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“The future of health care in India critically depends on the development of cold chain.” Elaborate.

By Srirangam Sriram, Sriram's IAS, New Delhi.
The safe delivery of vaccines for mass immunisation against Covid-19 is a massive challenge and India will need to significantly ramp up its cold chain facilities. Unlike drugs, virtually all vaccines need to be transported at cold temperatures, usually between 2 and 8 degrees Celsius. Covid vaccines need to be kept at minus 70 degrees celsius. In the refrigerator, they lose their potency in 24-48 hours.

In 2019, the overall cold storage capacity in India stood at around 37-39 million tonnes — one of the largest in the world. A vast portion of the cold storage available in India is used for agricultural produce and very few are pharmaceutical compliant, according to the World Health Organization guidelines.

A significant number of vaccines provided by the government fall under the traditional cold chain temperature range, stored between 2 -8 degrees Celsius in the cold chain.

Centre’s Universal Immunization Programme (UIP) mechanism is supported by more than 27,000 functional cold chain points of which 750 (3 per cent) are located at the district level and above. The rest are located below the district level. This includes 76,000 cold chain ’equipment’, 2.5 million health workers, and 55,000 cold chain staff.

However, in the cold chain infrastructure to handle vaccines at 2-8 degrees Celsius, minor improvements will be required to improve the last mile. India is in a position to not only augment and strengthen but also add to its cold chain capabilities for vaccines such as Pfizer’s that need to be kept in minus 70 degrees Celsius. This is a constraint especially with large numbers of doses in India running into billions.

Large-scale immunisation will not only require substantial increase in the number of cold-chain points but also equipment such as reefer vans and deep freezers.

Career Guidance 20-50 cold rooms per state will be required to hold the vaccines until they are ready to be transported in refrigerated trucks. Private sector needs to be roped in. IISc is working on a "warm vaccine" that can be stored for over a month at 37 degrees Celsius, and needs no cold chain for storage.
Published date : 21 Nov 2020 12:18PM

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