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|The cold chain technology will boost the Expanded Programme on Immunisation|
For decades, Vietnam has made great strides in the implementation of the country’s Expanded Programme on Immunisation (EPI), initiated by the Ministry of Health (MoH) in 1981. It became a bright spot in the Southeast Asian region with regards to the coverage of the programme nationwide. So far, the EPI has benefitted millions of women and children, with 95 per cent of children under a year old being vaccinated.
The MoH has now set the goal to improve the proportion of vaccinations in areas that are at high risk of outbreaks and in locations which are geographically difficult to reach, such as remote, mountainous or island areas. However, ensuring the highest standards of a cold chain for vaccines has become a barrier to success.
Vaccines have strict requirements on preservation during transportation. It is essential that they are stored continuously at a temperature of between 2-8 degrees Celsius. Any deviation or interruption in the cold chain from production and storage to transport and use can potentially damage the integrity of the vaccine, resulting in reduced efficacy and safety in treatment.
Doan Huu Thien, director of the National Institute for Control of Vaccines and Biologicals (NICVB), said, “To meet the goal of the EPI, we have faced many challenges, such as access to local health centres, changes in temperature through different seasons and regions, and limited transport systems in remote areas. The importance of maintaining the cold chain to protect the prescribed temperatures during transport is crucial in helping to ensure the integrity and quality of pharmaceuticals, as well as patient safety.”
Evidently, provinces in such remote areas are still unable to ensure the quality of the cold chain for vaccines. In these places, infrastructure under the EPI and funded by the government is being downgraded. In many communes, the majority of refrigerators have been in use for 15 years. In some districts, there is also no specific storage for vaccines.
Furthermore, employees of the medical prevention departments in these areas are not trained in vaccine management and preservation. For example, in the northern province of Son La, which is home to 204 communes and 112 underprivileged communes, Dr Nguyen Tien Dung, director of the Son La Centre for Disease Control in the northern province of Son La, said that it is difficult to ensure vaccination for children, especially those located in the most remote areas. As shown in a 2018 survey, about 464 out of a total of 3,323 villages in 101 communes do not have access to the EPI.
“Ensuring the cold chain for vaccines is extremely important for vaccination. However, many refrigerators and other freezing facilities in the cold chain are currently spoilt and cannot be repaired,” said Dung. “Lack of staff is another headache for the province.”
In view of this, NICVB, the National Institute of Hygiene and Epidemiology (NIHE) and Zuellig Pharma have officially announced a $600,000 project to support the EPI in six northern provinces including Hai Duong, Bac Ninh, Quang Ninh, Ha Giang, Son La, and Yen Bai. These provinces will be assisted through the use of the eZCooler, an innovative packaging technology that ensures the integrity of temperature-sensitive products to the last mile of transportation.
Under the project, Zuellig Pharma, one of the largest healthcare service groups in Asia, will contribute eZCoolers in three capacities of 8 litres, 12 litres and 96 litres to these provinces, while co-operating with the NICVB and the NIHE to provide training to employees of their medical prevention departments on international standards and Good Storage Practices under the World Health Organization for cold chain supply management and usage of the eZCooler itself.
Nguyen Minh Hang, deputy head of the MoH’s Preventive Medicine Department, said at the project launch, “We highly appreciate the NICVB, the NIHE, and Zuellig Pharma in launching this. The management board should co-operate with the NICVB and the NIHE in assessing its effectiveness so as to create a premise for the sustainable development of the cold supply chain in other localities in the future.”
According to London-based market research firm Business Monitor International, Vietnam’s healthcare expenditure was estimated at $16.1 billion in 2017, representing 7.5 per cent of its GDP, and the ratio will continue to grow at 12.5 per cent a year to $22.7 billion by 2021. Vaccines and cold chain products make up a significant part of this expenditure.
Marc Franck, chief executive officer of Zuellig Pharma Vietnam, said, “We are honoured to contribute our innovative solutions to this project to ensure that everyone in the country has easy access to vaccines. We have been entrusted by companies around the world to undertake the supply of pharmaceuticals for nearly a century in Asia, and nearly 20 years in Vietnam. Today, we are happy to be able to share our expertise and technology with the Vietnamese government and will work closely with all parties to make healthcare more accessible in the country.”