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Augmenting Transport versus Increasing Cold Storage to Improve Vaccine Supply Chains.doc

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Augmenting Transport versus Increasing Cold Storage to Improve Vaccine Supply Chains

AugmentingTransportversusIncreasingColdStorageto ImproveVaccineSupplyChains LeilaA.Haidari1,DianaL.Connor1,AngelaR.Wateska1,ShawnT.Brown2,LeslieE.Mueller1, BryanA.Norman3,MichelleM.Schmitz1,PromaPaul1,JayantRajgopal3,JoelS.Welling2,JimLeonard2, Sheng-IChen3,BruceY.Lee1* 1PublicHealthComputationalandOperationalResearch(PHICOR)Group,SchoolofMedicineandGraduateSchoolofPublicHealth,UniversityofPittsburgh,Pittsburgh, Pennsylvania,UnitedStatesofAmerica,2PittsburghSupercomputingCenter,Pittsburgh,Pennsylvania,UnitedStatesofAmerica,3DepartmentofIndustrialEngineering, SchoolofEngineering,UniversityofPittsburgh,Pittsburgh,Pennsylvania,UnitedStatesofAmerica Abstract Background: When addressing the urgent task of improving vaccine supply chains, especially to accommodate the introductionofnewvaccines,thereisoftenaheavyemphasisonstationarystorage.Currently,donationstovaccinesupply chainsoccurlargelyintheformofstorageequipment. Methods:ThisstudyutilizedaHERMES-generateddetailed,dynamic,discreteeventsimulationmodeloftheNigervaccine supplychaintocomparetheimpactsonvaccineavailabilityofaddingstationarycoldstorageversustransportcapacityat differentlevelsandtodeterminewhetheraddingstationarystoragecapacityalonewouldbeenoughtorelievepotential bottleneckswhenpneumococcalandrotavirusvaccinesareintroducedby2015. Results: Relieving regional level storage bottlenecks increased vaccine availability (by 4%) more than relieving storage bottlenecks at the district (1% increase), central (no change), and clinic (no change) levels alone. Increasing transport frequency (or capacity) yielded far greater gains (e.g., 15% increase in vaccine availability when doubling transport frequencytothedistrictleveland18%whentripling).Infact,relievingallstationarystorageconstraintscouldonlyincrease vaccineavailabilityby11%,whereasdoublingthetransportfrequencythroughoutthesystemledtoa26%increaseand triplingthefrequencyledtoa30%increase.Increasingtransportfrequencyalsoreducedtheamountofstationarystorage spacenee