APS111&113 - 2014 Client Statement
1
Strengthening the Cold Chain for Vaccinations Equitable access
to immunizations is one of the most successful and cost effective
health treatments [1]. Through various World Health Organization
(WHO) immunization programs diseases such as small pox have been
eradicated. To put that into perspective as recent as 1950s there
were 50 million global cases of small pox. Vaccination dropped that
figure to 10-15 million by 1967 when the World Health Organization
undertook the worlds first global immunization push. By 1977 the
last natural case of the disease that had plagued humankind for
thousands of years and killed as many as 10-15% of all infants, was
eradicated [2].
In May 2012 the World Health Assembly approved the Global
Vaccination Action Plan (GVAP). The GVAP would see universal access
to vaccinations for every man, woman and child on the planet. The
goal is to expand the already 2.5 million lives saved each year by
vaccinations by eradicating other vaccine-preventable deaths from
diseases such as polio, diphtheria, tetanus, whooping cough,
measles, Haemophilus influenza type b disease, and epidemic
meningococcal A meningitis [1].
A major obstacle in this goal is not the manufacture of the
vaccines. The challenge actually lies in the logistics, the supply
chain that transports these vaccines from the manufacturer to the
patient. This supply chain is difficult since vaccines are highly
temperature sensitive. If a vaccine falls below 2 C or rises above
8 C, even for a short period of time, they may lose their viability
[3]. This network of people, processes and equipment that maintain
this tight control over temperature is called the Cold Chain
[4].
In the developed world, with ready access to electricity-fed
cold storage and refrigerated transportation vehicles, maintaining
the Cold Chain is not difficult. In the developing world however,
where access to electricity can be unreliable or non-existent,
maintaining the Cold Chain is a daunting task [4].
Currently the Cold Chain begins with electricity-fed
refrigerated transportation vehicles or containers. However, the
farther along the chain you go, the more difficult it is to
maintain. Keeping a valid Cold Chain in an electrically
refrigerated cargo transport plane is easy; doing the same during a
multi-day trip made by bicycle or donkey is an entirely different
challenge level. Additionally there is a high probability of long
layovers at unrefrigerated intermediate depots.
A second major problem is the weight and bulk of the vaccine
transportation device. Firstly there is significant cost to
transportation; this cost is strongly correlated with the weight
and bulk of the cargo. Secondly some of the key transportation
modes used near the end of the Cold Chain--bicycles, walking,
donkey, etc.--rule out vaccine transportation devices such as full
sized-refrigerators.
As part of the Decade of Vaccines the WHO has posted the
following design challenge. Design a vaccine transportation device
given the following design criteria. You are not responsible for
the design of the entire Cold Chain.
The design cannot change the existing primary vaccine packaging.
These 30 cm x 30 cm x 30 cm boxes are sealed and the interior
monitored by temperature sensitive labels to track vaccine
viability. This packaging cannot be opened.
The primary vaccine packaging box is made of cardboard and the
vials are glass.
APS111&113 - 2014 Client Statement
2
The design must maintain a temperature range of 2C to 8C at the
primary vaccine packing box for at least 12 hours with an average
solar radiation exposure of 300 W/m^2 and an ambient temperature of
35C to 40C.
The design must be portable using the widest possible range of
transportation methods. The cold chain may utilize a large number
of different transportation vehicles ranging from trucks to
bicycles, donkey or even no vehicle (pedestrian travel). Keep the
design as light as possible and minimize the bulkiness to
facilitate carrying and packing.
These vaccines are transported by both highly trained medical
professionals and individuals with no medical training.
If active refrigeration is utilized, either of the following
equipment may be used with no additional monetary cost. The WHO has
received a large donation of both of these models.
Laird Outdoor Thermoelectric Cooler Assembly (model
AA-250-48-44-00-XX) [5] Whynter 65 Quart Portable Fridge / Freezer
(model FM-65G) [6]
Client: Dr. Edward Jenner World Health Organization - Family,
Women's and Children's Health (FWC) Immunization, Vaccines and
Biologicals (IVB) [email protected] Warning: This is a fictitious
project. Do not contact the client. They will not know what you are
talking about.
References [1] World Health Organization. (2013). Global
vaccination action plan [Online]. Available:
http://www.who.int/iris/bitstream/10665/78141/1/9789241504980_eng.pdf?ua=1
[2] World Health Organization. (2001, October). WHO fact sheet on
smallpox [Online]. Available:
http://www2.cdc.gov/nip/isd/spoxclincian/contents/references/factsheet.pdf
[3] World Health Organization. (2006, August). Temperature
sensitivity of vaccines [Online]. Available:
http://whqlibdoc.who.int/hq/2006/WHO_IVB_06.10_eng.pdf [4]
Logistics Cluster. (n.d.). Cold chain [Online]. Available:
http://log.logcluster.org/response/cold-chain/index.html [5] Laird
Technologies Inc. (2012). Outdoor thermoelectric cooler assemblies
AA-250-48-44-00-XX [Online]. Available:
http://www.lairdtech.com/WorkArea/linkit.aspx?LinkIdentifier=id&ItemID=2147486929
[6] Whynter Inc. (2014). Whynter Quart Portable Fridge/Freezer
[Online]. Available:
http://www.whynter.com/productdetail/refrigeration/portable_freezers/308
