Getting ready for the premium pharma service delivery

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Distributing a COVID-19 vaccine — if one is approved for use — will be the second huge logistical challenge spawned by the pandemic for shippers and logistics service providers, which earlier this year mobilised the supply and delivery thousands of tonnes of protective gear across the world for healthcare workers. This time the job is securing and moving fragile vials of medicine under exacting conditions for the world’s best shot to stamp out the coronavirus and restore economies to normal by doing the critical work of consolidating operations and capabilities as well as connecting all vaccine supply chain stakeholders to foster effective communication and collaboration.

Upamanyu Borah

The global aviation industry says now is the time to prepare for ‘the mission of the century’– delivering an effective COVID-19 vaccine safely and securely to billions of people in some of the most remote parts of the world. Now that would require capability-based planning crucial to the quick and efficient transport and distribution of COVID-19 vaccines when they are available.

Airline regulatory bodies and stakeholders have urged governments to begin careful planning with industry stakeholders to ensure full preparedness when vaccines for COVID-19 are approved and available for distribution.

At some point in the long-term, one or more vaccines will be proven to safely protect against the novel coronavirus. The next step may be even more difficult, ensuring that at least 70 per cent of the world’s 7.8 billion people receive the vaccine (or develop immunity through infection) in order to establish immunity levels needed to keep the virus in check.

This highlight that in the months to come, air freight will make an important contribution to the global public good and in fighting the pandemic by playing a vital role in the COVID-19 vaccine global supply chain. The freight industry will need to respond quickly and efficiently to handle the challenges of shipping vaccines from drug makers to billions of people, once COVID-19 vaccines are adequately available.

The now-Goliath task of COVID-19 vaccine delivery

Most importantly, the potential size of this ‘mission like no other’ delivery is enormous. “Just providing a single dose to 7.8 billion people would fill 8,000 747 cargo aircraft. Land transport will help, especially in developed economies with local manufacturing capacity. But vaccines cannot be delivered globally without the significant use of air cargo,” says global airlines body International Air Transport Association (IATA).

This would call for rigorous planning and adjusting strategies with the evolution of the stages of delivery and distribution, since vaccines would need to be continually delivered over time and new challenges may emerge.

Additionally, vaccines must be handled and transported in line with international regulatory requirements, at controlled temperatures and without delay to ensure the quality of the product. While there are still many unknowns (number of doses, temperature sensitivities, manufacturing locations, etc.), it is clear that the scale of activity will be vast. Capability building, such as the expedited setting up of cold chain facilities will be required to ensure delivery to every corner of the planet is executed seamlessly.

In general, air cargo plays a key role in the distribution of vaccines in normal times through well-established global time and temperature-sensitive distribution systems. This could not be a particular challenge given that, but how do you prepare for something when you do not know where it will be produced, in what quantities, where it needs to go to, how it needs to be transported and in what time-frame?

The distribution operation—taking drugs from far-flung manufacturing sites to medical teams via warehouses, cargo terminals, airports and final storage points, all in a matter of days—promises to be a logistics high-wire act with risks at every stage. Breakdowns in refrigeration equipment, transportation delays, broken packaging or other mishaps could leave many thousands of doses useless.

Time and temperature sensitivity will vary for different vaccines. Several candidates have had success in early trial phases, and some are more fragile than others. “Single or multiple dose approach, cold-insensitive, cold-sensitive, or frozen, will all have different impacts on the supply chain. So the soonest air freight sector is aware of what is coming, the better they can plan and adapt capacity. Stakeholders need to look at every possible aspect of how they can get ready and contribute to the fast and exceptionally reliable distribution of the vaccines worldwide,” says Celine Hourcade, Transition Director- Sustainability and Transformation Projects, The International Air Cargo Association (TIACA).

Collaboration for guidance on air cargo logistics

The International Air Cargo Association (TIACA) and pharma.Aero have already announced a collaboration to develop global guidance for the air cargo industry to enable the optimal transportation of the COVID-19 vaccine.

To address concerns regarding the global supply chain ability to transport a COVID-19 vaccine, the joint working group will will consist of members of both organisations and will also reach out to various international organisations. It will bring to the table key industry stakeholders, including pharmaceutical manufacturers and logistics businesses.

The aim of this programme is to provide the air cargo industry with more clarity of the demands, expectations and quality supply chain requirements, including but not restricted to critical trade lanes, air cargo capacity, handling and storage, as well as track and trace requirements for a COVID-19 vaccine. The organisations say that this will ensure that once the vaccine is available in the market, the air cargo industry will be ready to respond to the needs of the shippers and transport vaccines in optimal conditions to all corners of the globe. At the same time, shippers will be able to gain more understanding about the capabilities of the various logistics players.

