Episode 07: The logistical challenges of rolling out a COVID-19 vaccine in Africa - Featuring Mohammed Akoojee of Imperial Logistics

January 26, 2021
For the second part of this two-part series on logistics, IFC talks to Imperial Logistics CEO Mohammed Akoojee again to discuss how African nations are planning for the distribution of a COVID-19 vaccine.

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For the second part of this two-part series on logistics, IFC talks to Imperial Logistics CEO Mohammed Akoojee again to discuss how African nations are planning for the distribution of a COVID-19 vaccine. Akoojee dives into some of the considerations and essential factors that go into one of the biggest vaccination campaigns the continent has ever seen, including vaccine scarcity, cold chains and making sure the doses are secure.

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Jasmin Bauomy (host): Remember when people were panic buying toilet paper at the beginning of the pandemic and there were shortages? We've come a long way since then.

News clip: Tensions flared when three women became involved in a toilet paper tussle.

News clip: Customers were waiting up to three hours.

News clip: Why the rush on toilet paper, in particular?

[sound of women fighting]

JB: The ongoing pandemic has really brought logistics into the spotlight. And what started with toilet paper shortages in a lot of Western countries, is now the monumental challenge of distributing COVID- 19 vaccines across the world. And so, today we're talking about how that's being handled in Africa.

You're listening to Creating Markets and I'm your host, Jasmin Bauomy. And if you listened to our last episode, you may just recognize this voice.

Mohammed Akoojee (CEO of Imperial Logistics): I don't think we've seen a vaccination or a logistics challenge where you've got to get product to 40 million people, for example in South Africa, over a short period of time.

JB: This is Mohammed Akoojee. He's the CEO of Imperial Logistics. It's one of the biggest logistics companies in Africa, and the company is based in South Africa. And so, a lot of what Mohammed and I talk about focuses on how it's going there.  But we'll also talk about the bigger picture and the challenges across the continent.

News clip: There is a metaphorical queue, I guess, forming around the world as, as more vaccines are also approved.

News clip: News that a vaccine is near will be welcomed as much in Africa as elsewhere.

Although there await logistical challenges relating to how it is rolled out.

MA: In my mind, a majority of Africa's vaccines will come through an organization like COVAX.

JB: Right. COVAX. I should probably just quickly explain what COVAXis since you'll hear a lot about it in this episode.  And so here's a news piece that really does the job.

News clip: More than 150 nations representing nearly two thirds of the world's population have committed to receiving COVID-19 vaccines through COVAX. Now, the initiative set up by the World Health Organization aims to ensure 2 billion doses of safe, effective, and affordable COVID-19 vaccines by 2021.

MA: There are countries like South Africa that are doing bilateral negotiations with manufacturers to see if over and above the COVAXallocation we can source more than, than what COVAXcan provide.

JB: Imperial is part of a South African task force that's been put together to coordinate vaccine distribution. And so it consists of people from the pharma industry, government representatives, healthcare experts and logistics companies. And they all meet regularly to talk about who will provide the vaccine, who will pay for it and who will deliver it and how that works.

And so, Imperial already has clients in the pharma industry and is also trying to coordinate with them. 

MA: At this stage when we talk to our clients and principals that have already got the vaccines call it registered in many parts of the world, their response is: “We don't have stock for Africa.” So, until we get stock for Africa, there is no role to play for us with the manufacturers directly.

JB: And even though African nations are in the middle of coming up with solutions, sometimes it just can all get a little bit frustrating to think of all the challenges.

MA: Absolutely. It gets frustrating because everybody is in panic mode and everybody wants the vaccine yesterday. But I think at the end of the day, you have to be solution-driven in these kinds of discussions.

One of the frustrating things for me is also, if you take a lot of the Western world, like America and Canada and Europe, and even some other parts of the world, they've bought a lot more doses than they need for the population of their countries.

They've got the money to pay for that upfront. So, what happens is they then secure that supply by paying upfront and the manufacturers then are obliged to deliver that first.And that's where Africa tends to be at the back of the queue.

And that is a frustration because if those countries could say: “No. Let us for the next six months just buy enough for what we need,” these manufacturers could then have capacity to provide product for markets like Africa.

JB: So, let's look at some of the factors that are going into organizing the distribution of a vaccine. And the first factor is: keeping up with the cold chain, which isn't always an easy feat in many African countries, considering that there's just not always electricity.

And we're not even talking about the Pfizer-BioNTech vaccine that people are using right now because, well, just to remind you, it has to be stored at minus 70 degrees.

And so for many African countries, that’s just almost out of the question. But 2 to 8 degrees- now, that seems possible, at least in those countries where Imperial has access to points of sale.

MA: We've got enough capacity in our supply chain for 2-to-8-degree storage.

Now, we do take product into six, six and a half thousand points of sale. For example, in South Africa, through our distribution network in the healthcare space. But we don't go there every day.

Now, if the requirement is you have to take the vaccines there every day, you would have to probably invest in some form of transport fleet or more capacity in terms of maintaining the cold chain.

JB: You know, what would make a big difference is if a vaccine was actually produced on the African continent. And it would make the supply chain just so much easier to handle, and there is still hope that it may happen that way.

