Health check: Insight into cargo’s developments in the Covid-19 vaccine distribution process

In two previous articles, Airline Cargo Management looked at how the air cargo sector has prepared for the “challenge of a lifetime” in transporting Covid-19 vaccines across the world, and detailed some success stories. Here, Jason Holland assesses the latest developments in the vaccine distribution process, with a broader look at how the unprecedented collaboration and innovative procedures introduced will impact the wider pharmaceuticals and healthcare cargo sector in the future.

This piece first appeared in the Summer issue of Airline Cargo Management, you can read the full magazine here. 

The air cargo industry has been preparing for Covid-19 vaccine distribution for about 12 months, “ever since the World Health Organization (WHO) officially declared the crisis a pandemic”, says Glyn Hughes, director general of The International Air Cargo Association (TIACA).

TIACA and Pharma.Aero joined together to form a task force called ‘Project Sunrays’, which earlier this year published a series of best practices and key considerations to enhance the industry’s preparedness. Hughes notes that, even though Covid-19 vaccine distribution has now been operational for the past few months, only about 15 per cent of the global population has received at least one shot, according to OurWorldInData.org figures, “and much of that has been nationally developed and distributed”. 

Therefore, the bulk of the global distribution – particularly to the least developed countries with more challenging infrastructure – has yet to occur, he says. “So it’s fair to say the most significant operational challenges lie ahead, particularly with the reduced number of passenger flights. Capacity challenges and reduced global networks will be obstacles to overcome.”

It is also fair to say that the progress already made by the air cargo industry will enable better decisions to be made when it comes to meeting these challenges.

“At an industry level, first it is important to highlight we have responded very well to the challenge [of vaccine distribution], both in terms of quality and speed,” says Cristina Oñate, VP of marketing and product development at LATAM Cargo. “Second, we have seen steady growth in terms of volumes. Third, information has improved: at the beginning data was highly unpredictable and that made execution very complex. 

“Having those communication channels pre-established with the different core players of the pharma supply chain has been key in obtaining the best information available each day in order to offer and deliver the best solution for each shipment.”

As the world begins to open up again, and concern about Covid-19 recedes, supply is becoming less of an issue for moving vaccines around, according to Peli BioThermal’s Adam Tetz. “As more passengers fly, there are more aircraft for use of transport on the lower deck,” he says. “This increases capacity, which is helpful, as there are more vaccines to transport around the world.”

FedEx Express’ senior vice president, international commercial services Grant Cochrane rates Covid-19 vaccine transportation as being “among the most important work in the history” of the company. He says: “We see it as our purpose and responsibility to use our network and expertise during this time of global need. 

“We want to get Covid-19 vaccines into the market to help save lives, keep small businesses open, help schools reopen. With borders and economies opening back up, there is an opportunity to offer a path to normalcy all around the globe.”

Remaining flexible has been key for companies in transporting the vaccines, notes John Cheetham, chief commercial officer at IAG Cargo. “Many of our regular shipments of the Covid-19 vaccines now tend to be in smaller amounts,” he explains. “As such we make sure to transport these as and when they arrive, so they can get to the necessary destinations as quickly as possible. 

“We always ensure that capacity is made available, and our in-house expertise of managing vaccine transportation means we are well equipped to continue supporting these vital shipments as long as is needed.”

Volga-Dnepr Group’s global director healthcare Yulia Celetaria says lessons are being learned with every vaccine shipment. “The basics are that airport and ground handling facilities are to be better equipped, especially when it comes to temperature facilities with -20°C settings,” she says. Echoing Cheetham, Celetaria says experience has shown that “it is better to plan smaller batches of vaccines to guarantee a stable and smooth handling process”.

Looking at next steps, she says the industry is talking about how to introduce standard operating procedures for Covid-19 vaccines “which will sum up all existing vaccine handling procedures and will embrace IATA CEIV and GDP best practices, IATA vaccine guidelines and other related documents”.

Andreas Seitz, CEO of aircraft equipment solutions company DoKaSch, says that even though the “massive transport challenge” of vaccine delivery has not materialised to the extent envisioned by many, he expects more vaccine transports in the second half of 2021. That’s because COVAX – a worldwide initiative co-led by Gavi, the Coalition for Epidemic Preparedness Innovations (CEPI) and the WHO that aims to offer equitable access to Covid-19 vaccines – ramps up. “Since structurally weak countries in particular have no production capabilities, imports via air cargo are the best way,” he explains. “We are prepared to do our part.”

DHL Global Forwarding’s CEO David Goldberg agrees that today’s most prominent challenge will be successfully distributing these vaccines to different corners of the world. “We have seen time and time again that cooperation and partnership is key,” he states. Barriers for each country must be understood, and plans put in place “to source the necessary final mile transportation and temperature controlled-compliance”.

