by Kaan Savul, Head of International Cooperation and Global Affairs, Ecolog Deutschland, Düsseldorf
To the many entrenched global inequalities – wealth distribution, education attainment, life expectancy and human rights – we can now add access to safe, effective vaccinations.
In many developed countries, 80% or more of the adult population has now received two Covid-19 jabs, and health ministers are talking about booster programmes and making vaccines available to children. By comparison, in most parts of Africa, vaccination rates hover below 2%. This glaring statistic has prompted significant nervousness within the global community and the past few weeks and months have seen multiple headline-grabbing financial commitments from political leaders including the G7, alongside donations of industrial quantities of vaccines. Hot-off-the-press pledges to African countries have included 4.4 million doses from the US to Nigeria and Ethiopia, 817,000 doses to Kenya from the UK, 260,000 doses to Mozambique from China and many more.
Generating momentum for vaccination
So why, with such an intense global effort, do vaccination rates in Africa remain so low? Numerous explanations have been suggested – public mistrust of governments and public health officials, a youthful population that doesn’t recognise the risk, anti-vaccination propaganda, and the fact that Covid-19 symptoms lack the graphic nature associated with other prevalent diseases on the continent.
None of these challenges seem insurmountable and, at EcoCare, we are confident that vaccination rates will rapidly gather momentum once concerted efforts to reassure at-risk populations are underway.
Many of the tools to raise take-up are self-evident, and simply require effective implementation through advocacy by trusted community and religious leaders, mandates by major employers, especially where staff operate in close proximity and healthcare professionals as early adopters.
Alongside actions such as these, which create a positive backdrop for testing and vaccination programmes, one cannot underestimate the importance of the customer experience when they come forward to receive a jab. If this process is wrecked with bureaucracy, complexity and anxiety, then bad word-of-mouth will spread to family members and peer group. To this end, vaccinations programmes are no different from TripAdvisor: positive recommendations are essential to generate momentum and future customers!
For this reason, it should be no surprise that our operating model for our African and other countries under development, testing and vaccination programmes are rooted in ‘delivering with integrity’. The goal is to make the process smooth and seamless for all who encounter it.
EcoCare’s bold vision
Many of the vital operating principles have been enshrined in our EcoCare Pledge, and I will highlight four where we’ve managed to maximise customer attractiveness through innovation, technical excellence, and a bold vision.
1. Maximising customer attractiveness
Our safety compliance is second to none, not least because we recognise that any safety breach would overnight undermine trust and confidence in the programme. Our containerised Biosafety Level-2 (BSL-2) laboratories are configured to be compliant with the diagnostic safety recommendations of the Robert Koch-Institut Berlin (RKI), and the special WHO and Centre for Disease Control (CDC) instructions for testing SARS-CoV-Safety are also embedded throughout our physical and digital processes.
2. Robust infection protection
In our vaccination and testing centres, protocols include robust infection protection, a designated chief emergency doctor on every shift, traceability logging, antigen tests offered where needed and mandatory training on hygiene, vaccine handling and patient processes.
In our digital platform, we capture, document, protect, report and archive viral data throughout the vaccination process, embedding quality at every step.
3. Leveraging logistics and engineering
Engineers are natural problem solvers, and the challenge of last-mile vaccination supply has sparked their curiosity. We have learned that the easy part is transporting a few hundred thousand doses to a secure warehouse; the difficulties mount when one tries to transfer the doses onwards from the warehouse and into people’s arms. We have designed multiple service modules that can cope with these complexities. These are:
vaccination centres, established within existing facilities and/or a standalone setup;
mobile testing units that are highly flexible and involve buses or trucks on 20 or 40 ft containers;
mobile containerised testing infrastructure, capable of deployment in vastly different locations due to their adaptability and self-sufficiency;
central testing facilities, designed for high processing capacity to ensure maximum throughput.
4. Reaching diverse communities
Any vaccination programme in Africa will have failed if its ambitions are limited to protecting the high earning business community in the major cities One of our most important commitments is to spread the benefits of vaccination beyond the major urban conurbations into rural areas and vulnerable communities. And this pledge is not idly made. In Ecolog’s 20-year history, we have been engaged by many multinational bodies to complete complex logistical operations in some of the world’s most inaccessible regions – including Ulaanbaatar, Maputo, Kabul, Somalia, and Tetovo.
The evidence suggests that those at greatest risk from Covid-19 are usually those with other health conditions, and these are exacerbated when the public health infrastructure – for example, water supply and sanitation – is lacking.
For a given quantity of vaccines, most lives will be saved if the products can be delivered intact and with world class safeguarding to those distant communities.
“Out of complexity, find simplicity.”
Every customer contact is an opportunity to build confidence in the ethics and impact of vaccinations, and we have designed each such interaction with an eye to reassuring those who are hesitant and overcoming skepticism. Thus communication must be clear and simple and all the required information in one place, but communication must also be regular in before and after. For sure, digital is first but we are making alternatives available by allowing access to our EcoCare App via mobile phones. Last but not least, whereever necessary, paper alternatives are of course available. Clinical protocols are adhering to best practice in terms of confidentiality, ID verification, informed consent, and applying exclusion criteria to ensure wellbeing.
Albert Einstein once declared, “Out of complexity, find simplicity.” In this short piece, we hope we’ve conveyed that delivering vaccines from the border to the point where they can be safely injected in difficult environments is a hugely complex multivariate challenge. However, it must not seem that way to the customer, whose role is simply to arrive on time at the mobile centre, receive their jab, and proceed about their business. For the customer, receiving protection from a virus that has ravaged the world must be as simple as biting an apple.
That is the legitimate expectation, and that’s what all of us involved in vaccination supply, working in collaboration, must ensure.