From donation to delivery: how UNICEF gets COVID-19 vaccines where they are needed most
UNICEF teams are on the front lines leading the largest and most complex vaccine supply operation ever, with donors playing a crucial role
From donation pledges at high-level forums, to reaching the arms of people on the opposite side of the world, each vaccine undertakes an extraordinary journey. UNICEF – as the key delivery partner for COVAX – is at the heart of this journey, leading the largest vaccine supply operation ever.
As COVID-19 continues its relentless march with the ever-present threat of new variants, COVAX – the global vaccine equity mechanism co-led by Gavi, the Vaccine Alliance, WHO and CEPI – has provided a lifeline for millions of people across the world, with dose donations making a vital contribution.
Bangladesh, like many countries, was hard hit by the second wave of COVID-19. Cases soared with the arrival of the Delta variant, and hospitals were filled to capacity.
“Most hospitals were shouldering extra patient loads with no additional resources, and staff had to work around the clock. Many doctors, nurses, front line workers and their families were infected by COVID-19, while some died,” said Dr Zahid Hassan, Health Officer, UNICEF Bangladesh.
In response to the intensified health crisis, the demand for COVID-19 vaccines swiftly peaked. However, the lack of vaccine supply meant that the national COVID-19 vaccination campaign had to be put on hold between May and June 2021.
“We were used to vaccinating about 500 people a day. Then suddenly, over 3,500 people were queueing each morning, but we didn’t have enough doses. When the vaccination campaign was suspended, many people came to the hospital looking for a vaccine but they had to leave empty-handed,” said Dr Mohammad Daud Ahmed Talukder, Medical Officer, Bangabandhu Sheikh Mujib Medical University Hospital, Dhaka.
"The emergence of the Omicron variant provides another stark reminder of what is at stake if we allow vaccine inequity to prevail. We cannot vaccinate our way out of the pandemic one country at a time. We must work together to protect every one of us from COVID-19.”
Boosting vaccine equity with dose donations
Delivering vaccines fairly across low- and middle-income countries is the best way to bring the COVID-19 pandemic under control and stop deadly variants that could potentially evade vaccines.
“The emergence of the Omicron variant provides another stark reminder of what is at stake if we allow vaccine inequity to prevail. We cannot vaccinate our way out of the pandemic one country at a time. We must work together to protect every one of us from COVID-19,” said Ann Ottosen, Senior Manager with UNICEF Supply Division’s Vaccine Centre.
Export restrictions, vaccine nationalism, and manufacturing and regulatory delays contributed to setbacks in vaccine supplies to COVAX in early 2021. In response, donor countries helped overcome inequity by sharing their vaccine supplies. Significantly, vaccine sharing accounted for 40 per cent of COVAX deliveries in 2021.
But before planes filled with COVID-19 vaccines can touch down on the tarmac, an incredible amount of work takes place behind the scenes to make these shipments a reality.
“What may seem straightforward from the outside is actually incredibly complex. It all starts with political commitment, but then we get down to the granular details, ensuring country acceptance and capacity, import approvals, and indemnification and liability agreements are in place before legally binding purchase orders and transport arrangements can be made. These processes typically take several weeks, but vary in each scenario,” said Ann Ottosen.
Vaccines are just one part of the story. UNICEF is also shipping syringes and safety boxes while shoring up cold chain capacity to ensure vaccines are stored at the right temperature from the moment they leave the manufacturer to the moment they are used.
It’s a mammoth operation, requiring all the pieces of the puzzle to fit into place at precisely the right time.
“Bangladesh has gone from being a severely undersupplied country, to having a steady, more predictable vaccine supply in just a few months. Now, we need to focus on turning vaccines into vaccinations, and strengthening our health system to ensure essential health services can continue.”
Transforming the landscape
Recent donations via COVAX from Canada, France, Germany, Japan, Norway, Sweden, Switzerland, the United Kingdom, and the United States, along with large quantities of vaccines secured by the Government of Bangladesh in bilateral deals, have helped Bangladesh to deliver over 117 million vaccine doses to its population (as of 21 December 2021).
“While there is a long way to go to reach our vaccination targets, Bangladesh has gone from being a severely undersupplied country, to having a steady, more predictable vaccine supply in just a few months. Now, we need to focus on turning vaccines into vaccinations, and strengthening our health system to ensure essential health services can continue,” said Dr Hassan.
The pandemic has generated the largest, most complex vaccine roll-out in history. In 18 months, united efforts aim to vaccinate up to 70 per cent of the world’s population. Nothing on this scale was ever previously attempted.
“The pandemic is far from over, and we know that the virus is always two steps ahead. All countries must work together to overcome barriers across the supply chain to get jabs into arms, through predictable supplies including dose donations, political commitment and tailored support to overcome specific challenges. Global solidarity is needed now, more than ever before,” said Ann Ottosen.