Extending the useful life of export packaging

by Dmitri Davydov, UNICEF Supply Division and John Lloyd, PATH In partnership with the United Nations Children’s Fund (UNICEF), the Danish Technical University has begun a pro bono study on vaccine export packaging designs that would extend the safe, useful life of export packaging to allow for distribution beyond government central stores. Currently, vaccine packaging used for international distribution is not designed for journeys longer than 48 hours. However, vaccines are at risk where international transportation to hard-to-reach consignees exceeds the validated packaging performance limits, especially in the case of shipments to the West Bank and Gaza, Somalia, South Sudan, Lesotho, Timor Leste, and North Korea. In addition, countries lacking adequate cold transport capacity often reuse the packaging for in-country distribution, inadvertently putting vaccines at risk of thermal damage, reducing vaccine potency and effectiveness. Rather than making it more difficult for countries to reuse the export packaging, UNICEF, PATH, and the World Health Organization (WHO) are working on ways to extend its useful life so that it can be more safely reused to deliver vaccines from the government central stores to subnational locations. The Danish Technical University study is a first step in that direction, as it will identify engineering design concepts that address the needs of users at both the supplier and country levels and increase sustainability and shipping efficiency requirements (including sustainable alternatives to dry ice and efficient bulk factors). Further research will be made into options to reduce the total systems cost to the child, leveraging public-private partnership and innovative business models for manufacturing new designs, if applicable. Validated designs and a choice of acquisition mechanisms will be made available to the industry on an open-platform basis. Why longer-lasting export packaging is needed Each year UNICEF Supply Division oversees nearly 1,800 vaccine shipments to over 80 countries located mostly in Africa, Asia, and Eastern Europe. Sixteen suppliers use their own boxes based on WHO guidelines to pack and ship vaccines from their facilities on all continents except Australia directly to the recipient countries. Shipping boxes represent half of the total weight of vaccine shipments, as well as a share in vaccine cost. UNICEF pays for vaccine, its packaging, and for each kilo of air freight. Shipping boxes are designed to use passive coolants (e.g., gel/cool packs, ice packs, or dry ice, depending on the requirements for the particular vaccine and supplier choice) to maintain appropriate temperatures set by WHO guidelines on safe vaccine shipments (48 hours). Most suppliers use boxes that do not perform beyond 72 hours of temperature maintenance. Upon arrival, national ministries of health unpack vaccines for warehousing at central cold stores before repacking them again for in-country distribution (often combining more than one vaccine type in the same box). Countries are expected to procure and keep stock of reusable WHO Performance, Quality and Safety (PQS)-listed cold boxes for this purpose. However, with increased quantities of vaccines and bulkier packaging, countries need larger boxes for efficient distribution. Countries are partially solving this problem by reusing export packaging, but since the packaging is not currently designed for extended use, the practice can put vaccines at risk of exposure to heat or cold. While the presence of vaccine vial monitors on each vial helps detect undue exposure to heat, the damaging exposure to freezing temperatures continues to represent a serious risk to vaccine during in-country distribution. Expected impact of the solution Improved export packaging will provide many countries with a cost-effective and safe option for transporting vaccines from the national to subnational levels while simultaneously reducing the overall cost of distribution to the child. By extending the life span of shipping solutions, eliminating the need for redundant cold boxes, reducing weight/volumes per dose, and providing options for environmentally friendly disposal, the solution is environmentally sound as well. We encourage your questions or comments. Please click reply at the bottom of the page.