The Ultimate Challenge for Aviation: Transporting the COVID-19 Vaccine Worldwide
December 2020 will go down in history as the month when the COVID-19 vaccine started to be distributed on a large scale. By the 21st, according to Bloomberg’s tracker, more than one million doses were administered in the United States and in the United Kingdom alone, with almost three million of the Pfizer Inc. (PFE) BioNTech SE (BNTX) shots distributed in the U.S.
Despite the million figures reached in the first weeks of distribution, the challenge is much larger than that. Of the leading vaccine projects, only the vaccine from Johnson & Johnson (JNJ) requires a single dose. The others require twice as many doses to ensure their efficacy in one patient.
Bloomberg estimates that the 8.2 billion doses already reserved in agreements between the biotech companies and governments will be enough to vaccinate just over half of the world’s population -- with rich countries owning most of these deals.
"What is often forgotten, is that we may well need to vaccinate each year, for the next 3 or 4 years, perhaps longer. If it takes us 3-4 years to complete one round of vaccinations, demand from richer countries for booster shots will delay global vaccination for perhaps a decade" - Shakeel Adam
Besides, all vaccines have strict refrigeration requirements for efficacy to be assured. This is especially true with Pfizer/BionTech's shot, which requires storage at -70º C, with the concession of 15 days in a dry ice-filled thermal box. But still, even at more manageable temperatures, all vaccines require strict temperature controls to avoid vaccine destruction.
IATA has published reports indicating that to provide a single dose to each person in the world, the equivalent of 8,000 cargo Boeing 747 jets would be needed. If the dose is doubled, this number is also doubled. And while this may seem little (as an aircraft can obviously do multiple rotations and vaccines will be mass-produced on a rolling basis during 2021 and beyond), it is necessary to put that in a global perspective.
On December 10, the first allotment of vaccines was transported between Lansing, Michigan, to UPS’ “Worldport” hub in Louisville, Kentucky. When the boxes were deplaned from the 757 and shuffled to other flights in the company’s vast domestic network, it was known that the cold chain could be maintained seamlessly. UPS -- as did FedEx, DHL and other logistic giants -- had invested millions even before the pandemic to keep the cold temperature of packages intact.
When we move to poorer countries, however, the scenario is drastically different, especially in the so-called “last mile” of the cold chain. And to assess that, airlines and stakeholders alike must act decisively in order to ensure that the vaccines will be able to save lives in the most remote communities
“Even within Europe, North America, China and few other spots in the world, the last mile logistics will mean a lot of complications. While the cold chain is the most challenging issue when it comes to the spoilage, security against theft, sabotage or unintentional tampering will be real and significant concerns”, says Shakeel Adam, Managing Director Aviado Partners.
At Geneva-based Gavi, the Vaccine Alliance, this issue is seen with much concern. In a November article titled “The longest mile in the COVID-19 vaccine cold chain”, it says that “supplying rural healthcare centers and remote villages at the end of the ‘gnarly’ last mile is where logistics falter and up to 25 percent of vaccine doses are lost”, quoting Professor Toby Peters, from the University of Birmingham.
That is to say, there is already an existent cold chain structure in most large population centers of lower-income countries. In Africa, for instance, flag carriers Ethiopian Airlines and Kenya Airways take huge pride in their cargo hubs at Addis Ababa and Nairobi respectively. In South America, LATAM Cargo takes pride in its 30 “receiving points of medical supplies”.
The challenge, however, is more specifically the last-mile delivery to the smaller communities that usually lack the refrigeration support and infrastructure that the COVID-19 vaccines require. Not only in Africa or small remote nations, but also in small rural communities in the United Kingdom, the United States of America, Canada, China, Russia. This is a global challenge.
In another document, IATA claims “more than ever, the industry needs to invest in implementing an integrated multimodal transport solution as an enhanced business model to strengthen the network and the last mile delivery” so these temperature requirements are strictly followed and the waste of valuable doses is reduced to a minimum.
“Ethiopian Airlines and Kenya Airways have been doing an exceptionally good job with cold-chain deliveries in normal conditions. But these are not normal conditions”, Adam says. “Most of the African passenger airline capacity is on the ground. Almost 200 airports in Africa are not equipped to handle cargo aircraft not to mention cold-chain deliveries”.
On a positive note, Gavi says such investments may have future payoffs as biotech companies look for additional markets to serve. Such upgrades in the cold chain infrastructure, they say, “could open new, long-term markets for pharmaceutical companies, resulting in better access to other vaccines besides COVID-19”.
Adam echoes this expectation but warns:
“We hope that the investments made due to COVID-19 are not like the investments in facilities in Olympic games, meaning that most of facilities are not being used after the games are over. We do see some bright spots amongst start-ups. Many companies are coming up with business models utilising the infrastructure set up for COVID-19 cold chain.”
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