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Fixing weak links in vaccine supply chain

It’s immunisation morning in 2016, and teams of vaccinators are fanning out across Delta state.

Each local government area is assigned a six-member command centre that includes a local immunisation officer, a coordinator of primary health care, a health educator, a disease surveillance officer and a malaria focal person.

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They are the honchos—to ensure all commodities and materials needed for vaccination have been picked up and stored for use on the said morning.

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Officials meet early and pick up supplies for their teams—vials of measles vaccines packed into in icebox, syringes and needles, cotton wool, methylated spirit. They are the humans in a “supply chain” to get vaccines to millions of Nigeria’s children.

And the consensus is that the supply chain for immunisation is inadequate: the materials, activities, individuals, structures, resources relevant for facilitating effective and safe delivery of vaccines is overwhelmed by an ever-increasing population in need of vaccines.

Attention has turned to supply chain, and the brightest focus on the leaders and managers of the chain. Global courier firm UPS and Gavi (the Vaccine Alliance) have developed a strategic training executive programme (STEP) that is hoped will produced “skilled and competent individuals” to shore up supply chain for immunisation in Nigeria.

National Primary Health Care Development Agency requested Gavi to have STEP implemented in Nigeria.

Chinenye Ekpemauzor, a deputy director at the agency, took the course to know “what leadership is all about”.

“I have gained useful insights on how to become more strategic, efficient and accountable for my actions in my organisation,” she later said.

The Africa Resource Centre for Supply Chain (ARC) advocated for it to impress on authorities the relevance of STEP to decision makers in immunisation.

STEP presents a unique opportunity for countries like Nigeria to develop supply-chain leaders who will advance transformation in effective and efficient immunization delivery, explains Azuka Okeke, regional director for ARC.

“One of the key areas of focus of the STEP training in Nigeria is building strong leaderships at national and state government levels that will drive ownership of health programmes beyond vaccines management,” says Okeke.

Mr. Magloire Achidi, Supply Chain Consultant for Global Alliance for Vaccine and Immunisation (GAVI) and Pharm (Mrs). Azuka Okeke, Regional Director, Africa Resource Centre for Supply Chain (ARC) during the GAI STEP training in Nigeria
Mr. Magloire Achidi, Supply Chain Consultant for Global Alliance for Vaccine and Immunisation (GAVI) and Pharm (Mrs). Azuka Okeke, Regional Director, Africa Resource Centre for Supply Chain (ARC) during the GAVI STEP training in Nigeria

The Gavi-sponsored STEP training isn’t restricted to Nigeria. It is based on an academic framework of professional competencies expected for supply-chain managers. It combines traditional learning with on-the-job training to help supply-chain leaders develop their “problem-solving skills and foster effective team-building approaches,” says Magloire Achidi, supply-chain consultant for Gavi.

Without a desk, recorders on a measles vaccination team in Asaba improvise, a woman turning her back into a desk while a man tallies up the vaccine shots. Photo by Judd-Leonard Okafor

“Leaders bring people together to tap their collective wisdom. When doing so, you must be prepared for differences of opinion and conflict,” says George Bray, vice president for member engagement at the International Federation of Pharmaceutical Wholesalers and one of the sponsors of GAVI’s STEP training.

“Becoming an effective negotiator can reveal new opportunities, sharpen your focus, satisfy your needs and improve your relationships.”

“Leadership is getting the work done through people. A leader sets direction, motivates and builds an inspiring vision, as well as creates something new,” says Kevin Etter, director of public health and safety at UPS.

“Leaders inspire others, possess decision-making capabilities, and should be focused on the vision to inspire others to the overall goal.”

As state immunisation officer in Niger, Dr Samuel Jiya is right at the head of Niger’s immunisation supply chain.

Millions of vials of vaccines shipped into Nigeria’s ports move from national drug stores to regions, and onward to stores in states, further down to local government areas.

They move through local immunisation officers and into the hands of vaccinators. The chain lengthens and broadens as vaccinators make their way across communities nationwide.

“One measure of one’s success is the degree to which one build up others who work with that individual,” says Jiya.

“Team effectiveness happen when there is a clear and compelling purpose, skills that are complementary, and mutual accountability. Everybody in a team is important, and that is why we must sustain team relationship.”

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