While recognising the work COVAX is doing, Miami-Dade Aviation Department’s manager aviation trade & logistics Emir Pineda points out “that a lot more needs to get done to make sure vaccines are transported to some of the hardest to reach places on the planet”. 

Pineda says that once the majority of the US population is vaccinated “in the near future”, the US government will begin exporting vaccines to the Caribbean and Latin America in large quantities. Once this happens the volumes of vaccines being shipped from and through Miami International Airport, as a gateway to the region, will “increase dramatically”.  

“Currently, the forwarding community is soliciting RFPs [request for proposals] from the airlines to reserve capacity for vaccine distribution,” he says. “Most experts believe it will take approximately 2-3 years to inoculate the entire planet.”

LATAM Cargo’s Oñate foresees a scenario in the coming months in which some current vaccines will finish arriving in South American countries “and some new brands will start being delivered by the pharmaceutical companies, as per their agreements”. This will mean collaborating with other companies – pharmaceutical companies, freight forwarders, pharma packaging or container providers. “Based on our experience, we believe that offering 24/7 communication and transparency as well as maximum flexibility to adapt if the terms change last minute are the keys for the success of that cooperation,” she says.

Peli BioThermal’s Tetz says logistics chains have adapted – and will continue to adapt – to hot spot outbreaks of Covid-19 worldwide, where there is a need to ship large volumes into specific regions. “This unbalanced nature of demand, based on varying regional infection rates, forces logistics systems that ship the vaccines and therapies to be continually flexible,” he says. “Constantly modifying these logistics chains requires nimbleness in people, processes and material and is opposite to how logistics systems work most efficiently, and most affordably, which is an expected, steady flow from points of origin to destination.”

He expects a “rapid reaction force” from points of origin of the manufacture of the vaccines and therapies to develop. “A dedicated set of resources such as expert teams with a fleet of supporting transport vehicles and temperature-controlled shippers will support a region with an outbreak of Covid-19,” he says. 

This will enable the quick delivery of “a huge volume of needed Covid-19 vaccines, therapies and supporting supplies to a country with an infection rate that would overwhelm the local healthcare systems without outside help”. 

Assessing air cargo’s contribution to vaccine transportation as a whole, Etihad Cargo’s manager global cool chain solutions Fabrice Panza notes that while it is difficult to accurately calculate the combined number of vaccines shipped by air to date, “air cargo will account for around 40 to 50 per cent of the six to eight billion forecasted to be produced this year. There are strong indications that there will be a very high volume of vaccines being shipped during the last quarter of 2021.”

Raised profile

Besides the continuation of the Covid-19 vaccine transportation programme, the air cargo industry will also need to keep transporting related medicines and equipment. Volga-Dnepr Group’s Celetaria still sees a huge demand for such cargo. “With localisation of production there has been a demand for filling line and respective equipment which could boost production rate locally,” she says. “Resurgence of the pandemic in various countries triggers demand for PPE, test kits, oxygen tanks and concentrators, vials, etc. which are also treated as humanitarian cargo and are processed accordingly.”

What about the wider transport of pharmaceuticals and healthcare products, both today and in the future? Can the lessons learned so far from Covid-19 operations be translated into this broader sector?

Celetaria estimates that the healthcare industry will need air freight as a vital logistics provider until at least 2024 in terms of “regular medical shipments, urgent deliveries associated with another Covid-19 resurgence, humanitarian missions or vaccine transportations”. 

She adds: “To avoid any supply chain disruptions, better capacity planning and forecasting will be required due to the slower passenger flights resuming. Following the digitalisation path, transparency and end-to-end track and trace of the supply chain will become one of the focal points of healthcare logistics. That will require a better collaboration between shippers, freights forwarders, airports, suppliers and airlines, with sophisticated IT tools which reinforce the efforts and provide the right grounding.”

IAG Cargo’s Cheetham says the pandemic has highlighted “just how important air cargo is and everyone’s dependence on it to transport key medical supplies at speed at a time of fast change for people and communities”. 

Even once the pandemic subsides, he expects there to be high demand for pharma and medical related air cargo transportation as the “unparalleled benefits” that air cargo provides will remain – speed, efficiency and flexibility. 

“With Covid-19 in mind specifically, it’s likely that there will be a sustained demand for testing kits and increased demand for antivirals – specifically new innovative treatments in addition to other therapeutical treatments,” he says. “We expect international collaborations for medicine equity and other humanitarian and health crises over the longer term to continue – such as the UNICEF Humanitarian Airfreight Initiative, which we joined earlier this year.”

DHL Global Forwarding’s Goldberg says Covid-19 has been a catalyst for change in the sector. “The logistics and healthcare industries will have to continue to be extremely flexible and fast,” he says. “More active supply chain risk management processes are important post-pandemic and exploring alternative logistics and delivery routes, new technologies and innovations within both industries is also crucial. 

