Cold chain for a hot zone

UPS Healthcare's humanitarian aid to Malawi shows skill, will, and a good heart beneath it all.

A nurse giving a COVID-19 vaccine In Malawi

Not every person can point out Malawi on a map.

That didn't stop COVID-19 from finding the east African nation.

The pandemic blazed through, spreading even to remote villages in this developing country of 18 million. Leaders looked to the international community to support efforts to bring life-saving vaccines to Malawi's people.

Malawi is rugged, and some parts are notoriously hard to reach. Many villages lack consistent electricity, running water, and other services … including refrigeration. Since the most available and effective COVID vaccines must be kept at ultra-cold temperatures (-20°C to -80°C), Malawi faced a life-and-death question:

How could vaccines be effectively distributed in a country without an ultra-cold supply infrastructure?

Enter UPS, in the person of Vice President of Healthcare Sales, Craig Arnold.

Thanks to the efforts, expertise, and infrastructure offered through Craig and UPS partners he assembled, an ultra-cold supply chain is now in place. Vaccines will begin reaching Malawians in October 2021.

How all this happened speaks to the good heart and global community-mindedness of UPS.

A passion project

Craig got a first taste of humanitarian service in 2010 when he volunteered in Haiti. He arrived just a couple days after a devastating earthquake that took 200,000 lives. Twenty-three days and 10 UPS flights later, Craig and a small team from the Salvation Army, supported by funding from the UPS Foundation and security from the United States Army's 82nd Airborne Division, had successfully delivered 1.2 million meals.

"I saw how that mission tied three things together," Craig says. "International experience. Logistics expertise. And humanitarian efforts."

Relief work became, Craig says, a "passion project." By day, he helped UPS Healthcare move medical supplies and drugs around the world. Nights and weekends, he kept up links to The UPS Foundation and to non-governmental organizations (NGOs), often finding connections overlapping with UPS work. He headed up logistics efforts for the Salvation Army after natural disasters in the Philippines, Puerto Rico, the Virgin Islands, and Vanuatu – in all cases relying on the network, expertise, and generosity of UPS to deliver much-needed aid.

In March 2021, the UPS Foundation announced a commitment to support the equitable distribution of COVID-19 vaccines worldwide, funding advancement of 20 million doses to low- and middle-income countries. (To date, the Foundation has more than doubled that distribution, after a slow start waiting on vaccines). In June 2021, the United States government made a commitment to provide 500 million doses to the developing world, and Craig's day job and passion project converged again.

He used personal vacation time to travel to Malawi. It took maneuvering, but he finally talked his way into the country during stops in Europe and Kenya. What Craig found demanded his most creative problem-solving skills.

There were no freezers with ultra-cold temperatures and no dry ice capabilities in the country. Malawi would need to build an ultra-cold supply chain largely from scratch. So that's exactly what Craig, and members of the Ministry of Health's COVID taskforce, pulled off.

The cold chain works like this:

Doses arrive in Lilongwe, the capital city, and are taken to a central vaccine storage site. There, doses that can be used in the local area in the next 30 days go into normal refrigerators (appropriate for short-term storage of the vaccine). Still, 60 percent of the doses are needed outside the capital city. To transport these, UPS supplied portable ultra-cold Stirling freezers that operate at -80°C. This allows 29 district hospitals to receive life-saving vaccines.

"These portable ultra-cold freezers are a game changer," says Craig. "Each unit holds 8,120 doses at -80°C. We will have one at each district hospital … this means 250,000 doses at a time will be safely positioned to reach every corner of the country."

Some overland trips will be hot, long, and arduous, but the Stirling freezers can be kept cold simply by plugging them into the cigarette lighters of transport vehicles.

Delivery from the district hospitals to far-flung vaccination sites in the countryside requires another kind of cold-chain packaging – Orcas. UPS will donate 50 of these cold containers designed for hand-carrying delivery to remote locations.

"As long as the doses are used within 30 days," Craig says, "they can be kept at 2°C to 8°C after they're thawed. Orcas are phase-change, material-based cases that can hold vaccines at those temperatures for three to five days without electricity … five times longer than water-based carriers."

Finally, UPS is helping the Ministry of Health by providing a technical advisor, Michael Andrew. He was there with Craig during the planning stage and is still there to ensure smooth execution. UPS is also providing training and a certification process for people handling doses along the supply chain.

Official hand-off accomplished

The inspiration and innovation of Craig Arnold and his UPS partners were recognized on September 8, when Malawi's Minister of Health, the Honorable Khumbize Kandodo Chiponda, and the United States Ambassador to Malawi, Robert Scott, met in a ceremony to officially hand over cold-chain resources and launch the vaccination effort.

The good done here will outlast COVID-relief efforts.

"The freezers and cooling boxes will be useful for 10 years," says Craig. "This project will enable the movement of any vaccines and treatments that require ultra-cold transport, including cell and gene therapy treatments and oncology drugs.

"We built this cold-chain system to get Malawi over the hump with 1 million doses of vaccine," Craig says. "But this asset will stay in place, ready to use, for a lot longer time."

Malawi's grateful memories of Craig and UPS Healthcare will stay in place for a long time too.

Smiling women

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