According to the organisations, the guidance will be developed gradually in four work packages through a joint group to ensure feedback from all stakeholders in the supply chain of air cargo and pharmaceuticals.

“Setting up reliable end-to-end air transportation for pharma shippers is part of the vision and mission of Pharma.Aero. Amongst our members, i.e. life sciences and pharmaceutical shippers, certified airport communities and air cargo operators, we have a track record of project-based collaboration,” says Nathan De Valck, Chairman of Pharma.Aero. “As a result, Pharma.Aero is well-positioned to make a valuable contribution in preparing the air cargo industry for this immense challenge.”

Air France KLM Martinair Cargo (AFKLMP) has also formed a taskforce to define the steps needed to help ship COVID-19 vaccines. Working in close consultation with the pharma industry and related forwarders, the airline has assessed specific requirements for shipping COVID-19 vaccines when they become available. It has adapted its operation in terms of equipment and dedicated monitoring and service, as well as the capacity it can offer.

The state of storage preparedness

Priorities for preparing facilities for this distribution include availability of temperature-controlled facilities and equipment – maximising the use or re-purposing of existing infrastructure and minimising temporary builds; availability of staff trained to handle time- and temperature-sensitive vaccines and robust monitoring capabilities to ensure the integrity of the vaccines is maintained

Logistics operators say they are preparing as much as they can while waiting for information from vaccine makers and their governments about details such as how many vials they will need to handle, the dimensions of the vaccines’ packaging and the timing of the distribution.

Shipping companies have been expanding their refrigeration and freezing capabilities in recent years, particularly as the healthcare industry has grown and pharmaceutical transport has become a bigger business.

United Parcel Service Inc is building two giant freezer farms capable of super-cooling millions of vials of a COVID-19 vaccine, preparing for the day when it will need to deliver the medicine at high speed across the globe. The facilities, under construction in Louisville, Kentucky, and the Netherlands, near UPS air hubs, will house a total of 600 deep-freezers that can each hold 48,000 vials of vaccine at temperatures as low as -800 C. That’s on par with some of the coldest temperatures in Antarctica.

“The challenge for us will be to be on our ready at any moment to ship from one place to another,” says Wes Wheeler, President of the Healthcare Division at United Parcel Service Inc. “The freezer farms need to be designed so that UPS can quickly carry out this process without compromising the viability of vaccines.”

“Each site can be used as a pit stop during distribution and to store vaccines that are awaiting emergency-use authorisation from the Food and Drug Administration. Some pharmaceutical companies plan to stockpile doses before drugs are authorised so that distribution can start as soon as they have the green light,” says Wheeler.

“After taking delivery of frozen vaccine vials packaged in large trays, UPS expects to thaw them and then rearrange them in separate trays so that multiple smaller shipments can be sent on to their destinations,” adds Wheeler.

Kuehne+Nagel has opened two pharmaceutical and healthcare hubs at Brussels and Johannesburg airports for the distribution of vaccines and other products. The facilities have the advantage of direct tarmac access, which minimises the amount of time medical products are exposed to the elements when being moved between aircraft and refrigerated rooms inside the warehouse. The new premises have dedicated areas for all ranges of temperature-sensitive products: ranging from -20°C, +2° to +8°C and +15° to +25°C. In addition, these facilities have the ability to change or add dry ice as required for deep frozen shipment where temperatures need to be maintained below -60°C.

“Today, new pharma and healthcare products tend to be more valuable, more temperature-sensitive and have additional requirements for storage and transportation conditions. Such capabilities and facilities are not easily available globally,” says Yngve Ruud, Executive Vice President- Air Logistics at Kuehne+Nagel. “The new hubs in Brussels and Johannesburg will ensure that our pharma and healthcare customers can fully rely on Kuehne+Nagel to handle the specific challenges of integrity as well as provide end-to-end visibility and regulatory compliance along the logistics journey of their sensitive products. So, they can focus on the health and well-being of their patients; because this is what matters the most.”

Lufthansa Cargo, the freight arm of Deutsche Lufthansa AG, sped up construction of its pharmaceutical storage facility at Munich Airport, in part to be ready for a vaccine. The Lufthansa Cargo Pharma Hub Munich offers space for up to 96 pallets and loose cargo in two different temperature ranges (+2 to +8 °C and +15 to +25 °C) and a freezer (down to -18 °C) on almost 1,000 sq mt and on several levels.

“With the new Pharma-Hub at our hub in Munich, we have created a state-of-the-art infrastructure for temperature-sensitive freight that will guarantee our customers even higher transport quality for their pharma shipments in the future. Particularly in the context of the corona pandemic, the relevance of stable supply chains and fast transport of medicines or vaccines has once again been demonstrated,” explains Harald Gloy, Board Member- Operations at Lufthansa Cargo.

