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Misinformation, difficult logistics and a military coup: Overcoming challenges to get COVID-19 vaccines to the last mile in Burkina Faso

4th March 2022

Since the beginning of the pandemic, more than 20,700 people have been infected with Covid-19 in Burkina Faso with more than 375 deaths, but the country has one of the lowest vaccine uptake rates in Africa, at just 5.48 per 100 of the population, compared to 15.41 in neighbouring Ghana. Under our Helpdesk programme with UNICEF, we helped establish vaccination campaigns in Burkina Faso and other developing countries to ensure health systems and populations can mitigate the effects of COVID-19.

In 2021, the US Government donated one billion Pfizer vaccines through the COVAX scheme for developing countries. UNICEF quickly realised that the challenges of limited ultra-cold chain (UCC) capabilities combined with a lack of local expertise meant that many of these vaccines would simply be wasted. Crown Agents was one of the first organisations in the world to move the Pfizer vaccine, with none of the doses we have shipped so far being spoiled. We were therefore well placed to provide technical guidance to countries which are receiving ultra-low temperature equipment and Pfizer vaccines through COVAX and were asked by UNICEF to launch a Helpdesk. Under the programme, we provide support and advice to UNICEF Country Offices and Ministries of Health on how to manage their Pfizer vaccine supply chains, as well as offering technical assistance to countries who are receiving, handling, storing and administering the vaccines and UCC equipment procured by UNICEF.

Vaccines – a delicate cargo

The Pfizer vaccine needs to be kept at -70°C to avoid spoilage, meaning a specialist UCC is needed to transport the doses right to where they are needed. This is especially challenging when trying to reach remote and isolated communities. Many developing countries have struggled to afford the highly specialised freezers, temperature monitoring devices, refrigerated trucks and equipment required to facilitate this. The World Health Organization (WHO) has reported over 50% vaccine wastage globally, in part because healthcare providers in poor or rural areas may not have the resources or reliable electricity supply to support cold chain requirements to the last mile.

The situation in Burkina Faso

Burkina Faso received 1.1 million Pfizer doses in November, most of which had an expiry date of 28th February; yet by mid-January, only 300,000 of those doses had been used under the government-led roll out. Over 700,000 much-needed vaccines were therefore about to be wasted, representing a huge loss for the country’s health system and the fight against COVID-19. It was increasingly difficult to get vaccines to the local health facilities due to the challenges of procuring refrigerated trucks and ensuring adequate use of temperature monitoring devices during transportation. The country was also struggling with a high degree of vaccine hesitancy due to the spread of misinformation and a lack of trained health workers to administer the doses. The situation was made worse by the rapidly escalating political tensions, culminating in a military coup on the 24th of January 2022.

How we rose to the challenge

We acted quickly to overcome these problems, placing a qualified consultant on the ground to help UNICEF distribute the 700,000 remaining doses by providing technical expertise in managing the ultra-cold chain, developing standard operating procedures and creating logistics and mitigation plans to get the vaccine into people’s arms. Our role was to provide training for UNICEF and the Ministry of Health to manage their UCC and transport Pfizer vaccines from the central warehouses where they were being stored in UNICEF-procured UCC freezers to the local level. With an expert knowledge of managing the Pfizer vaccine, we were able to advise at every stage, from storage, handling and transportation of the vaccines right the way through to administration in local health facilities. As of 31st of January 2022, over 91% of the vaccines had been used, and at least 90% of the target population in seven regions of Burkina Faso had been vaccinated.

Ensuring effective community outreach was also a central component of the campaign, led by UNICEF, to combat the widespread misinformation that has prevented better uptake of the vaccine so far. Utilising the youth population was key to this approach. Moumouni Sanogo, Chief of Social Behaviour Change at UNICEF Burkina Faso commented that “Young people are the agents of change. When young people talk to young people, the message gets through. And as far as Covid 19 is concerned, young people are showing their capacity to innovate by getting vaccinated and by convincing other young people to get vaccinated.” By ensuring effective outreach in their neighbourhoods and cities, these young people are raising awareness of the effectiveness of the vaccine and stopping false information spreading amongst their communities.

Looking towards the future

Although we have made excellent headway in Burkina Faso, the recent political issues have caused multiple concerns for the continuation of the vaccination campaign. We are working closely with UNICEF and the Ministry of Health to determine the next stage of the vaccination roll out, drawing on our 180-years of experience in supporting governments and organisations through crisis situations.

Along with Burkina Faso, our Crown Agents team have now assisted ten countries, including Tajikistan, Nicaragua, Kyrgyzstan, Cambodia, Ukraine, Ethiopia, Benin, Sierra Leone and Nepal to effectively roll out their vaccination campaigns and use the specialised equipment needed to maintain the UCC. This means that ten countries now have the necessary ultra-cold chain infrastructure and knowledge in place to transport essential vaccines and medicines to the last mile, which is critical for development and will support health systems well beyond the pandemic.

If you would like to discuss how Crown Agents could help with the procurement and supply of COVID-19 vaccines in your country, please contact us:

Bryan Richmond, Covid Response Lead