Vaccination: rattling the supply chain.

摘要: The first decade of this century was perhaps the most productive in history vaccine development, seeing release a plethora new life-saving vaccines for rotavirus diarrhoea, types meningitis and pneumonia, human papilloma-virus (HPV) infections that cause cervical cancer. "We are very different situation now compared to 10 years ago;' says Dr Osman Mansoor at United Nations Children's Fund (UNICEF) New York. Mansoor, who is UNICEF's senior health adviser Expanded Programme on Immunization Vaccines, notes more pipeline. In fact than 80 late stages clinical testing, 30 them designed protect against major diseases including dengue malaria. At same time, global market booming: since 2000, revenue from sale has almost tripled reaching US$17 billion by mid-2008. While expansion accounted sales costly industrialized countries, also developing countries due efforts GAVI Alliance (formerly Global Vaccines Immunization), public-private partnership established 2000 increase immunization poor countries. [ILLUSTRATION OMITTED] World Health Organization (WHO) UNICEF estimate just over 80% world's children have access immunization, as measured coverage third dose DTP (diphtheria, tetanus pertussis) vaccine, while an increasing number powerful vaccines. "In past, relied package six diseases" Project Optimize Coordinator Modibo Dicko, referring WHO's Immunization, which launched 1974. "Now some doubling they offer." As encouraging all seems, scaling up programmes introduction putting unprecedented strain delivery systems not changed decades. James Cheyne, supply-chain consultant, started his career logistics Burma (now Myanmar) 1977, good position judge those he had hand designing several himself. Cheyne cites unnecessary layering distribution networks one main concerns. "Typically there central store supplies regional stores, then feed provincial stores district turn supply local centres," says, pointing out made sense ago, because lines communication were weak, these days low-cost telecommunications technology things. "You don't need each administrative level anymore we cell phones person centre can call directly; says. Making better use kind core aspect work being done Optimize, collaboration between WHO PATH Program Appropriate Technology Health), nongovernmental organization. For Michel Zaffran, director information key combating biggest problems faced systems--overstock supply. On face it idea hampered too much seems paradoxical. But, fact, overstocking increases cold storage costs generates waste (when lost, damaged or used before their expiry date, when vials multi-dose vial get used). want little buffer stock possible, but still enough vaccinate children," Zaffran arguing means place technologies give managers real-time picture how throughout country whether quantities meet requirements strategy. …