What would it take to deploy COVID-19 vaccines through sustainable cold chains?
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Amidst uncertainty surrounding the outlook for COVID-19 fatalities and infections, developing and deploying a vaccine is the topmost global priority. Health and logistics systems under stress will be challenged for the global distribution of a new vaccine, when and if it becomes available. If the protocols for handling such a vaccine resemble those for existing ones, it will need to be supported by strong and sustainable cold chains. This poses a daunting development challenge.
Healthcare programs have made great progress in developing countries since the World Bank’s first health project to fight river blindness in West Africa in the 1970s, and vaccines have become an integral part of healthcare around the world. Yet, one in five children worldwide still lack access to even the most basic vaccines, causing 1.5 million preventable deaths every year. The WHO estimates that, among the 19.4 million infants who were not reached by routine immunizations in 2018, most were in rural areas with weak medical supply chains. One major cause is the lack of uninterrupted cold chains, from the point of vaccine production to the patients.
One of the main problems associated with weaker vaccine cold chains is often the lack of reliable electricity supply. Despite the critical role energy plays in enabling health services, many facilities in rural developing environments still suffer from energy poverty. In sub-Saharan Africa, only 28% of healthcare facilities enjoy reliable electricity supply.
In order to counter global pandemics like COVID-19, even remote and sparsely populated areas require access to vaccines. Delivering a new vaccine will further strain limited cold chain capacities in low-income countries. There will be a sizeable increase in energy demand from additional cooling volumes for stationary refrigeration in distribution hubs, health facilities, and storage facilities. In addition, the amount of cooling required in refrigerated vehicles to transport these vaccines will grow significantly.
Capabilities to meet such demand are often based on unreliable fossil fuel-centric electricity grids, and expensive diesel-powered generators and trucks. While existing grids and diesel generators may address the most urgent loads, they can be complemented with cost-effective solutions to improve affordability and reliability, mitigate fuel supply risks, and reduce harmful emissions. Solar-plus-storage units can boost electricity reliability at grid-connected hospitals, complement diesel generators to create affordable hybrid systems at off-grid sites, and provide reliable stand-alone generation at rural locations. In addition to medical cooling, reliable electricity supply can power critical medical equipment such as ventilators and oxygen concentrators as well as local producers of masks and personal protective equipment (PPE).
Solutions on the demand side can also reduce energy usage through energy efficient cooling and refrigeration technologies with better insulation, off-grid direct current (DC) based refrigerators, solar cooling, or solar direct drive vaccine refrigerators that “store the cold” without batteries. Improving energy efficiency and reducing operating costs frees up scarce local resources to maximize testing and the provision of care. As the need for refrigeration expands, it is also an opportunity to replace conventional refrigerants—based on greenhouse gases with high global warming potential—and transition to more climate-friendly refrigerants across the stationary and mobile vaccine cold chain.
We need a global effort to establish and sustain medical supply chains to deliver a COVID-19 vaccine when it becomes available. This urgent requirement can also provide an opportunity to address cold chain reliability for future health needs, provide energy access to critical services, mainstream energy efficient and solar-based technologies, and lay the ground for a sustainable economic recovery after the immediate crisis has passed. Systems-based thinking and an integrated approach can help to adequately meet the post-COVID-19 health recovery needs while, at the same time, supporting efforts to address the climate challenge and provide sustainable economic growth.
The World Bank is acting upon this challenge. A multi-sectoral technical assistance program, the ESMAP Efficient, Clean Cooling Program, was established in 2019 to accelerate the uptake of sustainable cooling solution, including refrigeration and cold chain in developing countries. In parallel, efforts are underway to mobilize donor funds to support governments—mostly in Sub-Saharan Africa—to respond to COVID-19 by rapidly electrifying health facilities with distributed solar PV/battery solution, including the provision of off-grid solar products and associated solar refrigeration to safely chill vaccines all the way to village clinics.
Now is the time to recognize energy’s vital role as an enabler of health care delivery, and to strengthen the nexus between development objectives for clean energy (SDG 7) and health (SDG 3).
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Solar direct drive vaccine refrigerators indeed present a more sustainable solution in off grid communities and/or places with weak/unreliable grid connectivity. Question then becomes how can we accelerate the access, affordability and availability of these energy solutions to underserved health facilities in such uncertain times?
