Bruce Y Lee1, Diana L Connor2, Angela R Wateska2, Bryan A Norman3, Jayant Rajgopal3, Brigid E Cakouros2, Sheng-I Chen3, Erin G Claypool3, Leila A Haidari4, Veena Karir2, Jim Leonard3, Leslie E Mueller2, Proma Paul2, Michelle M Schmitz2, Joel S Welling5, Yu-Ting Weng2, Shawn T Brown5. 1. International Vaccine Access Center (IVAC), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Public Health Computational and Operations Research (PHICOR), Pittsburgh, PA (formerly) and Baltimore, MD (currently), United States(1). Electronic address: brucelee@jhu.edu. 2. Public Health Computational and Operations Research (PHICOR), Pittsburgh, PA (formerly) and Baltimore, MD (currently), United States(1). 3. Department of Industrial Engineering, University of Pittsburgh, Pittsburgh, PA, United States. 4. Public Health Computational and Operations Research (PHICOR), Pittsburgh, PA (formerly) and Baltimore, MD (currently), United States(1); Pittsburgh Supercomputing Center (PSC), Carnegie Mellon University, Pittsburgh, PA, United States. 5. Pittsburgh Supercomputing Center (PSC), Carnegie Mellon University, Pittsburgh, PA, United States.
Abstract
BACKGROUND: Many of the world's vaccine supply chains do not adequately provide vaccines, prompting several questions: how are vaccine supply chains currently structured, are these structures closely tailored to individual countries, and should these supply chains be radically redesigned? METHODS: We segmented the 57 GAVI-eligible countries' vaccine supply chains based on their structure/morphology, analyzed whether these segments correlated with differences in country characteristics, and then utilized HERMES to develop a detailed simulation model of three sample countries' supply chains and explore the cost and impact of various alternative structures. RESULTS: The majority of supply chains (34 of 57) consist of four levels, despite serving a wide diversity of geographical areas and population sizes. These four-level supply chains loosely fall into three clusters [(1) 18 countries relatively more bottom-heavy, i.e., many more storage locations lower in the supply chain, (2) seven with relatively more storage locations in both top and lower levels, and (3) nine comparatively more top-heavy] which do not correlate closely with any of the country characteristics considered. For all three cluster types, our HERMES modeling found that simplified systems (a central location shipping directly to immunization locations with a limited number of Hubs in between) resulted in lower operating costs. CONCLUSION: A standard four-tier design template may have been followed for most countries and raises the possibility that simpler and more tailored designs may be warranted.
BACKGROUND: Many of the world's vaccine supply chains do not adequately provide vaccines, prompting several questions: how are vaccine supply chains currently structured, are these structures closely tailored to individual countries, and should these supply chains be radically redesigned? METHODS: We segmented the 57 GAVI-eligible countries' vaccine supply chains based on their structure/morphology, analyzed whether these segments correlated with differences in country characteristics, and then utilized HERMES to develop a detailed simulation model of three sample countries' supply chains and explore the cost and impact of various alternative structures. RESULTS: The majority of supply chains (34 of 57) consist of four levels, despite serving a wide diversity of geographical areas and population sizes. These four-level supply chains loosely fall into three clusters [(1) 18 countries relatively more bottom-heavy, i.e., many more storage locations lower in the supply chain, (2) seven with relatively more storage locations in both top and lower levels, and (3) nine comparatively more top-heavy] which do not correlate closely with any of the country characteristics considered. For all three cluster types, our HERMES modeling found that simplified systems (a central location shipping directly to immunization locations with a limited number of Hubs in between) resulted in lower operating costs. CONCLUSION: A standard four-tier design template may have been followed for most countries and raises the possibility that simpler and more tailored designs may be warranted.
Authors: Bruce Y Lee; Leila A Haidari; Wendy Prosser; Diana L Connor; Ruth Bechtel; Amelia Dipuve; Hidayat Kassim; Balbina Khanlawia; Shawn T Brown Journal: Vaccine Date: 2016-08-26 Impact factor: 3.641
Authors: Leila A Haidari; Shawn T Brown; Marie Ferguson; Emily Bancroft; Marie Spiker; Allen Wilcox; Ramya Ambikapathi; Vidya Sampath; Diana L Connor; Bruce Y Lee Journal: Vaccine Date: 2016-06-20 Impact factor: 3.641
Authors: Sarah N Cox; Patrick T Wedlock; Sarah W Pallas; Elizabeth A Mitgang; Tatenda T Yemeke; Sarah M Bartsch; Taiwo Abimbola; Sheryl S Sigemund; Aaron Wallace; Sachiko Ozawa; Bruce Y Lee Journal: Vaccine Date: 2021-05-25 Impact factor: 3.641
Authors: Leila A Haidari; Shawn T Brown; Patrick Wedlock; Diana L Connor; Marie Spiker; Bruce Y Lee Journal: Vaccine Date: 2017-04-19 Impact factor: 3.641
Authors: Bruce Y Lee; Patrick T Wedlock; Elizabeth A Mitgang; Sarah N Cox; Leila A Haidari; Manoja K Das; Srihari Dutta; Bhrigu Kapuria; Shawn T Brown Journal: BMJ Glob Health Date: 2019-09-05
Authors: Patrick T Wedlock; Elizabeth A Mitgang; Assaf P Oron; Brittany L Hagedorn; Jim Leonard; Shawn T Brown; Jennifer Bakal; Sheryl S Siegmund; Bruce Y Lee Journal: Vaccine Date: 2019-03-23 Impact factor: 3.641