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CLICK TO ADD TITLE. The 6th Global Health Supply Chain Summit November 18 -20, 2013 Addis Ababa, Ethiopia. HERMES Computational Simulation Modeling to Improve Vaccine Supply Chain Operations in Two West African Countries: Niger and Benin Bryan A. Norman. [SPEAKERS NAMES]. [DATE].

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The 6th Global Health Supply Chain Summit

November 18 -20, 2013Addis Ababa, Ethiopia

HERMES Computational Simulation Modeling to Improve Vaccine Supply Chain Operations in Two West African Countries: Niger and Benin

Bryan A. Norman

[SPEAKERS NAMES]

[DATE]

slide2

HERMES Team

Tina-Marie Assi,

PhD

Former Co-Coordinator

Diana L. Connor,

MPH

Co-Coordinator

Leslie E. Mueller,

BS

Analyst

Michelle M. Schmitz,

BA

Analyst

Shawn T. Brown,

PhD

Technical Lead

Bryan A. Norman,

PhD

Industrial Engineering

Rachel B. Slayton,

PhD

Former Co-Coordinator

Leila A. Haidari,

BS

Analyst

Jayant Rajgopal,

PhD

Industrial Engineering

Angela R. Wateska, MPH

Co-Coordinator

Brigid E. Cakouros,

MPH

Senior Analyst

Veena Karir,

PharmD, MS

Senior Analyst

Sheng-I Chen,

PhD

Industrial Engineering

Proma Paul,

MHS

Senior Analyst

Joel S. Welling,

PhD

Developer

Bruce Y. Lee,

MD, MBA

Scientific Lead

Erin G. Claypool,

PhD

Industrial Engineering

Jim Leonard

Developer

Roslyn J. Phillips, MPH

Senior Analyst

Yu-Ting Weng,

MS

Developer

overview
Overview
  • HERMES Overview
  • Examples of In-Country Work
  • Sample studies
  • Summary and Discussion

For more information visit- http://hermes.psc.edu

modeling is widely used
Modeling Is Widely Used

Air and Space Travel and Exploration

Finance and Investment

Transportation

Sports

Natural Resource and Energy Exploration

Military/Defense

For more information visit- http://hermes.psc.edu

slide5

HERMES Vision

For more information visit- http://hermes.psc.edu

hermes can address
HERMES can address…
  • Impact of introducing new technology
    • e.g., vaccines, storage, and monitoring
  • Characteristics of vaccines and other technologies
    • e.g., vaccine vial size, vaccine thermostability, cold device capacity
  • Configuration and operations of the supply chain
    • e.g., storage, shipping frequency, personnel, ordering policy
  • Effects of differing conditions/circumstances
    • e.g., power outages, delays, inclement weather, limited access
  • Investment or allocation of resources
    • e.g., adding refrigerators vs. increasing transport frequency
  • Optimizing vaccine delivery
    • e.g., minimize cost, cost per outcome, maximize immunizations
discrete event simulation
Discrete Event Simulation

For more information visit- http://hermes.psc.edu

steps to model supply chains
Steps to Model Supply Chains
  • Identify purpose of simulation
    • Questions to address
    • Perspective of user
  • Determine level of detail required in the simulation model
    • Less detail to address general, simpler questions
    • More detail to address more complex questions

For more information visit- http://hermes.psc.edu

steps to model supply chains1
Steps to Model Supply Chains
  • Gather and input supply chain data into HERMES
    • Evaluate the data that is available.
    • Less data  less detailed simulation model
    • More data  more detailed simulation model
  • Decision maker can directly run HERMES on any laptop computer

For more information visit- http://hermes.psc.edu

hermes gui
HERMES GUI
  • Simplifies
    • Data input
    • Running models
    • Evaluating different scenarios
    • Identifying bottlenecks
  • Seeking Beta testers for the HERMES GUI for early 2014

For more information visit- http://hermes.psc.edu

overview1
Overview
  • HERMES Overview
  • Examples of In-Country Work
  • Sample studies
  • Summary and Discussion

For more information visit- http://hermes.psc.edu

slide13

Examples of In-Country Work

For more information visit- http://hermes.psc.edu

overview2
Overview
  • HERMES Overview
  • Examples of In-Country Work
  • Sample studies
  • Summary and Discussion

For more information visit- http://hermes.psc.edu

niger supply chain
Niger Supply Chain

Serum Institute

Sanofi Aventis

Central Store

Regional Store

Regional Store

Regional Store

Regional Store

1 Month

Regional Store

Regional Store

Regional Store

42 District Stores (Chest Refrigerators and Freezers)

1 Month

600+ Clinics (Small Refrigerators and/or Freezers)

