Background: Supporting the United Kingdom’s global vaccine roll-out
In early December 2020, the UK’s Medicines and Healthcare products Regulatory Agency (MHRA) gave temporary regulatory approval for the Pfizer–BioNTech vaccine, becoming the first country to approve the vaccine and the first country in the Western world to approve the use of any COVID-19 vaccine. The same month, the MHRA gave the first approval to the Oxford/AstraZeneca vaccine as its second vaccine to enter the UK national rollout.
Subsequently, the UK Government pledged to vaccinate all British adults by autumn. It appointed Crown Agents, the not-for-profit international development organisation, in January 2021 to assist with the Covid-19 vaccine roll-out to the British Overseas Territories. Some of the Territories are located in the world’s most isolated places, such as the Pitcairn Islands and Tristan Da Cunha, which is described as the most remote settlement on earth.
Later that year in July, the UK Government announced that it would donate nine million British Oxford AstraZeneca vaccines globally to fight Covid-19 and deliver on its G7 commitments.
The nine million vaccines were part of the first tranche of the 100 million vaccines the Prime Minister pledged the UK would share within the next year. At least 80 million of the 100 million doses will go to COVAX, with the rest going to countries directly. Four million vaccines would be donated bilaterally, whilst the remaining amount would be offered to COVAX, the worldwide initiative aimed at equitable access to COVID-19 vaccines. Once again, the Government contracted Crown Agents to ensure the safe delivery of those four million vaccines at destination.
Most recently, Crown Agents arranged vaccine shipments to the South Pole on behalf of the FCDO, which was received by the British Antarctic Survey (BAS) research facility in Rothera, Antarctica – the furthest south any British Covid-19 vaccine has yet travelled.
Logistics is often seen simply as getting supplies from point A to B. Vaccines, however, demand much more than that: They need to be maintained within strict temperature regimes, otherwise they spoil and the entire operation is wasted. As the organisation contracted by the Foreign, Commonwealth and Development Office (FCDO) to lead on the vaccine logistics, we planned and advised on every part of the journey, land, air and sea. This involved arranging temperature-controlled storage and transport and contingency planning in case of last-minute problems. With the vaccine needing to get to its destination within a certain timeframe, there cannot be a single incident which takes the journey beyond this window.
A delicate cargo with no precedents…
Since the UK was among the first countries to authorise the use of these vaccines, we were the first in the world to arrange international transport of these vaccines. This made the operation even trickier, as there were no lessons learned we could refer to.
Crown Agents transported both the Pfizer and AstraZeneca vaccine. Before dispatch, we carried out detailed Route Risk Analyses, where our logistics experts work with the UK Government to map out the entire journey and predict any points during the shipment where the vaccines might be exposed to an incorrect temperature – known as an “excursion”.
To ensure the vaccines remain stored at the correct temperature at all stages of the journey, we provided a temperature-controlled environment at all times. By maintaining the entire cold chain throughout, it is ensured that the risk of any temperature excursion is absolutely minimised. Otherwise, the vaccines spoil, which makes them unusable upon arrival.
The Pfizer vaccine needs to be transported at an ultra-cold temperature of -70 degrees, which can be rather challenging if it is flown from the UK to a hot Caribbean island. Furthermore, it has only four freeze and thaw transitions before it becomes unusable. The AstraZeneca vaccine needs a 2–8-degree environment, which could be perceived a lesser challenge, but these are still very restricted temperature requirements which need constant monitoring throughout the vaccine’s journey.
…going on complex journeys across the globe
When freight is sent to small islands, it is often the case that only small airplanes can land on the airfield. As a result, the vaccines have to be packed in isothermal packages to fit onto the carriers. The packaging ensures the appropriate temperature only a certain amount of time before it sublimates, which means that the Pfizer vaccine must arrive at destination within 84 hours, and the AstraZeneca vaccine within 92 hours.
Many of the destinations we were sending the vaccines to were located in very remote corners of the world: St Helena, for example, is 2,630.52 miles away. Located six hours from Johannesburg by air, there is only one flight a week landing on the island. Other Overseas Territories, such as Pitcairn, needed a 14-day ship journey on top of air travel.
