Vaccine rollout is an opportunity to create a new, sustainable cold chain that will be of use well beyond the current crisis
After 11 dark months, the end of the COVID-19 pandemic is tantalizingly in sight. In recent weeks, two coronavirus vaccines – one from Pfizer-BioNTech and another from Moderna – were revealed to be more than 90 per cent effective in clinical trials.
But if they’re approved by regulators, getting the vaccines into the hands, or arms, of billions, will be a daunting task.
The Pfizer jab requires long-term storage at -70°C while Moderna’s must be kept at -20 °C long term. (Both can last for shorter periods in a regular refrigerator, where temperatures are between 2°C and 8°C.) The Oxford/AstraZeneca vaccine can be stored and transported long term at regular fridge temperatures.
In any of the above scenarios, rolling out COVID-19 vaccines on a global scale will require an enormous expansion in capacity of the global cold chain, the linked system of infrastructure that allows a product to move from its site of production to final destination while remaining appropriately chilled.
“The vaccination against COVID-19 is an inflection point that will determine how cold chains are handled on a global scale for the next two decades,” emphasizes Ligia Noronha, Director of the Economy Division at the United Nations Environment Programme (UNEP).
In many developing countries, the technologies are sparse, and experts believe the demands of a COVID-19 vaccine could finally lead to long neglected investments in their cold chains. They warn, though, against quick and dirty solutions.
“It can go in three directions,” says Toby Peters, a professor of cold economy at the University of Birmingham in the United Kingdom. “One is that we solve the problem, but we do it in a way which is financially and environmentally inefficient. Or, we do it in a way which is a little bit greener. Finally, we can solve it in a way which actually has a lasting legacy.”
Bottlenecks in developing countries
One place where distribution challenges loom large is Africa.
Universal vaccine access is a challenge in developing economies, due to inadequate refrigerated cold chain networks, especially in rural communities, which have the highest poverty levels. This impacts not just vaccine access, but also food security and livelihoods. Farmers lose anywhere between 30% - 50% of food produced for human consumption due to poor post-harvest practices and lack of cold storage.
To tackle those problems, UNEP is partnering with the governments of Rwanda and the United Kingdom, and a consortium of universities on a new Africa Centre of Excellence for Sustainable Cooling and Cold Chain (ACES). With a hub in Kigali and Living Laboratories anticipated in rural communities throughout Africa, it focuses on developing cutting-edge cold chain solutions. The first phase is well underway with an in-depth cooling needs and gap assessment nearing completion, allocation of the site on the University of Rwanda campus, and initial layout of the facilities.
More broadly, the UNEP-led Cool Coalition is bringing together academics and industry experts to help countries advance sustainable cold chains fit for both vaccines and agricultural produce.
The vaccination against COVID-19 is an inflection point that will determine how cold chains are handled on a global scale for the next two decades.
Rethinking cold chains
Globally, the scale of a coronavirus vaccine rollout means that simply expanding the current vaccination cold chain is not feasible. Child vaccination programmes, for example, typically reach around 115 million infants annually worldwide. Estimates for vaccination levels required to achieve effective global ‘herd immunity’ to COVID-19, by contrast, run as high as 5.5 billion people. And then with two doses required.
“It’s a completely different scale and complexity of problem that you have to solve,” explains Peters, who co-leads the technical assistance team behind ACES. “This is about speed and volume.”
A business-as-normal approach would see widespread use of polluting diesel generators to power fridges in places where electricity supply is fragile or non-existent. It could mean the use of climate warming refrigerants such as hydrofluorocarbons that can have a global warming potential hundreds or even thousands of times greater than carbon dioxide.
Experts are also concerned that states will struggle to handle the enormous quantities of solid waste – from glass vials to used needles – that a global vaccination programme will generate.
That’s why many are urging countries to consider the environment and strive for long-term solutions while ramping up their vaccination programmes.
“If best practices are embedded now, there is a chance for what Brian Holuj, a programme management officer at UNEP’s United for Efficiency (U4E) Initiative, describes as “solutions that stick.”
That means better refrigerants, superior efficiency, and less reliance on polluting diesel generators, he explains. It requires a trained workforce equipped to optimize the system and service its components. There will likely also be new opportunities for sustainable cooling experts in the ‘cool’ marketplace. Measures will also need to be put in place to manage the needles and other disposables inherent in a widespread vaccination campaign.
As billions of dollars will be invested in storage and handling of the COVID-19 vaccine, experts are exploring how to do this with a mind towards the future.
A key opportunity is to create a new cold chain for the COVID-19 vaccine, part of which at least could, once the current crisis has passed, be used to transport other goods, like agricultural produce.
Globally, a third of food production is lost to wastage between farm and fork. Better cooling could significantly reduce that figure and bring higher incomes for farmers. A UNEP-supported programme in Tamil Nadu state in southern India, for example, works with refrigeration firm Tabreed - to provide sustainable cooling for local mango farmers. A programme like that could work for both COVID-19 vaccines and later as an enduring legacy for farm produce.
“If we establish cold chains for COVID immunization efforts that can later be used for agricultural purposes the legacy impact would be much greater. It would be hugely beneficial for the countries, a double investment of sorts,” says Benjamin Hickman, who is coordinating the Cool Coalition’s work on cold chains.
Back in the United Kingdom, Toby Peters points out that, given the sheer scale of the cold chain requirements for a vaccine, it may be more productive to repurpose current food distribution systems, rather than upscaling medical networks.
“While we have to manage cross-contamination risk, a fridge doesn’t know whether it’s holding a vaccine or a tomato,” he says. “Do you even use the medical cold chain to take it to these big new vaccination points? Or do you go to Booker’s or Brake Brothers and say, you’ve got a very highly complex, highly effective cold logistics network for managing cold products.” (Booker’s and Brakes, previously known as Brake Bros, are large food wholesalers in the UK.)