“Digitalisation and the need to adapt to new technologies that will increase productivity, transparency and resilience, as well as leveraging partnership, is also important. We cannot live in a silo and, as we’ve seen, no single logistics provider or life sciences and healthcare company can fulfil the task for distributing vaccines globally alone. Working together, along with NGOs and governments is key, and will continue to be as new medicines are rolled out.” Covid-19 vaccine transportation has elevated pharma standards in the industry, agrees LATAM Cargo’s Oñate. “In order to prepare for a much larger volume than usual in a very short period of time, airlines had to ensure that their assets, tools and processes were scalable and robust. We see in the industry that these enhanced pharma solutions will become the new norm.”

Miami-Dade’s Pineda believes air cargo has taken on a “higher profile” during the pandemic, and this could lead to more investment and development, which will in turn provide greater efficiencies and lower cost to transport pharma in the future. “The importance of pharma programmes such as IATA’s CEIV and European Union’s GDP will make it easier for more companies to justify the cost of the certification of these programmes and lowering the cost of temperature related losses,” he says. “This will lead to more pharma product moving by air than ever before under a global certification process, by qualified staff providing quality products at a competitive cost.”

Peli BioThermal’s Tetz thinks the move to more fuel-efficient planes during the pandemic, as larger, inefficient planes were grounded, will also impact future operations. “Air cargo worldwide will be more efficient for smaller loads, meaning that air cargo of life sciences materials and temperature protection of them will be pushed further around the world,” he says. “Large volume shipments will be sent on several efficient planes, rather than on just a few jumbo jets.”

Digital future

The transportation of Covid-19 vaccines has already led, and will continue to lead, to new innovations and the introduction of new technologies. Visibility is one area of the pharma and healthcare sector that will come increasingly into focus, according to LATAM Cargo’s Oñate, with demand for more and better information about products. “In order to improve the gathering of this information, making it more efficient and available online in real time, different technologies are being developed and implemented. 

“From smart RFID tags to wireless track and trace data loggers, these different technologies are being implemented to provide a complete track and trace of the complete logistics chain – from production to end consumer,” she says. “These new technologies not only track the location of the shipment, but also its temperature and humidity; they allow for the set-up of alerts, which can help reduce possible temperature excursion by creating a proactive monitoring system.”

The information about the package is as important as the package itself as it moves through the transportation network, says FedEx Express’ Cochrane. The company uses monitoring technology called ‘SenseAware’ and a priority alert service to track vaccine shipments as they move through its network. “We have dedicated customer support agents who are monitoring vaccine shipments, ready to intervene if delays caused by issues such as weather, traffic congestion or customs clearance threaten delivery times,” he reports. 

“We have developed sensor-based monitoring technology and other advanced monitoring services that can help medical communities and authorities ensure critical shipments reach their destinations safely.”

This technology is being complemented by FedEx’s ‘Surround’ platform – a collaboration with Microsoft that launched in May 2020 and which leverages artificial intelligence and predictive tools to proactively monitor conditions surrounding the packages.

Technology is also driving enhancements in pharma packaging solutions, from passive to active. “These improvements aim to provide a more robust and more protected cold chain,” explains Oñate. “Some of them are new and improved isolation panels, better autonomy, more sustainable solutions that reduce CO² emissions and solutions that can be reutilised and refurbished. From the airline perspective, it is important to learn to manipulate and transport all these different options to be able to always offer our clients the best alternatives for their valuable shipment.”

Peli BioThermal’s Tetz expects to see more tracking of location and temperature by pallet, or even individual parcel “in order to create efficient shipping lanes by diagnosing and resolving problems along existing shipping lanes. This will lead to a decrease in loss of life sciences materials due to protecting temperature control throughout the entire lane.”

Etihad Cargo’s Panza says digital solutions have been a “vital driver” in the company’s response to the pandemic. “We have seen an important increase of our online bookings, as well as more active tracking devices being qualified. We continue to work with partners to implement tools to track the physical flows in real-time and share this data directly with our clients.”

DHL Global Forwarding’s Goldberg sees other new technologies and emerging trends as being robotics, AI and 3D printing – with each expected to have a huge impact on the healthcare sector and wider air cargo industry. “With the spread of Covid-19, we experienced an increasing demand for digital solutions from our customers and partners – specifically from our life sciences and healthcare customers,” he says. “We have become more resilient and flexible, and are adapting and accelerating new technologies quickly. This is vital for any business, especially the freight forwarding one. As a business we have to liaise with our customers about our digitalisation efforts, and encourage them to implement them.”

Data analytics will also continue to be “extremely important to improve processes, provide greater visibility for our customers and give us the insight to continue to be flexible and nimble for future growth and success”. Data analytics also plays a big role in risk management when it comes to temperature-controlled shipments. Goldberg explains: “Risk management solutions will enable the pharma industry to turn supply chain disruption and global environmental and socio-political volatility into competitive advantage by providing them with  a holistic, end-to-end view of their supply chains and real-time risk visibility.” 

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