EtC

In 2010 Bill and Melinda Gates proposed to make this the "Decade of Vaccines" by committing $10 billion to the research, development and distribution of life saving immunizations.

Energize the Chain (EtC), a not-for-profit organization was founded in the same year, following what turned out to be a very widely read opinion piece that was published in the 18, September 2010 issue of the New Scientist. EtC strives to ensure the equitable and sustainable distribution of vaccines to the most remote parts of the world by securing the integrity of the vaccination cold chain and solving the "last mile" delivery problem. In the developing world, the vaccination cold chain is too frequently compromised by power outages and interruptions in the electrical grid. Energize the Chain offers an innovative solution: co-locating vaccine refrigerators with cell tower sites.

Access to cell phones and service is nearing global omnipresence. While there is often no other reliable source of uninterrupted electricity supply present in rural parts of the developing world, cell towers stand tall and active on the horizon, and their operators and suppliers are incentivized to maintain constant power at all times. Energize the Chain recognizes the valuable potential of this energy resource for both public health transformation and economic advantage for cell tower operators. This is a progress report on the activities, successes and challenges we have experienced over the past year.

Rapid progress was made in implementing this innovative cold chain strategy after Energize the Chain presented its strategy to a receptive audience of cell tower operators and suppliers at the GSMA Green Power for Mobile Conference in Mombasa, Kenya in March 2011. We developed a very close working relationship with Econet Wireless, the major cell tower operator in Zimbabwe. Thanks to the commitment of Econet Wireless engineers and managers we now have 10 fully operational pilot sites in Chikombedzi district, Zimbabwe. These sites operate using True Energy refrigerators and remote monitoring units. We also recently received two new grants, one from the Rockefeller Foundation to begin work in the Ganjam Disrict of Orissa, India, and another from the Hague Institue for Global Justice for a feasibility study to develop a governance structure for infectious disease. At all stages of our planning we have greatly benefited from discussions with the incredibly knowledgeable cold chain experts at UNICEF.

We are at a unique place in history where 1) the advancements in cell tower technology have driven down power needs at the tower sites and enabled tower companies to complement power grid inefficiencies with solar, diesel and battery backup power, 2) innovations in refrigeration technology in compressive refrigerators as well as ice-lined refrigerators make it possible for us to house them at the same facilities without overhauling the structural requirements of existing facilities and 3) new vaccines are on the horizon that will put an even greater stress on the capacity of cold chain.

We have learned a number of valuable lessons over the past year:

Our operational plans have to integrate technology, health, business and most importantly human relations. Key stakeholders—the cell tower companies, nonprofit organizations in health and development, foundations and governmental health organizations have to collectively recognize and solve the risks and benefits of the Energize the Chain model. Securing the telecom partners is of critical importance and is frequently more challenging than engaging the health partner. Due to the unique nature of each country's cold chain, immunization program and telecom operations, expansion of EtC's strategy requires a country-specific assessment and pilot study. This is a 1-2 year process. Obtaining accurate spatial data using Geographical Information Systems (GIS) mapping of cell tower and health clinic locations and access roads is crucial and continues to be a challenge. We had to recognize that the central principle is to extend and enhance immunization capacity, and not to replace successful existing delivery structures. By either using existing methods or developing more advanced techniques, the monitoring and tracking of our sites is a major component of our model. Energize the Chain provides the opportunity to work with telecom and health system workers to leverage the information systems to improve vaccination systems, such as monitoring refrigerator temperature and function, or managing immunization records. Have Your Say Rate this feature and give us your feedback in the comments section below

EtC

Rerouting Power. Reshaping Health

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