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[Note: This case study was originally published in 2009. Download a PDF or read the case study here.]

Vaccines can be rendered useless by just a few degrees difference in temperature or by temperature changes over a prolonged amount of time, thus, making transporting these delicate solutions difficult. Transport might be between islands or on dirt roads across rivers and swamps. Health workers carry the vaccine using trucks, motorbikes, boats, canoes, bicycles and, in many cases, on foot. With all these steps, the journey might take a year, with the most challenging leg at the very end where the vaccinator struggles to reach populations dispersed by difficult geography, famine or war. The vaccine is at constant risk of damage.

Lessons Learned:

• Be thoughtful about making or demanding technical or manufacturing changes to a product to avoid making it impossible for the supplier to provide.
• Widespread support of an initiative like vaccine vial monitors can facilitate changes in global policy that allow more flexibility in the way that vaccines are used, resulting in further cost savings.
• A cost increase, even though minimal, can become a large obstacle to ensuring supply as procurers are often extremely price sensitive.