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The Livestock Vaccine Supply Chain: Why It Matters and How It Can Help

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The Livestock Vaccine Supply Chain: Why It Matters and How It Can Help Vaccine 37 (2019) 6285–6290 Contents lists available at ScienceDirect Vaccine journal homepage: www.elsevier.com/locate/vaccine Review The livestock vaccine supply chain: Why it matters and how it can help eradicate peste des petits Ruminants, based on findings in Karamoja, Uganda ⇑ Daniel Acosta a, , Saskia Hendrickx b, Sarah McKune c a Feed the Future Innovation Lab for Livestock Systems, Department of Animal Sciences, Institute of Food and Agricultural Sciences, University of Florida, Gainesville, FL, USA b Feed the Future Innovation Lab for Livestock Systems and Department of Animal Sciences, Institute of Food and Agricultural Sciences, University of Florida, Gainesville, FL, USA c Feed the Future Innovation Lab for Livestock Systems,Department of Environmental and Global Health, and the Center for African Studies, University of Florida, Gainesville, FL, USA article info abstract Article history: Understanding factors that hinder vaccination, including logistical and social constraints, is critical to Received 22 May 2019 finding the most effective approach for the global eradication of peste des petits ruminants (PPR). Received in revised form 3 September 2019 Vaccination projects should analyze the supply chain and take it into consideration when planning Accepted 4 September 2019 and creating a vaccination strategy. Adequate supply chain management of the PPR vaccine could lead Available online 13 September 2019 to reduced cost, increased availability, and the construction of a data platform for other livestock vac- cines. Integrating the supply chain of PPR vaccine with other veterinary or health commodities could Keywords: reduce cost, as well as increase uptake. The use of a thermostable vaccine could potentially have a pos- Livestock vaccine itive impact on the eradication of PPR in remote areas, such as the Karamoja subregion in Uganda, as it PPR Peste des petits ruminants did with rinderpest across Sub Saharan Africa. In terms of vaccine delivery, the use of community animal Supply Chain health workers (CAHWs) could be beneficial in certain areas, such as the Karamoja subregion of Uganda, Logistics by alleviating supply chain constraints in the last-mile delivery, as well as increasing coverage and Karamoja uptake. A gendered approach to livestock vaccines should also be considered, as decision-making power One Health regarding livestock vaccination is gendered in many various contexts. The PPR eradication strategy—as Gender well as other livestock vaccination programs—would be more effective and efficient if the supply chain Vaccine Distribution management were considered as a key component in the process and efforts tailored, accordingly. Ó 2019 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Contents 1. Introduction . ..................................................................................................... 6285 2. Methods . ..................................................................................................... 6286 3. Results. ..................................................................................................... 6286 4. Discussion. ..................................................................................................... 6288 5. Conclusion . ..................................................................................................... 6289 Declaration of Competing Interest . .................................................................................. 6290 Acknowledgements . .................................................................................. 6290 Conflicts of Interest . .................................................................................. 6290 Ethical Approval and Informed Consent.................................................................................. 6290 References . ..................................................................................................... 6290 1. Introduction Only two diseases have been eradicated worldwide, and those are smallpox in humans (1980) and rinderpest in livestock ⇑ Corresponding author. (2011). The eradication program of rinderpest marked the end of E-mail address: daniel.acosta@ufl.edu (D. Acosta). https://doi.org/10.1016/j.vaccine.2019.09.011 0264-410X/Ó 2019 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). 6286 D. Acosta et al. / Vaccine 37 (2019) 6285–6290 devastating cattle pandemics, which affected both cattle and remaining 49, all were meaningful in conceptualizing and develop- humans, whose livelihoods were dependent upon livestock. One ing this review. Eleven of those were not cited directly, however of the biggest challenges for the eradication of the rinderpest virus informed and reinforced messaged conveyed here. was its entrenchment in pastoral areas of the Horn of Africa where For the participatory methods, fourteen interviews were con- conventional control methods met additional challenges, including ducted with: district veterinary officers, storage managers, veteri- extremely poor infrastructure, lack of security, and weak gover- nary drug shop owners, logistic specialists from NGO’s operating nance [1,2]. in the region, lab technicians, and staff from the Ministry of Agri- The United Nations Food and Agriculture Organization (FAO) culture, Animal Industries and Fisheries (MAAIF). Sixteen focus and the World Organization for Animal Health (OIE) are currently group discussions (FGDs) where conducted with Community Ani- leading a global effort to eradicate another animal disease: peste mal Health Workers (CAHWs) and livestock owners. Assessments des petits ruminants (PPR) [3]. PPR is a disease of sheep and goats in the form of physical inspections were conducted in Uganda that has devastating impacts on small ruminant populations in (Kotido District, Amudat District, Kaabong District, Moroto District, Africa and Asia, with serious consequences on livelihoods. PPR is Kampala, and Entebbe). The objective of the semi-structured inter- caused by a morbillivirus in the family of paramyxoviruses, which views varied depending on the group interviewed. In the case of is related to rinderpest and measles in humans. Because of this CAHW’s, the focus was placed on the process of livestock vaccina- relationship, it is possible that some historic vaccination strategies tion and treatment in general, more concisely: working conditions, for these diseases may have relevance to the eradication of PPR [3]. lead times between storage facilities, incentives, and constraints. The experience of other vaccination programs and strategies must For livestock keepers: knowledge of vaccines, willingness to pay also be reviewed, as they may have faced similar challenges and be for vaccines (WTP), access to vaccines, and perception of the work positioned to provide insights and tools to advance PPR eradication being done by CAHWs. Selection of participants in FGDs of CAHWs efforts. One of the main challenges for vaccination programs in was done with previous consultation with the DVO in each district remote areas is the logistical challenge of distributing vaccines, to assess which of the CAHWs where still active. Participants of all but this is by no means their only challenge. Cultural and social FGDs where asked to participate and sign a consent if they agreed challenges may create comparable, if not greater, barriers to the to participate in the nature of the study. Other stakeholders where eradication efforts of PPR. Successful vaccination programs rely interviewed to assess their involvement and estimate the cost and heavily on the supply chain. Historically, logistical challenges have lead times in every level of the supply chain. Data was collected by been identified as the cause of low vaccination coverage in various the lead author with the assistance of translators when needed, efforts [2,4–8]. A well-designed supply chain can have a positive throughout June-August 2018. The table below summarizes the impact on vaccination efforts via reduced costs and improved cov- data collection methodology, and the map shows the studied dis- erage. Despite its seemingly essential nature to vaccination tricts (see Fig. 1 and Table 1). endeavors, the World Health Organization (WHO) states that the supply chain for human vaccines is often neglected [7], which is also the case for livestock vaccines based on results from this 3. Results study. The objective of this research is to underscore the impor- tance of the supply chain of the PPR thermostable vaccine, based Through interviews and assessments with DVOs, storage man- on the literature and findings on the study in the subregion of Kar- agers, and veterinary drug shop owners in the livestock vaccine amoja, Uganda. supply chain of Karamoja, several challenges where identified, such as: poor infrastructure, inadequate cold-chain capacity, infor- mation scarcity, and insufficient funding. This is congruent with 2. Methods literature that describes many places in sub-Saharan Africa still facing these challenges [7,9,10]. Out of the four districts studied Information presented here was obtained through a review of in Karamoja, only one met the criteria of necessary and appropriate literature and an observational study utilizing participatory field equipment for safe storage of vaccines in the cold chain. Lack of methods in the Karamoja
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