The benefits of redesigning Benin’s vaccine supply chain

Vaccine
Volume 32, Issue 32, Pages 4013-4110 (7 July 2014)
http://www.sciencedirect.com/science/journal/0264410X/32/32

The benefits of redesigning Benin’s vaccine supply chain
Original Research Article
Pages 4097-4103
Shawn T. Brown, Benjamin Schreiber, Brigid E. Cakouros, Angela R. Wateska, Hamadou M. Dicko, Diana L. Connor, Philippe Jaillard, Mercy Mvundura, Bryan A. Norman, Carol Levin, Jayant Rajgopal, Mélanie Avella, Caroline Lebrun, Erin Claypool, Proma Paul, Bruce Y. Lee
Abstract
Introduction
New vaccine introductions have put strains on vaccine supply chains around the world. While increasing storage and transportation may be the most straightforward options, it is also important to consider what financial and operational benefits can be incurred. In 2012, suboptimal vaccine coverage and impending vaccine introductions prompted the Republic of Benin’s Ministry of Health (MOH) to explore ways to improve their vaccine supply chain.
Methods
Working alongside the Beninese MOH, we utilized our computational model, HERMES, to explore the impact on cost and vaccine availability of three possible options: (1) consolidating the Commune level to a Health Zone level, (2) removing the Commune level completely, and (3) removing the Commune level and expanding to 12 Department Stores. We also analyzed the impact of adding shipping loops during delivery.
Results
At baseline, new vaccine introductions without any changes to the current system increased the logistics cost per dose ($0.23 to $0.26) and dropped the vaccine availability to 71%. While implementing the Commune level removal scenario had the same capital costs as implementing the Health Zone scenario, the Health Zone scenario had lower operating costs. This increased to an overall cost savings of $504,255 when implementing shipping loops.
Discussion
The best redesign option proved to be the synergistic approach of converting to the Health Zone design and using shipping loops (serving ten Health Posts/loop). While a transition to either redesign or only adding shipping loops was beneficial, implementing a redesign option and shipping loops can yield both lower capital expenditures and operating costs.