I agree, reliable electricity is critical to improving health outcomes in rural health facilities especially in a COVID-19 world. Many health facilities in low- and middle-income countries operate without electricity, have unreliable electricity, or find that using electricity is cost prohibitive. In these settings, solar energy is a promising solution for powering the storage of vaccines and heat-sensitive drugs at controlled temperatures.
Solar direct-drive refrigerators in particular have many benefits over other types of refrigerators (see PATH’s Total Cost of Ownership tool below for a comparison). Some solar direct drive refrigerators now come with an accessory called an energy harvest control (EHC). It allows excess power generated from the solar panels and unused by the refrigerator to be safely used to power devices such as lights, fans, mobile phones, and some medical devices as required by the particular health facility and aligning with their needs and local guidelines. The EHC always prioritizes the safety of the vaccines before powering these additional devices.
In Senegal alone, our data show that 91 facilities are already equipped with solar direct drive refrigerators. By using an EHC at these facilities and potentially expanding to others in need of both cold storage for vaccines and access to power, the sustainable cold chains critical to equitable deployment of vaccines that you note can be made feasible while increasing ability to provide care (e.g., lights for nighttime operations and fans for comfort) to patients. For more information, please see the resources below or contact Pat Lennon (plennon@path.org).
Total Cost of Ownership Tool for Cold Chain Equipment:
https://www.path.org/resources/total-cost-of-ownership-tool-for-cold-ch…
Energy Harvest Control: Selection Guide:
https://www.technet-21.org/en/library/main/6329-energy-harvest-control:…
Energy Harvest Control: Frequently Asked Questions:
https://vaccineresources.org/details.php?i=2673
The treatment of the COVID-19 pandemic virus with Ebola treatment drugs now in America proves the close relationship between them, the lack of safe transportation for travel of specialized medical personnel to spread health awareness, apply treatment and fortifications in remote villages, and wait for poor, non-money patients to travel to hospitals in major cities was the reason The main development of Ebola became the COVID-19 pandemic. If the establishment of a safe transportation network for specialist travel is not given attention and spent on full testing of poor people in remote villages, spreading health awareness, applying vaccinations, treatment to these poor people, the physical, material losses will be very large in rich countries.
As the (COVID-19) the outbreak continues to impact our lives, we can save lives and also slow the global circulation of the viruses—is focused particularly now on developing countries, these are the actions that leaders should be taken immediately because there is no time to waste.
Spreading health awareness and treating the spread of diseases among people need accident-free transport to reach populations in distant remote places so as not to be a center of contagion all over the world as has been the case before for HIV and Ebola where it started in Africa and then spread everywhere. Because of the lack of safe transportation prevents access to those to complete the full immunizations also, laboratory workers are also at risk. Samples were taken from humans and animals for investigation of Ebola infection should be handled by trained staff and processed in suitably equipped laboratories, among these poor communities that do not have the money to travel to hospitals in big cities, Especially sick children and elderly people who cannot move and pregnant women who cannot afford to travel on unlit rough roads at night are extremely crowded during the day and they also make sure that women have access to life-saving medicines during childbirth.
Africa is a continent where there is much wealth, but many of the poor live in remote villages far from urban areas, however, there are no roads that are paved and luminous enough to move safely overnight because no new roads have been established to accommodate the continuous population increase,
Jean Todt, the UN special envoy for road safety said at the "Africa Road Safety 2017" conference in Cape Town, South Africa, at least 650 people are killed daily in road accidents across Africa. According to him, 90 percent of people and goods on the African continent are transported by land, adding that road accidents "can deprive any country of its true development potential". The continent suffers from the highest rate of traffic deaths on roads from any other country. The region though owned less than 5% of the world's registered vehicles still has 20% of the world's road accidents. "Therefore, Africa has been severely affected by the crisis of safety on world roads.
According to the (UNFPA) globally, 800 women a day die from pregnancy and childbirth without access to safe contraception, women are left vulnerable to pregnancy often when they are too young – with horrific consequences often from entirely preventable causes. Simple medicines can save the lives of mothers and their children, but for women living in conflict zones, displacement camps, or poverty, this basic access is out of reach. Because they are poor, they do not have the money to travel to hospitals in the main cities because they are accused of living in remote villages where there are no luminous roads to travel safely without accidents during the night long distances for the treatment or birth in the morning but forced to surrender to death in their homes. Even if they return, they are liable to die with their children at night accidents on the roads because of the lack of good illumination after all this effort and pains.
