Hospital staff Mitthi Jirel with UNICEF staff in the vaccine cold store
UNICEF Nepal/2021/LPNgakhusi
Mitthi Jirel (left) staff at the District Hospital in Dolakha District in northeastern Nepal, with UNICEF staff Preena Shrestha in the hospital's vaccine store room.

Recognizing the critical role played by a well-connected cold chain, UNICEF – since the very beginning of national immunization efforts in Nepal – has been working closely with the government and key partners such as Gavi to assess, expand and strengthen the country’s cold chain capacity.

This has included installation of cold rooms, refrigerators and freezers in vaccine storage facilities at the central, provincial, district and local levels, refrigerated containers for transportation, as well as supply of cold boxes and carriers to safeguard vaccines during the final leg of their journey to immunization sites. UNICEF also provides technical and logistical support at federal, provincial/district and local levels for effective vaccine and cold chain management.

This image shows cold chain officer at the Dolakha District Public Health Office, Shiva Ram Basnet, in front of a UNICEF-supported refrigerator
UNICEF Nepal/2021/LPNgakhusi
Shiva Ram Basnet, Cold Chain Officer at the District Public Health Office in Dolakha District in northeastern Nepal removes a box of COVID-19 vaccines stored in a refrigeration unit installed with UNICEF support following the 2015 earthquake

The support was further strengthened after the 2015 earthquake, which severely impacted health facilities around the country. For instance, in Dolakha District in northeastern Nepal, which was one of the worst-hit areas in the disaster, additional cold chain equipment and assistance was provided to many health facilities.

“The equipment from UNICEF has been in continuous use over the years for storing vaccines for routine immunization,” says Shiva Ram Basnet, cold chain officer at Dolakha’s Public Health Service Office. “It is designed to keep running even if the power supply is intermittent, which was often the case after the earthquake.”

This image shows a healthworker getting vaccinated
UNICEF Nepal/2021/LPNgakhusi
A healthworker from the Patan Academy of Health Sciences receives the COVID-19 vaccine at Patan Hospital in Lalitpur District in central Nepal.

Today, with the launch of the vaccination drive against COVID-19 in Nepal, these long-running efforts to reinforce the cold chain have never been more crucial.

This image shows the back of a truck with a sign reading "No cold chain, no immunization"
UNICEF Nepal/2021
A refrigerated container carrying COVID-19 vaccines
This image shows a healthworker in Saptari District preparing to administer COVID-19 vaccines
UNICEF Nepal/2021/PShrestha
A healthworker at the Kalyanpur Primary Health Care Centre in Saptari District in Nepal's southern plains prepares to administer COVID-19 vaccines

“The COVID-19 vaccination drive is the most extensive vaccination program not just in the country but the whole world because it is targeting all adults, everywhere,” says Pradeep Shrestha, Health Officer at UNICEF Nepal. “We are happy that the work UNICEF has put into the vaccine and cold chain management over all these years is helping in the roll-out.”

This image shows government officials and UNICEF staff moving a cold box containing COVID-19 vaccines on the runway at the Jumla Airport
UNICEF Nepal/2021/LPNgakhusi
Health officials and UNICEF staff move a newly-arrived cold box of COVID-19 vaccines across the runway at the Jumla Airport in Nepal's far-west
This image shows health officials at the Pandugufa Health Post in Jumla moving COVID-19 vaccines into the refrigerator provided by UNICEF
UNICEF Nepal/2021/LPNgakhusi
Health officials at the Pandugufa Health Post in Jumla District in farwestern Nepal, storing COVID-19 vaccines in a refrigeration unit
This image shows a porter carrying a cold box of vaccines in Jumla District
UNICEF Nepal/2021/LPNgakhusi
COVID-19 vaccines in a cold box provided by UNICEF being carried by a porter on foot to a vaccination site in Jumla District in far-western Nepal

And the efforts to strengthen the cold chain are continuing. In 2020 alone, UNICEF installed 290 pieces of cold chain equipment in different facilities nationwide. Plans are also in place to procure and install an additional 910 pieces to address still-existing gaps in select areas and facilitate smooth delivery of vaccines.

“We’re very thankful for UNICEF’s support,” says Bal Kumari Khadka, Cold Chain Assistant at the District Vaccine Store in Jumla District in Nepal’s remote far-western region.

“The fact that we have been able to run the vaccination campaign here simultaneously with other places around the country shows how important the cold chain system is in increasing vaccine coverage.”

This image shows Bal Kumari Khadka, Cold Chain Assistant at the District Vaccine Store in Jumla District in Nepal’s remote far-western region storing vaccines in a refrigerator installed with UNICEF support
UNICEF Nepal/2021/LPNgakhusi
Bal Kumari Khadka, Cold Chain Assistant at the District Vaccine Store in Jumla District in Nepal’s remote far-western region storing vaccines in a refrigerator installed with UNICEF support at the facility

The cold chain will also be used to store, transport and distribute vaccines received through the COVAX Facility, a partnership between CEPI, Gavi, UNICEF and WHO, made possible through generous donor support from governments, international organizations, foundations and the private sector. Nepal received its first consignment of COVID-19 vaccines - a total of 348,000 doses - that were shipped through the COVAX facility on 7 March 2021, in support of the Government of Nepal’s nation-wide vaccination campaign. 

 

This image shows 70-year-old Maisara Rawat from Jumla showing her vaccination card
UNICEF Nepal/2021/LPNgakhusi
Seventy-year-old Maisuri Rawat from Jumla District in far-western Nepal shows her vaccination card after receiving the COVID-19 vaccine in the second phase of the drive