Ebola Vaccine Challenge: Motorbikes and Kerosene Fridges

Interesting article from Bloomberg. http://www.bloomberg.com/news/2014-11-17/ebola-vaccine-challenge-motorbikes-and-kerosene-fridges.html This section on the supply chain challenges is particularly interesting: Muddy Roads “Even if we decide not to use the vaccine during this outbreak and stockpile instead, we’d be so much better off than having nothing,” said Walter Orenstein, associate director of the Emory Vaccine Center in Atlanta. As drugmakers prepare trials and eventually mass distribution, they must figure out how to keep the vaccines refrigerated from the moment they’re manufactured to their delivery across West Africa. That journey could involve trucks, planes, buses, motorbikes and even bicycles as the medication makes its way from European manufacturing facilities through airports and crowded cities, then down long stretches of muddy rural roads to village clinics. Most vaccines remain stable when cooled below 8 degrees Celsius (46 degrees Fahrenheit), but a few -- like those for polio -- must be stored at minus 15 (5 Fahrenheit) or colder. The cooling needs of the Ebola vaccine remain unknown, but some scientists fret that the gas- or kerosene-powered refrigerators and simple coolers used in remote areas of West Africa might not be reliable enough to protect it. “Temperature stability is a really big deal,” said Kate O’Brien, a professor of public health at Johns Hopkins University in Baltimore and member of a panel of experts who advise the WHO on vaccine programs. Past vaccination programs show the bottlenecks and gaps in delivery systems, some of them designed in the 1970s, said Bruce Lee, director of operations research at the International Vaccine Access Center at Johns Hopkins. During a recent polio campaign in Mali, a WHO team found a cold room so overstuffed that it couldn’t be closed properly. With boxes of vials spilling out the door, large quantities of vaccine had to be discarded because of heat damage. “The lower down the chain you go, the less likely it is to be in working order,” said Michel Zaffran, the coordinator of WHO’s immunization programs. Zaffran says he expects data from the manufacturers on the stability of the vaccines at various temperature ranges will be ready in January. Glaxo’s vaccine is being made at a factory in Pomezia, a Roman suburb near the beaches where U.S. troops landed in World War II. Inside the low-rise building, scientists grow cells in 50-liter plastic bags filled with a fluid that nurtures their development. To keep the newly grown cells from settling to the bottom, the bags rock back and forth on trays that look something like child-sized waterbeds.