Also for long-distance road travel at night where there is no lighting, for vehicles equipped for blood donation. It contains laboratories for blood quality analysis and conservation and then returns to blood banks in major cities to reach blood donors in communities that live far from civilized because of they have little money to travel to blood donation banks in major cities, which contributes strongly to increase blood yield and save many lives.
Manufacturing an invention of a device that provides powerful lighting for all types of vehicles using light tubes without dazzled for the actual application of a sustainable society.
I’m from Egypt at Africa, I have two inventions were implemented to develop the night lighting a system, patents No, 26771 / 2011 (Extra Spotlights through Xenon, Laser or LED Bulb) and patent No, 29238 / 2014 (A device that provides powerful lighting for all types of vehicles using lights tubes without dazzled) Issued by the Academy of Scientific Research in Cairo Egypt.
Towards reduce the killing of one million and 350,000 people are killed annually in road accidents (3,500 deaths daily worldwide as well. Every 6 seconds somebody somewhere in the world is killed suddenly and dramatically by injuries of up to five million deaths a year! Total victims reach approximately 6 million people per year (even if the accident reduction rate is 1%, life will be maintained at 60,000 people per year), also causing material losses of $500 billion (if a 10% a pause occurs, $50 billion will be available to change the global economy annually)
To develop the installation of the lighting place in a very narrow area directly in the front, it is not allowed to install a device to control of light away from the eyes of others, causing extreme confusion on vision since the first invention of 1886 till now, where Light flows by speed 300,000 m/s to strike the force of the human and animal eye nerve and the uncles temporary he the main reason for the increase of incidents the night.
Is done by installation inside of body vehicle to the rear is far from the front (An invention of a device that provides powerful lighting for all types of vehicles using lights tubes without dazzled) to control such glow on, then redirected to the front for radiate through the Tubes of lights within it a nanotechnology-treated lighting element, to support and increase the power of lighting without dazzled, with diffusion of light at a near-Earth horizontal level in all directions, they are installed inside the projector at specific angles and degrees to control the direction of light away from the vision of others, by optical sensors, one mounted at the driver's view level and the other above the light exit slot, They communicate with each other a special mobile device system (The ‘mobile edge)’ to signal a motor that moves the projector from the rear up or down to change the angle of the light output from the front at a specific level of the light a sensor installed in the vehicle by the driver below the eye level automatic 200 meters after which the dazzled light is lost, for steering the light is far from the other driver's vision level to prevent light dazzled interference traditional. (There are also other elements that will be explained later)
The invention controls at the dazzled lights when approaching the cars each other the strong headlights become very painful because they cause severe interference to the vision, as they approach each other, leading to a complete loss of vision and forcing the two drivers to turn off the strong lights and walk only in the light of small lights so that each car can Is a way away from the collision of the two vehicles and without disturbing the vision of the road to each of the leaders of the two vehicles to the other where this causes the loss of focus into making the safe decision.
As will light orientation control stops the diffraction and of light reflection from snow when it falls and covers everything on the roads with a white crystalline layer, considering that the crystalline ice property becomes a powerful reflector of light from everything on the road collides with the strong night lighting system now used directly in all vehicles where it starts the light is a random force in all directions without control and the road become ignited, causing severe interference to the driver's vision and all those on the road, The practical solution available now is to control the steering of the light in front of the vehicle only, at a level near the ground to reduce the reflections of light on all places covered by snow; this is only available at using the invention
.Also when the fog suddenly falls, the powerful foreground lighting used in all the vehicles becomes very confusing because the fog is made up of small atoms of water vapor, When the light collides with it, Which consists of contiguous straight photons at speeds of m/s 300,000 to collide with steam atoms and move them between them at the same speed and as a result of the heat of friction between they are divided into parts moving very quickly to become a curtain prevents vision, So we find the fog (water vapor atoms) moving at the brightness of light at the same speed of light and then evaporates, Therefore the invention controls the high level of light from the Earth so that the movement of fog water vapor atoms) is far from the level of view of the driver and others.
