After the announcement today that the AZD1222 vaccine developed by the University of Oxford and AstraZeneca – the “Oxford vaccine” – is 90 per cent effective against Covid-19 when given in two doses, we now have three powerful vaccines against the global pandemic. The UK has ordered 145 million doses of these treatments. This is of course great news, but it is far from the end of the pandemic. The UK and the world now face a vast logistical challenge.
Pfizer was first to announce the results of its phase three trials. Its supply chain team has been making plans for as long as the company has been working on a vaccine. The company will manufacture 50 million doses of its vaccine in Kalamazoo, Michigan, this year, and a further 1.3 billion doses by the end of 2021. Every day next year, 12 trucks will leave the factory to connect with 20 flights to deliver to finishing and distribution facilities around the world. These will take on the job of in-country distribution and the tricky “final mile” deliveries to hundreds of thousands of vaccination points and an army of trained vaccinators.
In the case of Pfizer’s treatment, all of the above must be conducted while keeping the vaccine at -75°C. If this temperature is not maintained, it can be rendered useless or even dangerous.
The makers of the second vaccine, Moderna, have said that it remains stable at -20°C, a temperature that many companies will be experienced in maintaining in the “cold chain” supply lines used to transport food. The Oxford vaccine, which uses a more established technology, can be stored at fridge temperature. But in every case we are looking at the need to develop supply chains at a scale and pace never before seen.
This technically demanding effort will require supply chain excellence. That’s not how we described the UK government’s PPE supply chain efforts earlier in the year. This time, professionals will be needed, not plucky amateurs with spreadsheets.
But what supply chain professionals already know is that, like many industries, the global logistics environment that has been ravaged by the pandemic. The grounding of many passenger airlines has reduced air cargo freight capacity by almost half, sending air freight rates rocketing. And this is before we see the impact of moving billions of doses of fragile, temperature-controlled vaccine around the globe as quickly as possible.
Regular trade that previously relied upon air freight will have to take a back seat next year, and the greater dependency this will place on ocean and ground transportation could have profound implications. Supply chains will slow, inventories and shortages will grow. The most obvious problems will develop at pressure points such as the ferry terminals at Dover and the container terminals at Felixstowe, particularly if a no-deal Brexit becomes a reality.
The scientists developing these vaccines will be familiar with the concept of the “rate-limiting step”: the stage of a chemical reaction that determines how quickly the reaction can happen. It is usually the slowest part of the reaction that sets the rate. This is also true of supply chains: the most difficult part sets the pace for the rest of the process.
For any vaccine that needs to be kept very cold, the pace will be set by the availability of specialised equipment to transport it. These cold-chain containers will need not only to pass through the complete supply chain, but to return to the start of it. This means delay anywhere in the chain will cause shortages all along it. Pfizer has developed a network of “freezer farms” and GPS-tracked “thermal shipper” boxes to keep the vaccine stable, but these resources will be subject to extremes of demand.
In the UK, there is also the question of organisation. The country has contracted to buy 355 million doses of vaccine from seven different providers. Each comes from a different company and potentially from a different country. Without a single organisation to plan the delivery of these goods, it will be impossible to ensure sufficient capacity at every stage and create a fully joined-up, end-to-end plan.
For those vaccines that are manufactured abroad, the UK will face the problem that demand will dwarf supply. This is another factor that often disrupts supply chains, as the lucrative possibilities offered by middle-men attempting to source the same product interfere with trading relationships.
If the UK government has not already done so, it should urgently charter, in advance, air and ground capacity on the necessary trade lanes and establish “bridges”. If we leave individual organisations to wait and hope for individual shipments, we will see a repeat of the UK’s catastrophic failure to secure PPE early in the pandemic. It is crucial that the lessons from other countries’ successful management of their PPE supply chains are learned in the UK.
The good news is that the digital capabilities of today’s logistics organisations are up to this task. The real-time tracking of all shipments using supply-chain “control towers” that co-ordinate all movements, end to end. The industry has spent 20 years perfecting the “final-mile” deliveries of e-commerce, making fantastically complex systems easy to use at the consumer level.
Vaccinating billions of people will require another order of flexibility, however. Commercial businesses struggle to operate “fully flexible” supply chains and make a profit, but this is a familiar requirement of military supply chains during war. Perhaps military planning for this effort should be involved from the start, and not appealed to when it goes wrong.
This will be a national effort, and the worst mistake we can make is to fail to recognise the scale of the challenge from the outset.
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