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Securing trust in the global supply chain of COVID-19 vaccines

Moving from development success to vaccination

The critical success factors identified in 2020 remain paramount. But now stakeholders need to act on the lessons learnt to strengthen the collective ability to respond to or—better yet—proactively address the existing global health issues.

The magnitude of suffering inflicted by COVID-19 is heartbreaking. Now, more than ever, leaders in the global health community must develop standards, processes and capabilities that ensure citizens across the globe have access to lifesaving therapies. A secure and equitable supply chain is a factor in expanding access, which in turn builds trust. Most relationships depend on trust, and trust is built through actions that reflect both competence and the right intent, which in turn are the products of demonstrated capability, reliability, transparency and humanity.

This report is a reflection of the progress made on all the pre-requisites identified in our Securing trust in the global COVID-19 supply chain report, published in December 2020. We have learnt more about the complexity of the four critical success factors for organisations and governments to secure public trust. There has been progress on all these fronts, although it has been uneven.

  • Trust in the COVID-19 supply chain has grown and shifted since their release. Many no longer are questioning “will vaccines work?” and “when will they be available?” but are now concerned with ensuring all parts of the world are vaccinated to reduce risk of new variants. Yet, there is still an ongoing need to build trust in the vaccine supply chain so that citizens believe they are safe and efficacious.
  • Optimising in-country administration of the vaccines has met hurdles as well, including the lack of cold chain storage, challenging management of expiry dates, disparate use of serialisation to uniquely identify products and unreliable infrastructure to navigate the last mile.
  • Communication campaigns have had varied impact. Significant investment by some governments, health care leaders and leaders of trusted nonprofits and non-governmental organisations successfully raised awareness and interest in the vaccines but fell short in addressing the root causes of vaccine hesitancy.

In this updated report, Deloitte, again in collaboration with GS1, a not-for-profit organisation that develops and maintains global standards for business communication, explores each factor in three dimensions. How can the life sciences stakeholders address the way forward?

● Expedited development of numerous effective vaccines: An unprecedented data sharing among rival drug manufacturers and support for clinical development by companies and governments made possible a remarkable achievement in the development of vaccines globally.

● Growing acknowledgement of need for global standards to secure supply chain: Given the number of manufacturers and different vaccines available, tracking and tracing shipping, delivery and administration of vaccines was bound to be complex. Many stakeholders now recognise the need for globally standardised product identification to track the location and use of vaccines to gauge vaccination rates, identify adverse events, better match demand with supply and stop fake vaccines from reaching patients.

● Using traditional and creative tactics to deliver safe and efficacious vaccines: Effectively navigating the last mile to get vaccinations in the arms of citizens requires exceptional logistical planning, secure health care facilities and reliable transport as well as community engagement and communication. Multiple activities and resources need to exist and align for vaccines to move from a manufacturing facility to a patient.

● Clear, transparent communications increased confidence in vaccines: Clear, co-ordinated and continuous communication from leaders in government, health care and local communities also builds trust in vaccines and increase vaccination rates. Transparency about progress in developing vaccines and their delivery, was effective in early 2021.

Despite the success in developing vaccines in record time, major challenges remain to convert the growing supply and availability of vaccines into high vaccination rates and equitable distribution and verified administration.

● Follow-on vaccine collaboration is limited by market realities: While the collaboration and data-sharing to bring vaccines to market was laudable and successful, it was also unusual and unprecedented. Going forward, one unanswered question for manufacturers and regulatory bodies is - How can we ensure ongoing collaboration while ensuring a return on investment and avoiding antitrust problems?

● Use of global standards for product identification remains ad hoc: Interoperable systems that could generate a transparent, end-to-end chain of custody could alleviate some of the concerns about product integrity and would create trust with the general public, especially in LMICs.

● More infrastructure development needed to deliver safe, effective, genuine vaccines: Infrastructure gaps and fragmented health care services frustrated the ability to turn available vaccines into actual vaccinations and highlighted the general inequities between developed nations and the rest of the world in terms of vaccine access.

● Disconnects in global and local communication networks undermine vaccine confidence: Initial efforts to describe and clarify the origin of the virus were often contradictory and hard to understand. This focus also sets a precedent in which skepticism about mitigations such a social distancing, masking and vaccines took hold in late 2020 and early 2021.

These challenges are significant but not insurmountable. In fact, many short-term and long-term solutions could address them and leave the world better prepared for future health crises.

● Facilitating future collaboration in vaccine development: To make information sharing and collaboration possible, national and regional governmental bodies need legal and commercial protocols that carve out exceptions to laws prohibiting anticompetitive activity and guaranteeing health care privacy during crises

● Requiring global standards and serialisation for current and future vaccine supplies: A pan-association effort that encourages and helps create foundational, backbone interfaces would allow each in-country system to feed traceability data into a global repository, making it easier to align supply with demand and improve supply chain security both of which play a role in increasing transparency and with-it, trust.

● Making last mile delivery easier today and in the future: Delivery requires co-ordinated action to address infrastructure and transport barriers to administering COVID-19 vaccines. The report suggests several actions that can be taken now to support delivery networks, ensure more effective operations and increase transparency and human engagement.

● Build global and local crisis communication networks: Mixing broadcast communications from national leaders with more targeted, community-based tactics led by local, culturally diverse teams could increase confidence in vaccines and with-it vaccination rates.

The release of numerous COVID-19 vaccines within a year of virus identification represents a significant achievement for manufacturers, governments and health care professionals in a variety of roles. More importantly, it has benefited billions of citizens across the globe, and reduced the incidence of severe disease and death. Manufacturers and global health care organisations rose to the challenge and trust in the COVID-19 supply chain has increased. That movement is a victory. Further, GS1 global product identification standards will continue to play a role in establishing trust in the global supply chain for innovative products such as new vaccines, enable a better overview of supply versus need, and optimise planning and availability of vaccines.

The COVID-19 pandemic will fade, but the need to deepen and broaden trust in medicine, health research, governments and NGOs remains. The momentum and insights gained over the past two years can be used to benefit citizens, countries and for-profit and nonprofit organisations a like.

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