There are contacts with the United Nations, the WHO, the World Bank, and the International Global Alliance of NGOs for Road Safety.
I have received more than one invitation to attend international conferences, the last attend I received from; 3rd Global Ministerial Conference on Road Safety: “Achieving Global Goals 2030” Considering the importance of the invention that was made on the international arena to reduce the accidents of night vehicles due to the problems of night lighting a system that is now used in all vehicles, The last attend I received from; 3rd Global Ministerial Conference on Road Safety: “Achieving Global Goals 2030”, Dear friends of road safety, On behalf of the Government of Sweden, and in collaboration with the World Health Organization (WHO), I have a great pleasure and the honour to invite you to participate in the 3rd Global Ministerial Conference on Road Safety, "Achieving Global Goals 2030” that will take place on 19--2 February 2020 in Stockholm, Sweden.
But given the latest developments around global health concerns, the festival was postponed the event will no longer run on these dates. It is therefore advised to change travel plans if you were planning to arrive in Bonn to join the festival. We are exploring new dates and will announce them as soon as possible. Thank you again for your incredible commitment and support, for your understanding of this complex and challenging situation, and please accept our most sincere apologies for any inconvenience and disruption that this decision may have caused to you and/or your organization.
The invention proves the close relationship between strong vehicle lights dazzled at night, which violate darkness of the sky with environmental pollution of lights and global warming to reduce climate change and pollution caused by the spread of optical dazzled have a direct adverse effect on human health, Because of the lack of attention to this pollution has devastating effects on all life and increase the climatic changes and natural disasters as the report, Short-lived climate pollutants, such as methane, black carbon, hydrofluorocarbons (HFCs)and tropospheric ozone have a powerful effect on global temperatures and many are also damaging air pollutants for example; methane is a potent greenhouse gas with a global warming impact 86 times higher than that of carbon dioxide over a 20-year time horizon, It is also the largest precursor to ground-level ozone a major component of smog, which can worsen bronchitis and asthma and damage lung tissue, Troposphere ozone exposure alone is responsible for an estimated one million premature deaths each year. All these pollutants increase strongly when exposed to strong lighting and evaporate to rise in the Earth’s atmosphere. Also, have a direct adverse effect on the natural environment for the life of insects working on the pollination of crops for continued agricultural production without the cost, such as bees endangered and poor production of food is very important for human health.
What is Light Pollution? Most of us are familiar with air, water, and land pollution, but did you know that light can also be a pollutant? The inappropriate or excessive use of artificial light – known as light pollution – can have serious environmental consequences for humans, wildlife, and our climate. By joining IDA you can make a difference in protecting our Planet, saving billions of dollars in wasted energy, and connecting future generations with our legacy of starry skies.
Mohamed Metwalli Khalifa Saleh (Mohamed Saleh)
Appropriate topic for consultation when the Upcoming Safe and proven candidate vaccine is likely to be made available shortly to countries.
1. Is it safe to store the upcoming said Covid 19 vaccine along with the other childhood vaccines, subject to availability of Adequate spare capacity In cold storage?
2. If the answer is yes then we have to get assessed the capacity of existing cold storage facilities at national , state, divisional, district level. (Current storage of Vaccines is for children (12% of total population) and pregnant women (1.5%). Covid 19 vaccine ? needs to administered for all ages (100% population) and hence the volume may be multi fold) moreover alternative sources of energy to sustain cold chain may also be made available in instance of electricity failure.
3. If the answer is no, then separate physical structure with estimated capacity has to be got created quickly for Cold storage of upcoming Covid 19 vaccine. Any way currently Covid 19 care hospitals and regular non Covid hospitals are segreagated in different premises with separate workforce.
4. Post Covid 19, the “new normals” and safety may lead us to have separate vaccination sessions for Covid 19 and regular childhood / PE vaccinations. We can ensure physical distancing, mask, hand hygiene, respiratory etiquette during both the sessions and see that the wait time for the beneficiary is least.
5. The trained workforce at front end for immunization however may be used to capture their skills to minimise adverse events and enhance social acceptance.
Hope to hear from others
Yes , it will be used as professional work support and knowledge improvement