With COVID vaccine programs now underway in the US and the UK, the question of how to ensure equitable and efficient distribution around with the world is vitally important. That’s the focus of a new collaboration between Gavi (Global Alliance for Vaccines and Immunisation) and Salesforce to help manage critical data needed to meet an ambitious goal of getting 2 billion vaccines to 190 countries by the end of 2021.
Created in 2000, Gavi is an alliance of partnerships tapping into both public and private sector bodies, including the World Health Organization (WHO), UNICEF, the World Bank and the Bill & Melinda Gates Foundation. In June, Gavi launched COVAX, a global alliance to ensure that people everywhere can get access to COVID-19 vaccines, regardless of the wealth or otherwise of the country they live in.
COVAX is intended to support the research, development and manufacturing of vaccines as well as negotiating pricing and distribution for the 190 countries that have joined the alliance to date. To achieve its aims, it needs access to consistent and reliable data - a so-called single source of truth - to keep on top of supply and demand challenges. Salesforce will supply its Work.com for Vaccines, Experience Cloud and Non-profit Cloud offerings to underpin Gavi’s COVAX country engagement platform which will be managing the critical information needed.
Work.com for Vaccines is the latest iteration of Salesforce’s ‘back to work’ offering launched earlier this year. It includes tools for vaccine inventory management, appointment scheduling, vaccine outcome monitoring and public health notifications and outreach, as well as a public health command center with a single dashboard that displays vaccine management data, such as current vaccine and medical product inventory levels, as well as predicting future vaccine needs.
The use of tech to provide reliable data is going to be critical in the vaccine rollout, says Dr. Ashwini Zenooz, Chief Medical Officer at Salesforce. Having joined the firm in this new role around two years ago, with a brief to bring clinical and health admin experience to bear on the tech development process internally, the events of this year have seen her remit expand considerably:
I've been able to partner with other other leaders within the company and collaborate with governments and other organizations, non-profits, companies, etc, to bring my clinical and public health knowledge and skill set, particularly back to this company so that we can make scalable impact, not only [in tems of] the technology to help fight this pandemic, but how we support our own employees during this time.
The commencement of vaccine programs in the US and UK is a big moment, she says, but there’s a long journey ahead with some significant challenges to come:
This is a historic mobilisation effort that we have not seen [before] in public health. We are talking about delivering billions of doses around the world. Just in the United States, we have 21 million healthcare workers and while a lot of planning has been underway to sort out the complex logistics, the partnerships, the ultra cold storage, this is going to be a tough effort.
This would not be possible without public/private collaboration to solve not only the treatment, but now the vaccines at this scale, so we need continued transparency and collaboration and not working in silos. This is not a one-and-done. This is going to go on for a few years, so we need to be able to collaborate.
Without mentioning the anti-vax movement specifically, Zenooz also cites major communications obstacles to overcome what she terms “vaccine hesitancy”:
We need to ensure that there's clear, transparent and truthful communication, so that we have the appropriate updates, not only within the front lines, but beyond that into our communities globally. I think it's our responsibility to provide these facts, including the science of this. There are some unique things about this particular vaccine compared to the others that we've had in the past. We need to explain how did we get these scientific answers so quickly? How are there so many more people involved in these trials? And how did we get them out so fast? And what are the things that we don't yet understand about this? I think it is very justified scepticism on these clinical trials and the new vaccines and we need to be able to have clear communication channels for these. I think it's an obstacle to not only distributing, but getting people to take this if we if we don't do that.
And that obstacle is one that has global reach and implications, she adds, which is where the new tie-up with Gavi comes into focus:
We can't end this pandemic if we don't have a global strategy and so we need equitable distribution. Given that we are a global economy, we need to have a global strategy. We've all heard some of the comments that have been out in the news around the UN Secretary General, for example, being concerned around vaccine nationalism. We need to be aware that people in many people in low income countries might have to wait until 2023 or 2024 for the vaccines. Or we've heard about poor countries, where only one in 10 people may get vaccination this year. These are all things that we have to take into account. We can't have a siloed strategy. I am in a technology company. I would say that technology is a key component to help navigate this complexity with some with great agility.
That’s a point of view that will sit well with Samira Asma, Assistant Director General, Data, Analytics and Delivery for Impact at the World Health Organization, who says:
Well-functioning metadata systems are extremely important for continuously monitoring vaccinations throughout the COVID vaccination program so that we can all collectively make the measurable impact in the lives of people that we are serving. It's important also to establish standard procedures for monitoring our various critical program planning and implementation elements, including performance targets, resourcing, staffing and various activities. It is going to be very crucial in terms of vaccine distribution, modelling, analysis and providing that flexible and real time process so that we can make data-driven decisions.
This is where the COVAX Accelerator program comes in, co-created by WHO, Gavi and CEPI (Coalition for Epidemic Preparedness Innovations) earlier in the year and which now has around 90% of the world's population signed on. Asma explains:
There has never been such a solidarity experience with the intent that there is an equitable distribution and access to all people everywhere. So keeping that in mind and as the vaccines are rolled out, it is important to ensure that we have a system that is well-functioning in each country. We know that there are data challenges and it is a formidable challenge to build on the existing infrastructure that is variable across countries. What we have done at WHO is set up monitoring and vaccination introduction, status and indicators and targets in terms of which phases the countries need to roll out the vaccines. We are working very closely with our regional offices and member states to ensure the tracking systematic tracking as the vaccines are rolled out.
Currently, we are building a set of monitoring frameworks as to what data needs to be shared and building on the existing vaccination programs in terms of having routine information on age and sex, making sure that the data is disaggregated, not only at national, but also at sub-national level. We are now developing the indicators and a monitoring and evaluation framework in terms of the whole data ecosystem and architecture. And there is already within the COVAX Accelerator, an agreement and understanding in terms of sharing of tools and technologies.
As the vaccines are rolled out, information systems are going to be crucial to see where the gaps are and where the deployment should occur and how we can overcome the roadblocks that countries would face. Without real-time, reliable, actionable data, it will not be easy for us. So investing simultaneously in strengthening countries data and Health Information Systems capacity is going to be very crucial. We have seen with COVID that there are significant data gaps in a number of countries, even [around] reporting the cases and the deaths. So there are two parts going hand in hand - strengthening the data systems as well as ensuring the roll out is equitable, and simultaneously strengthening the country's capacity.
After the events of 2020, it’s heartening that the year ends with the ‘light at the end of the tunnel’ routinely promised by politicians everywhere actually turning into practical possibility. But as Zenooz and Asma make clear, it’s not a case of ‘in one bound we are free’. For all the talk of new normals - whatever the hell that’s supposed to mean anyway - there’s a long road to travel yet. The innovation of the tech sector has done a lot to keep things up-and-running this year as we’ve moved into a world of remote working, remote shopping, remote socializing, remote everything. It now faces its most important challenge - to assist and empower the distribution of the vaccines that will, over time, turn things around for us all. It’s a challenge we can meet - and one that we’ll return to time-and-again in 2021. In the meantime, take your shot when it comes to your time and put this nightmare year behind us.