In addition to the new capacities for temperature-sensitive cargo at the southern German hub, Lufthansa Cargo is also expanding these capacities in the US. The Lufthansa Cargo Pharma Center Chicago at O’Hare Airport was opened there in June. Since the mid of this year, the 750 sq mt facility has been providing space on several levels for up to 54 pallets and 102 cool containers in two different temperature ranges (+2 to +8 °C and +15 to +25 °C) and in a freezer (down to -18 °C).

In recent years, Air France KLM Martinair Cargo (AFKLMP Cargo) has made health care-related services a strategic priority by improving processes, training staff and forming dedicated service teams for pharmaceutical customers. It also invested in temperature-controlled infrastructure at its hubs at Charles de Gaulle Airport in Paris and Schiphol Airport in Amsterdam.

The freighter airline is constructing a new climate-cool room at its Schiphol Pharma Hub, a further step in preparation for the distribution of COVID-19 vaccines – which will be handled by a dedicated task force.

AFKLMP Cargo said the additional cold room, with temperatures ranging from +2°C to +8°C, will provide the capacity required to handle COVID-19 vaccines. Using the latest technology, the carrier will offer a number of features, in addition to the expansion of more than 2,000 cu m in storage space, including an additional 152 skid positions, flexible temperature range and racks to accommodate odd-sized shipments, central control room monitoring, temperature alarm system, a speed door to limit exposure, and a dangerous goods and dry-ice-compatible service.

Enrica Calonghi, Global Head of Pharmaceutical Logistics at AFKLMP Cargo says, “AFKLMP Cargo is ready to play a key role in the distribution of COVID-19 vaccines, thereby helping to ensure that as many people as possible around the globe will have access to vaccines in these challenging times.”

“Just a few months ago, AFKLMP Cargo already invested in 1,118 cu m of additional controlled-climate room (CRT) at Schiphol using the same hybrid technology. With the construction of this brand-new climate-cool room, we will be as flexible as possible to handle more vaccines if necessary,” adds Calonghi.

Being in the same league, Swissport Cargo Services Deutschland is set to open a new cargo handling warehouse at Frankfurt Airport. The new building – located in CargoCity South at Frankfurt Airport (FRA) – has 17,000 sq mt of floor space, including temperature-controlled zones for handling sensitive pharmaceutical products.

“We are delighted that, from November, we will be in a position to handle the cargo of our customers in Frankfurt in one of Europe’s most state-of-the-art air cargo centers. Our new cargo warehouse has 50 percent more handling capacity and is therefore a commitment to growth at Frankfurt Airport,” says Willy Ruf, SVP Central and Eastern Europe at Swissport International AG. “With the integrated Swissport Pharma Center, which has several cooling zones, we are well-equipped to satisfy the stringent requirements for the temperature-controlled transportation of medicines and vaccines.”

Tracking the vaccine

Digital technology will be required to manage distribution once the products leave the factory, with sensors placed on every pallet, case or unit on the production floor to be tracked through their journey to the healthcare facility. The current practice of not tracking vaccines by dose because of their low cost may have to change with vaccines of a higher cost. Tracking with IoT sensors will help identify weak links along the supply chain, keeping in mind that more than 50 per cent of the temperature excursions occur during airline and airport handling, according to IATA.

Nippon Express (NE) is in the process of developing pharmaceutical supply chain networks that meet both the hardware and software requirements for Good Distribution Practices (GDP) and thereby enable safer and more secure supply of pharmaceuticals. To this end, construction is underway of a digital platform for the pharmaceutical industry that will utilise IoT devices and Blockchain technology to link temperature control and other logistics information end-to-end, and there are plans to make use of the logistics information to develop commercial distribution services.

This will seek to optimise supply chains for the pharma industry as a whole – by introducing a data-driven approach offering traceability and operational efficiency. The Company is also teaming up with industry officials to consider making this digital platform an open one so that interested parties can make joint use of it.

Earlier in 2020 Nippon Express established a Digital Platform Strategy Office. The objective is to provide the pharmaceutical industry (and other industries) with solutions designed to optimise supply chains.

FedEx has recently launched SenseAware ID, a lightweight sensor-based logistics device that delivers a new level of precision tracking. It transmits precise package location data every two seconds via Bluetooth Low Energy (BLE) to WiFi access points or established gateway devices throughout the FedEx Express network. Packages equipped with the SenseAware ID sensor are tracked hundreds of times versus dozens of times with traditional package scanning protocols, which provides an unprecedented amount of real-time data about the location of the shipment.

SenseAware ID will give FedEx healthcare customers the possibility to closely monitor and proactively protect shipments using additional FedEx healthcare services, including cold-chain storage, thermal blankets and temperature controlled containers.

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