Kate Elder is MSF Access Campaign Vaccines Policy Advisor.
Vaccines require constant refrigeration at very specific temperatures from the time they’re picked up at the manufacturing facility until we administer them to patients. It’s a long journey. It starts where they’re made, in places like India and Belgium. Then they’re stocked at an MSF supply warehouse in Bordeaux or Brussels, where we load shipments to the field onto trucks with ice-lined boxes. They’re transferred to airplanes because delivery by plane is faster. When they reach their destination country, we move them immediately to fridges in an MSF storage facility, then logisticians assemble orders bound for vaccination sites. Finally, the last leg of the trip, from capital to patient, gets them to children in remote towns and villages.
This is the “cold chain,” and any break in this chain threatens the efficacy of the vaccines. The last leg poses the biggest hurdle because we’re often in regions where temperatures are quite high and refrigeration and electricity are unreliable or non-existent. Our teams have to pack vaccines in coolers and, depending on the terrain, carry them on foot or transport them on motorbike, four-wheel-drive vehicle, or boat. We have to move quickly to ensure that the vaccines don’t spoil in the heat.
While working to strengthen the cold chain is important, MSF is also advocating for another alternative: urging pharmaceutical companies to develop vaccines that are easier to use, with greater tolerance for heat so that they can be kept outside of refrigeration. That would help us reach many more children and probably save a lot of lives in the process.