No cold chain, no immunization

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Bade Babu Thapa (right) with UNICEF cold chain consultant Nawaraj Khadka (left) in a cold room at the Central Vaccine Store under the Department of Health Services in Kathmandu. © UNICEF Nepal/2021/PShrestha

UNICEF's long-running efforts to assess, expand and strengthen Nepal’s cold chain capacity are proving crucial to the delivery of vaccines around the country as part of the ongoing COVID-19 vaccination campaign

“Getting the vaccines themselves is one part of the work, but without proper storage and transport systems, it’s not possible to take them to the community”, says Bade Babu Thapa, Senior Pharmacy Officer at the Central Vaccine Store in Kathmandu, under the Government of Nepal’s Department of Health Services, while talking about the importance of a strong cold chain – which refers to a series of precisely coordinated events in temperature-controlled environments to store, manage and transport vaccines – in ensuring the success of any immunization campaign. The Central Vaccine Store is the national-level facility responsible for storing and dispatching vaccine supplies across the country for use in immunization programmes at the community level.

Recognizing the critical role played by a well-connected cold chain, UNICEF – since the very beginning of national immunization efforts in Nepal – has been working closely with the government and key partners such as Gavi to assess, expand and strengthen the country’s cold chain capacity.

This has included installation of cold rooms, refrigerators and freezers in vaccine storage facilities at the central, provincial, district and local levels, refrigerated containers for transportation, as well as supply of cold boxes and carriers to safeguard vaccines during the final leg of their journey to immunization sites. UNICEF also provides technical and logistical support at federal, provincial/district and local levels for effective vaccine and cold chain management.

The support was further strengthened after the 2015 earthquake, which severely impacted health facilities around the country. For instance, in Dolakha District in northeastern Nepal, which was one of the worst-hit areas in the disaster, additional cold chain equipment and assistance was provided to many health facilities.

“The equipment from UNICEF has been in continuous use over the years for storing vaccines for routine immunization,” says Shiva Ram Basnet, cold chain officer at Dolakha’s Public Health Service Office. “It is designed to keep running even if the power supply is intermittent, which was often the case after the earthquake.”

Today, with the launch of the vaccination drive against COVID-19 in Nepal, these long-running efforts to reinforce the cold chain have never been more crucial.

And the efforts to strengthen the cold chain are continuing. In 2020 alone, UNICEF installed 290 pieces of cold chain equipment in different facilities nationwide. Plans are also in place to procure and install an additional 910 pieces to address still-existing gaps in select areas and facilitate smooth delivery of vaccines.

The cold chain will also be used to store, transport and distribute vaccines received through the COVAX Facility, a partnership between CEPI, Gavi, UNICEF and WHO, made possible through generous donor support from governments, international organizations, foundations and the private sector. Nepal received its first consignment of COVID-19 vaccines - a total of 348,000 doses - that were shipped through the COVAX facility on 7 March 2021, in support of the Government of Nepal’s nation-wide vaccination campaign.