600+ Clinics

For more information visit- http://hermes.psc.edu

slide17

Vaccine Availability

Vaccine Availability (%)

Vaccine Availability (%)

Vaccine Availability (%)

Vaccine Availability (%)

slide19

Truck Capacity Utilization

10-dose measles vaccine vial size

5-dose measles vaccine vial size

2-dose measles vaccine vial size

1-dose measles vaccine vial size

slide20

Storage Capacity Utilization

10-dose measles vaccine vial size

5-dose measles vaccine vial size

2-dose measles vaccine vial size

1-dose measles vaccine vial size

benin the problem
Benin: The Problem

1 http://www.who.int/immunization_monitoring/data/ben.pdf- 2011 Government and WHO-UNICEF estimate.

  • The Benin supply chain may not be effectively getting vaccines to the population.
    • At least 15% of children in Benin are not receiving full vaccinations (as measured by estimated DTP3 coverage).1
    • Impending new vaccine introduction (e.g., rotavirus vaccine) may exacerbate this problem.
  • The Benin vaccine supply chain may also cost more to operate than it should (not completely efficient).

For more information visit- http://hermes.psc.edu

benin objectives
Benin: Objectives
  • Evaluate the current Benin vaccine supply chain:
    • Identify vulnerabilities (bottlenecks)
    • Calculate operating costs (storage, transport, labor, and building)
  • Assess Benin vaccine supply chain’s ability to handle new vaccine introduction.
  • Identify an alternate, more efficient vaccine supply chain design.
  • Establish a blueprint for redesign.
  • Build a business case to change the system.
  • Determine if costs could be lowered and coverage increased from the current system.
slide27

Approach: HERMES Modeling Each Scenario

Data on Benin Vaccine Supply Chain

  • 2010 Cold Chain Equipment Management (CCEM) assessment
  • Pilot 2012 EVM+HERMES
  • 2008 Comprehensive Multiyear Plan (cMYP)
  • Personal communications with Benin Ministry of Health (MoH), WHO, UNICEF, Project OPTIMIZE, and other key stakeholders

Detailed Simulation Model of the Benin Vaccine Supply Chain

Run Simulation

Measure Vaccine Availability

Measure Operating Costs

Measure Capital Expenditure

Make Additions to Relieve Bottlenecks

Run Simulation

Measure Vaccine Availability

Measure Operating Costs

For more information visit- http://hermes.psc.edu

current system not completely effective or efficient
Current System: Not Completely Effective or Efficient

Vaccine availability:93% (71% after rotavirus introduction)

Total annual operating costs:$1,113,954 ($1,117,494 after rotavirus introduction)

Logistics cost per dose: $0.23($0.26 after rotavirus introduction)

* Current Bottlenecks: Storage at National Store and transport between all levels

slide30
Capital Expenditures Required to Achieve Each Design Alternative that will Accommodate Rotavirus Introduction
slide35

Conclusions

  • Zone Sanitaire plus 4 x 4 Truck Loops at Lowest Level is clear choice.
    • Lower capital expenditures
    • Lower operating costs
    • After four years over half-million in cost savings
  • Combination of Zone Sanitaire and Truck Loops leads to a synergistic effect.

For more information visit- http://hermes.psc.edu

overview3
Overview
  • HERMES Overview
  • Examples of In-Country Work
  • Sample studies
  • Summary and Discussion

For more information visit- http://hermes.psc.edu

summary and discussion
Summary and Discussion
  • HERMES can rapidly create a simulation model of any supply chain
  • Serve as a virtual laboratory to help a wide variety of vaccine decision makers answer any number of questions
  • Already implemented in multiple countries

For more information visit- http://hermes.psc.edu

looking to the future
Looking To The Future
  • Over the next ten years most GAVI countries are expanding their vaccines
    • MenAfriVac®, Rotavirus, PCV-13, others
  • Many new vaccines are relatively large
    • Even more burden on the vaccine cold chain
  • Higher coverage rate targets for current and new vaccines
  • Cost effective distribution is critical to achieve coverage targets

For more information visit- http://hermes.psc.edu

acknowledgements
Acknowledgements
  • Funded by the Bill and Melinda Gates Foundation and the U.S. National Institutes of Health
  • Valued collaborators include: World Health Organization (WHO), UNICEF, PATH, Agencie de Medecine Preventive (AMP)

For more information visit- http://hermes.psc.edu