MA: So, the one that's being manufactured in South Africa has still got to go through the necessary testing.  Once that gets approved, then the product can be manufactured here.

But this first batch of one and a half million that's being bought by government is being imported from India through a company called Serum Institute, which is manufacturing it on behalf of AstraZeneca.

So, what that means is that that product will have to be imported. And then that product has to be warehoused and then distributed - so this first one and a half million doses is going purely to vaccinate healthcare workers. So, it will go mainly to hospitals and clinics.

Similar to Europe, there's been vaccination centers that have been set up. You can use pharmacies to be points of vaccination. Because at the end of the day, all you need is a nurse and you need a fridge to be able to keep the product temperature controlled.

I think in terms of our network, within our healthcare distribution channel, we get to like, I said, six to six and a half thousand points of sale. And we will offer that network to our clients, as well as to government, to use those points of sale or points of distribution to get the vaccine rolled out because our vehicles are going there anyway. Those areas would be places where you could put a fridge and a nurse and be able to vaccinate people.

JB:  It looks like there are some really good options for points of distribution for the vaccine. But there's a personnel challenge that needs to be met as well. For example, if we look at how many nurses there are in Sub-Saharan Africa, World Bank data shows that there's roughly one nurse for every 1,000 people.

MA: The big challenge is going to be nurses and healthcare workers, because there's currently a shortage in the system because a lot of our healthcare workers have been infected.

Where do you get so many people to give the vaccine?  You need to then think about staffing that network.

But if you use areas like pharmacies, for example, to do that, lots of pharmacies in South Africa and all around the world, would have facilities to vaccinate people and we would leverage that kind of network.

JB: Other than maintaining the cold chain and getting the vaccine to where it needs to be, logistics companies need to think of keeping those doses stored securely.

MA: So, I think the security of the supply chain is going to be very important. And making sure that there's proper management of the process in terms of vaccines not getting stolen or lost in the system, that it's properly recorded. All eyes will be on whoever does this process with the government. So, the monitoring and the process administration of this is going to be critical. And that's where a big part of the cost is.

JB: Mohammed is based in South Africa and Imperial's company headquarters are there, too. But since the company has positioned itself as a gateway to Africa, it'll be able to distribute the vaccine to several countries across the continent.

MA: Look at this stage, we're focusing on the countries where we have got local in-country distribution capabilities on healthcare. And those would be South Africa, Nigeria, Kenya, Ghana - where we've got physical infrastructure to be able to deal with it.  And there's enough to do within those countries first, before we start looking at taking on too much.

Because when you start distributing in those other markets, you'd have to use partners to do that. And then with a product like a vaccine, in terms of the cold chain, will it be met with a partner? You're sort of outsourcing that responsibility to somebody else.

JB: Now, some may think that there are other businesses reliant on cold chains, right? Like produce for example. And so maybe some people are wondering why can't vaccine distributors make use of these existing cold chains?

MA: You can't do the distribution of a vaccine out of a consumer warehouse facility. You have to do it out of a properly approved healthcare facility.

Because there are lots of cold chain type distribution businesses in our countries, but they will be distributing things you would find in a supermarket. But you can't put a vaccine in those storage facilities. It won't qualify. You won't be allowed to.

Any healthcare product has to be regulated in terms of how it's stored and where it's stored.

JB: You know, I just find it astonishing how complicated this entire process is. In fact, this vaccination campaign is expected to be among the largest in the continent's history. And just to give you a little bit of context, the first one was the campaign to eradicate polio, and that took around 9 billion oral vaccines that were distributed- and this is what matters -across 24 years.

And also, one can't ignore that the pandemic has accelerated certain trends in a wide range of industries. And it's no different in logistics.

MA: It's already changed the business. It's changed the industry from many respects. The bad of it is many logistics companies have, and will continue finding it very difficult to operate.  

But the impact of COVID on supply chains, the impact of COVID on how people, on how clients would source product, how our clients will want to understand their supply chains in terms of visibility and resilience, that has changed already.

But I think if ever there was a time to be in logistics it's now, because you can actually think about your business with a white piece of paper in terms of reinventing your business model, reinventing yourself and being in Africa. That even creates more opportunity with that kind of change.

JB: And here just a quick update to bring you up to speed: As the time of recording this, nearly 150 million doses of the AstraZeneca/Oxford vaccine candidate could be available by the end of March, pending the World Health Organization’s emergency use listings. How that will affect vaccine availability and distribution in Africa remains to be seen.

And that's it for this episode of Creating Markets. Thank you so much for listening. And if you enjoyed this episode, please feel free to share it with your friends and family and post it on social media.

IFC has actually recently launched a campaign on investment opportunities in logistics. And temperature-controlled logistics are more important than ever now in the transportation of COVID-19 vaccines. And I'll link some information below.

And many, many thanks again to Mohammed Akoojee and Imperial Logistics for taking the time to talk. This show is produced by the IFC comms team.  And this episode was sound edited by Nicholas Alexander and hosted by me, Jasmin Bauomy. And I'll talk to you again soon.