Master thesis Lund University on the COVID-19 vaccine supply chain in India

Abstract

The COVID-19 pandemic has subjected many countries to economic and political turmoil which has mandated the world countries to eradicate the disease immediately. This needs an effective immunization supply chain which helps in timely delivery and administration of vaccines to a country’s population.

But in many developing countries the immunization supply chain has many challenges which makes it difficult to carry out large scale vaccination. Hence, this study has focused on analyzing challenges in the immunization supply chain for one such developing country.
The immunization supply chain in general is comprised of various activities starting with planning, vaccine procurement, cold chain distribution and vaccine administration. All these activities will suffer challenges that must be well addressed for carrying out successful immunization. This is perhaps important especially when conducting COVID-19 vaccination where there could be challenges of higher intensity in all the activities.

In line with this statement, the study first analyzed the routine immunization supply chain of India and compared how it is different for the COVID-19 vaccination. This type of approach enabled an understanding of challenges in regular immunization followed by comparison with COVID-19 vaccination.

A case based research method was used to understand all the challenges in the COVID-19 immunization supply chain of India. The main form of data collection was based on secondary data from journals, news papers and government reports of India’s immunization program.

The study mainly has two types of conclusions. First comparing the routine immunization supply chain with COVID-19 immunization supply chain. The latter clearly shows many challenges with higher intensity such as a complicated supply chain system comprising of 29,000 cold chain points, disparity in cold chain points across states in India and improper planning of vaccine administration leading to vaccine wastages. Hence COVID-19 vaccination is a lot more challenging than the routine ones.

The second conclusion is that the challenges in India’s COVID-19 immunization supply chain resemble challenges found in the immunization supply chain literature of developing countries. The only two activities that seem more advanced compared to other developing nations include vaccine procurement where India has achieved self sufficiency and IT systems that are integrated in all vaccine stores of India for better vaccine stock visibility.

The study demonstrates to the stakeholders how the important the immunization supply chain is and how the challenges can be mitigated for achieving higher immunization in the future. The findings are generalizable to any other developing countries.

Background

The COVID 19 pandemic has subjected a lot of countries to economic and social turmoil. This has contributed to socio economic as well as psychological challenges undermining the economies of many countries. Immunization is the key in this crucial phase of pandemic that can save a lot of precious lives. But imminent challenges in immunization supply chain of world countries to the native population across the world are manifold. This must be enhanced to enable the world to come back to normalcy. Problems in distributing vaccines are aplenty depending on the adversity in each country. By studying this phenomenon, many solutions could be found that can benefit the concerned stakeholders.

Problem definition
Distribution of vaccines is often a challenge in developing countries, this is due to several shortfalls in the immunization supply chain setup like cold chain distribution, lack of infrastructure for last mile delivery and shortage of adequate staff for administering the vaccines and storage capacities at distribution centres which makes it challenging to conduct immunization.

Aim of the study
This study will identify the challenges in the COVID-19 immunization supply chain of India and identify the main challenges it faces in immunization its population against COVID-19 and describe how it can be mitigated by identifying suggestions from theory for future that will aid in strengthening the immunization supply chain. This analysis will be made in comparison to the routine immunization programme that happens in India.

Research methodology
To study the immunization supply chain of India, the case study research methodology is followed. A single case study is adapted to study the challenges of COVID-19 vaccination in India. The study on a higher levels follows an abductive approach to achieve the purpose of answering the research question. The qualitative data for the study is mainly collected through secondary sources such as Journals, articles and newspapers relevant to COVID-19 vaccination in India. Primary data is not utilized as there were challenges collecting data from the health care workers in India.

Conclusions

The challenges for COVID-19 immunization supply chain of India is much more than routine immunization supply chain. All the activities of immunization supply chain in India face challenges starting from planning the immunization supply chain, cold chain distribution till vaccine administration. Hence most of the challenges identified resemble theory which states the problems in immunization supply chain for developing countries. The only dissimilarity from theory is the vaccine procurement and information systems where India has achieved self sufficiency in vaccine procurement and has integrated information system in place in all its vaccine stores.

Contribution

The study will help the stakeholders to understand the main challenges in COVID-19 immunization supply chain and areas requiring attention for overall improvement. The identified challenges faced may be of some help for the stakeholders in India to tide over the shortcomings and ways & means to improve during the COVID-19 vaccination. Unless efforts are put at each stage of the vaccination drive, the challenges cannot be met with success; there could be downward trend in India’s immunization program in future. But since it is a pandemic, it could take time to implement considering the vastness of India’s immunization program and at present it looks like India is on the way to achieve its desired goal. This is also a way to help stakeholders for future immunization in India