Soft drink cold chain delivers vaccines to Africa’s most remote corners

Vaccines being delivered to a remote African village. [Project Last Mile/The Coca-Coal Foundation]

This article is part of our special report Progress and Partnerships in Development.

A bright idea turned into reality: vaccines are getting to where they are needed, even in the most remote places in several African countries, thanks to specialised refrigeration support from Coca-Cola.

The expansion of  Project Last Mile project to deliver life-saving medicines to the hardest-to-reach communities was announced today (8 June) at the European Development Days. The project is a public-private partnership that makes use of Coca-Cola’s supply chain management and expertise to support African governments in reaching the “last mile” to deliver vaccines.

Project Last Mile works in partnership with The Global Fund to Fight AIDS, Tuberculosis and Malaria, USAID and the Bill and Melinda Gates Foundation.

Making vaccines available to a given African country is not the end of the story. Even when they are available, vaccines are often confronted with “thermostability” issues, meaning they should be transported in the cold chain. Pharmaceutical companies make sure that the vaccines they produce can survive a few days outside of it.

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“Because ministries of health struggle to distribute drugs, we are working with them to train their technicians on not only to get drugs to where they need to be but getting them in the state they need to be, helping them with refrigeration, Susan Mboya, president of the Coca-Cola Africa Foundation, told EURACTIV.com.

A company like Coca-Cola has the capacity to penetrate African countries down to the most remote areas, providing cool drinks to its clients. Governments could only dream of a cool chain to deliver vaccines of the kind the soft drink company has.

“We don’t put vaccines in the same fridge, but it’s a good symbiosis,” says Mboya, who is a philanthropist and the daughter of one of the founding fathers of the Republic of Kenya, Tom Mboya.

She said that in Tanzania, Coca-Cola has lent technicians to the country’s health ministry, to train it to procure refrigerators, how to maintain them, and how to distribute them to the hospitals that need them, when they are needed.

EURACTIV asked Adrian Ristow, director of Project Last Mile, who had the idea of the symbiosis between the Coca-Cola cool chain and the safe delivery of vaccines.

“I think it was generated in discussions with the Gates foundation,” said Ristow, who recalled that in the early days of the project, Melinda Gates gave a TEDx talk, in which she exclaimed, “how can you find a Coke, but not medicines at the same destination”. This led to follow-up meetings in the US, between the Coca-Cola company, the Bill and Melinda Gates Foundation and the Global Fund, to explore whether there was some opportunity to learn from the experience of the soft drink company in Africa, to address typical challenges in medical supply chains.

“Coca-Cola maintains a huge asset base of refrigerators across Africa, this is hugely important for this business. So we started analysing the effectiveness of these refrigerators working all the time, and we compared that to the effectiveness of refrigerators working with vaccines, and the required temperature range which I believe if from 2 to 8 degrees,” he said.

What was found is that the performance of Coca-Cola system was a lot higher than of those maintaining vaccines refrigerators, with far fewer breakdowns.

“Coca-Cola had a much more structured process providing preventive maintenance, and being able to identify whenever there was a problem with a refrigerator, how quickly it could be fixed. The minute there is a problem there is a technician who has the necessary spare parts and goes to fix it. This leads to the Coca-Cola refrigerators working virtually all the time,” he explained.

For sharing those practices, a pilot project was first launched in Tanzania, then Ghana. The principle is that the government learns from the experience of the private company in the maintenance of coolers, or procurement and repairing procedure practices.

More recently, Project Last Mile has been working in Nigeria, a country that has had huge problems keeping its refrigerators for vaccines running.

“As you can imagine, a country as large as Nigeria requires a huge amount of competent people around the country,” he said, explaining that the Project Last Mile provides training, helping local experts identify and solve the problems.

Ristow said Project Last Mile was also learning from each country it works in, and sharing its knowledge.

“Conditions in Nigeria are very different to Tanzania for example, (where it) might be the road infrastructure, (or) might be the climate. We refine the processes and share those best practices with whatever government agency responsible for vaccines works with us,” he said.

Asked if work with USAID was negatively affected by the Trump Administration, he said that as the memorandum for cooperation was signed in 2014 for 5 years, and runs to the end of 2019, that the commitment remained in place.

The total amount invested in  Project Last Mile by partner organisations is $21 million. The countries covered by so far are Tanzania, Ghana, Mozambique, South Africa, Swaziland, Liberia and Nigeria.