For Pitcairn, the vaccines are being flown from Heathrow to Auckland, New Zealand. After a three-hour road trip to the port of Tauranga, the cargo was transferred to the supply vessel Silver Supporter for a two-week journey to the archipelago, deep in the Southern Pacific.
For the British Antarctic Territory, the vaccines were flown by the RAF from Brize Norton, via Senegal, to Mount Pleasant Airbase in the Falkland Islands. They were then taken by a BAS aircraft to the research station at Rothera, on the Antarctic Peninsula. The total voyage was almost 10,000 miles, covering 4 continents.
About Crown Agents
Crown Agents is the UK not-for-profit international development company with decades of experience supporting governments, working in some of the most difficult contexts in the world and focusing on the most vulnerable in society.
Crown Agents work reaches over 36 million people in 60 countries, with expertise in Procurement Reform, Public Sector Transformation, Humanitarian & Stabilisation, Last Mile Supply Chain, Health System Strengthening and Training & Professional Development.
Remarking on the work accomplished so far, Crown Agents’ Chief Executive Officer, Fergus Drake, states:
“Since March last year we have worked with the FCDO to ship medical items to literally the ends of the earth to support the UK Overseas Territories during the pandemic. From Pitcairn Island to Tristan Da Cunha, our teams have overcome extreme logistical challenges to deliver medical equipment – and supporting the safe arrival of vaccines all the way to Antarctica has certainly been a highlight. It’s fantastic to see the UK Government’s commitment to the people of the Overseas Territories. Only by sharing the vaccines across the globe will we be able to combat the pandemic, and that includes reaching those in even the most remote and sparsely populated regions.” ¬
Our four takeaways from moving the vaccine 5000+ miles across the globe
Global logistics during a pandemic: Prepare for the unexpected
The distribution of the COVID-19 vaccine has been said to be the ‘greatest logistical challenge of our time.’
We certainly experienced extreme complexities and substantial risks, which required meticulous end-to-end planning and thorough risk management.
Shipping the vaccine to the Overseas Territories does not only mean delivering a challenging product to hard-to-reach locations but also up facing COVID-19 restrictions at a global scale, such as shifting travel corridors and global travel disruptions, COVID-19 outbreaks in warehouses, tropical storms and grounded planes due to adverse weather as well as a new customs regime in the UK as a result of Brexit. All these eventualities had to be planned for whilst ensuring that the vaccines were kept at the correct temperature throughout their complex journeys.
The UK was under lockdown at the time of shipping some of the freight, and many international flights had been suspended. To manage supplies during a global pandemic requires detailed contingency planning, as well as flexibility to mitigate any challenges arising. On one occasion, a supermarket cold chain van in Turks and Caicos was commandeered to get the vaccines to hospital to ensure the right temperatures for the vaccine during transit.
The clock is ticking
As mentioned, both vaccines can only be maintained at the required temperature for a certain amount of time. This means that the timings of logistics had to be well coordinated at every point of the supply chain.
In the case of the Overseas Territories, this matters – sometimes only one flight would reach a Territory every two weeks, meaning packaging and repackaging of goods needed to be carefully planned. In addition, many commercial flights were cancelled due to the pandemic, which limited transport options even further.
Successful partnerships are key
To achieve successful and timely delivery, strong cross-party relationships were crucial, as was relying on a trusted network of global supply chain experts to get the job done- from delivery drivers and loading crew to cross government partners.
To ensure safe delivery to Tristan da Cunha, for example, the Crown Agents team worked closely with the UK Ministry of Defence (MoD). From the RAF Station in Brize Norton, a Voyager aircraft made the 8,000-mile trip to the Falkland Islands, via Dakar in Senegal to refuel, before HMS Forth sailed the 2,000-mile voyage to Tristan da Cunha.
Good distribution practice makes perfect
Even though we had substantial experience in rapidly shipping medical commodities across the globe, often in some of the most challenging environments, the Covid-19 vaccine was a new product for us to handle. This meant that all operational restraints needed to be looked at afresh and carefully considered to uphold Good Distribution Practices throughout the supply chain. For example, the vaccine needed to be moved in accordance with strict MHRA guidelines which is a highly regulated procedure. In addition, customs requirements differed for each country and needed to be carefully assessed to ensure there were no delays at the border of the relevant recipient countries.