The critical role of UNICEF in accelerating COVID-19 vaccine rollout through national logistics work

In-country logistics coordination paving the way for vaccine deployment  

In 2021, the COVAX Facility, the global mechanism for equitable access to COVID-19 vaccines, delivered over 958 million vaccine doses to 144 countries and territories with support from UNICEF as the procurement, delivery and lead programme implementation agency. This achievement has been made possible through in-country coordination led by the Expanded Programme on Immunization (EPI), Ministries of Health and in-country coordination groups like the COVID-19 response committees and National Logistics Working Groups (NLWGs).  

In-country coordination remains an essential step in the vaccine deployment process ensuring that countries are ready to receive and clear, store, distribute to service delivery points and administer doses. Since the start of COVID-19 pandemic, in-country logistics coordination groups have played a crucial role in ensuring the uninterrupted availability of routine immunization programmes, including preparations to receive and distribute COVID-19 vaccines. The coordination mechanism also oversaw the upgrade of in-country cold chain capacity and receipt and distribution all other supplementary supplies such as syringes and injection safety boxes. 

The NLWGs coordinates implementation of the supply and logistics component of the National Vaccine Deployment Plans (NVDPs) for COVID-19 vaccine rollout. They have a critical role in ensuring that supply chain interventions are not duplicative and coordinated with optimal visibility of the health products available at national and sub-national levels. They also identify resource needs to store and distribute, as well as define supply processes for COVID-19 vaccine introduction with partners.  

Under the stewardship of the immunization programmes, UNICEF continues to play its advisory role together with WHO and other technical assistance partners as key members of the NLWGs comprising local health and logistics professionals. UNICEF also provides technical assistance to the NLWGs leadership through capacity building and technical assistance support as key participant in the group. Recently, UNICEF deployed 80 Vaccine Management Specialists in 40 high risk countries to support the NLWG in COVID-19 vaccine rollout.   

Advancing coverage commitments and best practices in Nepal, Uzbekistan and Mozambique 

The National Committee for Vaccine and Cold Chain Management (NCVCCM), an equivalent of the NLWGs in Nepal, convenes partners to forecast needs and develop supply plans for the procurement of vaccines and ancillary supplies. This committee is led by the Ministry of Health and Population (MOHP) and the Expanded Programme on Immunization (EPI) with support from partners including UNICEF, WHO, United States Agency for International Development, KfW Development Bank, Department for International Development, UK, and FHI-360. “The NCVCCM is a key programmatic mechanism for leveraging partner competencies for COVID-19 vaccine rollout” says Pradeep Shrestha, Immunization Officer, UNICEF Nepal. This support has enabled the rollout of over 45 million doses of COVID-19 vaccines, with COVAX accounting for over 40 per cent of total doses available in the country. This has contributed to COVID-19 vaccination coverage rate of 52 per cent for fully vaccinated population in Nepal. 

“Bringing partners under the NLWGs as a unified system for a coordinated COVID-19 vaccine rollout is one of the reasons for accelerated vaccine deployment to districts and primary health centres in Uzbekistan” says Dr Dilorom Tursunova, National EPI-Coordinator of Uzbekistan. This mechanism proved to be an effective platform in Uzbekistan to speed up actions for vaccine deployment from the port of entry to distribution points and lower-level vaccine stores. As a result, supplies are distributed from national to district vaccine stores within three days, and to vaccination points at Primary Health Care level within five days of arrival at the port of entry which was initially 30 days. Uzbekistan has administered over 80 per cent of the over 49 million doses received from both COVAX and bilateral procurement, thereby contributing to its increasing vaccine uptake with a coverage rate of 39.1 per cent as of February 2022 (MOH Uzbekistan).  

Mozambique has also leveraged the power of partnerships through the convening power of the NLWGs to facilitate COVID-19 vaccine rollout. With challenges related to cold chain capacity especially at sub-national level, the group convened partners to assess supply chain capacity needs including funding requirement for COVID-19 vaccine rollout with EPI, National Medical Stores, WHO, UNICEF, UNDP, CHAI and VillageReach.  

Led by UNICEF, the group was instrumental in mobilizing about $2 million to procure and install cold chain equipment in Cabo Delgado, Niassa and Nampula provinces and having more planned for Maputo, Sofala and Zambezia. Having capacity to store vaccines in provinces brings them closer to the people, allowing improved vaccine uptake. With this support, the country is able to store over 25 million doses over time with COVAX accounting for more than 75 per cent of total doses delivered to Mozambique. This will potentially facilitate Mozambique’s effort to reach close to 40 per cent of vaccination coverage. “The NLWG has enhanced effective coordination of in-country supply chain partners in Mozambique for the rollout of COVID-19 vaccines especially in provinces” says Maureen Louise Gallagher, Chief of health and Nutrition Section, UNICEF Mozambique.   

Addressing inequity challenges

Having the right infrastructure, tools and processes will further drive efforts to successfully rollout COVID-19 vaccines to communities. The complexity of in-country rollout, particularly in low-income countries and fragile contexts, requires contextualized supply and logistics solutions which the NLWG should implement with partners. Coordinated in-country immunization supply chains interventions will ensure that countries are supported to vaccinate their population, thereby closing the inequity gap and keeping communities protected from the COVID-19 pandemic.