COVID-19 – Vaccine Distribution Indonesia Challenge & Opportunity

• A vaccine cold chain is much more stringent than even regular Pharma Cold Chain
• Vaccine development is happening at breakneck pace. A broken supply chain could derail this very quickly.
• Indonesia as the worlds largest archipelago brings with it a whole new series of challenges.
• This will require military precision to ensure vaccines arrive at destination “fit for purpose”.
• It is of critical importance that a vaccine is turned into a VACCINATION

• Maintain specific temperature range, typically 2 Deg C to 8 Deg C (Driven by Vaccine type)
• Impacted by Temperature, Barometric Pressure, Radiation/Light, Damage
• Must have a record of these parameters throughout the end – end journey.
• Must have specific SOP’s certified by International body/bodies.
• Must have specially trained personnel in vaccine handling

BUY

• Importation of vaccine from a certified distributor, shortens development time.
• Can start vaccinating people as soon as vaccine is released.
• Buy a % of initial finished vaccines and bulk supply a quantity to fill and finish in Indonesia

MAKE

• Making allows complete end–end in country control
• Potentially delayed start but thereafter timeline driven by Indonesia
• Forces the issue resolution of all infrastructure concerns
• Will help accelerate training & bring Indonesian standards inline with WHO & Global regulations
• Will have a knock-on effect of lifting total Indonesian healthcare system
• Will provide career path with good paying jobs in an ever-increasing health & life science industry

Will provide a boost to improve Indonesian “Cold Chain” logistics, impacting all fresh, chilled and frozen products nationwide.

• If manufacturing is to take place in Indonesia
• Confirmation of vial manufacturing capacity
• Syringe manufacture will need to be improved
• Current Indonesian syringe manufacturing is at 100mm units

• Vaccine hubs from which last mile carriers take the vaccine the remainder of the way.
• With the potential to deploy mobile health clinics.
• Logically these would follow the population centres
• These means that the National distribution skeleton is in place.
• The white space is the rural areas where investment to build cold chain facilities can be targeted, Lamongan development being considered is a prime example.
• Another opportunity is that the vaccines being considered in Indonesia do not require the extreme temperatures required for other types of vaccine.

• Vaccinations will have to happen in waves, driven by availability, with the goal being to achieve Herd Immunity.
• Herd Immunity will require at least 70% of total population being vaccinated (189mm) people.
• The vaccine will require 2 doses each person, equals 378mm doses Indonesian target doses should therefore be a minimum of 400mm doses.
• Larger employers could offer their in-house medical facilities for employee vaccinations.
• Manufacturers that start to build networks and collaborations to meet consumers where they live, and work will be better equipped to deliver medicines to all patients regardless of socioeconomic conditions.

• Use of Cloud based real time performance monitoring of vaccine supply chain from point of manufacture to point of vaccine administered.
• Temperature tracking in storage and throughout distribution with alerts for deviations to allow operators to react in real-time.
• Big Data Analytics helps providers pharmacists and vaccine administrators to share data.
• Tracking things like # of vials used, # of vials shipped, expected delivery dates
• Creating a virtual feedback loop to improve J.I.T. delivery.
• Accelerate use of IoMT specifically wearables linked to Apps.