Innovative freight solutions to deliver vaccines, despite COVID-19 disruptions

Despite decades of progress in childhood immunization, achieving coverage for the most underserved has been a steep challenge: 14 million infants annually receive no vaccines (zero-dose children), while a further 6 million receive some but not all vaccines. Even prior to the COVID-19 pandemic, global immunization coverage rates of diphtheria, tetanus, and pertussis containing vaccines (DTP3) had stalled at around 85 per cent for over a decade.

The COVID-19 pandemic has brought even more complexities to this already challenging scenario. By mid-May routine immunization services were disrupted in at least 68 countries, and more than 50 vaccination campaigns were postponed to avoid potential transmission of COVID-19. Lockdown measures in vaccine producing and receiving countries and the ensuing reduction in commercial flights had a heavy impact on vaccine deliveries. With shipments unable to arrive, many countries were at risk of supply shortages. As activities resume, vaccine manufacturers’ stock levels are very high, and a considerable backlog will now need to be delivered.  

Unprecedented impact on freight operations

Each year, UNICEF procures over two billion doses of vaccines on behalf of nearly 100 countries, to reach approximately 45 per cent of the world’s children under five years of age. From March to May in a typical year, UNICEF would have made more than 700 shipments of vaccines to countries; in the same three-month period in 2020 this number was nearly halved. The steep decline was due to the pandemic’s unprecedented impact on global freight operations, creating a massive backlog of shipments.
 
As of mid-June, commercial flights slowly began to resume, but at lower frequency and to limited destinations. This resulted in widespread competition for available cargo space and higher freight costs. Many countries continued to be extremely hard to reach by air, and some had no available commercial freight options at all.

“Following a regional vaccines availability assessment, the Regional Office identified several West and Central African countries at risk of stock-out due to logistics challenges related to COVID-19 containment measures,” said Marie-Pierre Poirier, UNICEF Regional Director for West and Central Africa. “At a time when outbreaks of vaccine-preventable diseases were being recorded in parts of the region, it was absolutely vital for us to do everything possible to make sure that no child’s life would be lost or jeopardized because of vaccines stock-out, and to support the Ministries of Health in the region to sustain routine immunization activities”

To get vaccines to countries in this challenging context, UNICEF is championing innovative, collaborative and agile shipping solutions, particularly for smaller countries with access challenges or for which individual charter flights would come at exorbitant costs.

Multi-stop charter flights

One such solution is the concept of multi-stop charter flights, which was first piloted by UNICEF in June. Under this approach, several smaller vaccine shipments are pooled into a single aircraft, making stops in several countries. UNICEF has arranged three such charter operations to date to deliver vaccines to hard-to-reach countries in West and Central Africa  – a region with some of the lowest immunization coverage rates in the world. This innovative freight solution substantially decreased the cost of delivery for each country, while supporting access to vaccines in locations that would be otherwise difficult to reach due to pandemic-related lockdowns and lack of commercial freight options.

The first multi-stop charter took place in early June, originating in India and delivering vaccines produced by Indian vaccine manufacturers to reach eight countries in West and Central Africa. Following on from the success of this operation, a second and third charter were coordinated in late June and early July, originating from the European logistics hub in Belgium and reaching a total of six countries in West and Central Africa, including those hardest to reach.

“These multi-stop charters represent an exceptional level of partnership and coordination between UNICEF, freight forwarders, countries and suppliers,” said Etleva Kadilli, Director of UNICEF’s supply and procurement headquarters. “Although there are additional complexities involved in making such operations a reality, it is solutions like these that are supporting countries in their efforts to continue, conduct catch up and further revitalize immunization services.”

Dedicated charters

UNICEF is also working together with partners to carry out dedicated charters for larger countries, consolidating vaccines and other cargo. For example, a collaboration with the European Union (EU) supported UNICEF to send more than 50 tons of vital supplies to Afghanistan, Burkina Faso, the Democratic Republic of the Congo (DRC) and Sudan on board eight EU Humanitarian Air Bridge flights as of mid-July. The EU Air Bridge was set up to respond to the challenges created by the COVID-19 pandemic. The UNICEF cargo included not only vaccines, but also medical equipment and other health supplies to help children and families, and to support the countries to keep up essential health services during the pandemic.

The impact is being felt on the ground. Despite the continued global cargo capacity operating at approximately half of normal levels, UNICEF achieved average levels of vaccine delivery in June, and by mid-July had successfully delivered vaccines to over 85 countries since the start of the pandemic. In a single week in July, a total of 81 shipments took place – the highest weekly number of vaccine shipments in over four years.

 “We managed to deliver these much-needed supplies to our region on time,” said Ms. Poirier. “This was thanks to the invaluable support of our donors who agreed to make flexible funding available so that we could develop timely and innovative solutions to successfully adapt to the situation”.