By: Salvidor Carlucci, 10 August 06

“We must not become immobilized

by what we think of as the "hugeness" of

our problems. Let us consider what can be

done, and start finding practical ways of doing things.”

-Nelson Mandela

After riding in 110F (42C) temperature to Tucson, Arizona and opening my hydration lotion I found it completely decomposed. It had turned from a bright white lotion to a pale yellow color. This was my first hand experience clearly witnessing how a healthcare product went bad due to inappropriate temperatures.

Below are some basic facts on Cold Chain Management and the impact on the Bottom of the Pyramid. 

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Cold chains in most Bottom of the Pyramid countries are in an advanced state of decay. Old, kerosene-powered refrigerators experience frequent downtimes due to lack of fuel and spare parts and inappropriate transport containers can expose goods to wide variations in temperature. As a result, temperature-sensitive healthcare products become spoiled, severely hampering efforts to increase immunization rates in areas where infectious disease is a persistent problem.[1]

Each year, around 91 million children are born in developing countries. Almost one-third of these children have no access to immunization against diseases such as HIV, cholera, polio, measles and tetanus. Vaccines are the most cost- effective healthcare intervention, yet while these are given routinely in affluent societies, they are still largely unavailable in poorer nations. [2]

Remote areas pose the greatest challenges to providing preventive healthcare. The population is sparsely scattered over valleys and hill tops, and often the only communication is by word of mouth. Medicines and vaccines cannot be transported easily because they lose their effectiveness if not kept cold. Vaccines and blood products, in particular, only remain safe to use for a few hours without reliable cooling. This constraint severely limits the ability of health clinics to cover a large area, and so the demand for reliable and cost-effective electricity generation for remote medical and healthcare applications throughout the world is increasing[3].

In the U.S alone, around one-quarter of all significant failures to comply with good distribution practice are due to inadequate control and/or monitoring of storage and transportation temperatures. While temperature controlled distribution has always been important to the healthcare industry, the current biotechnological revolution has further increased the need for the protection of thermally unstable products. At the same time, the healthcare supply chain is becoming more complex, with smaller and more frequent shipments further increasing the demand on solutions.[4]

To avoid temperature-related problems such as denatured proteins and a reduced shelf life, a wide array of packaging solutions have been used by the healthcare industry. The solutions consist mostly of insulating foam (usually expanded polystyrene or polyurethane) covered by a plastic layer. Gel packs and other phase change materials such as dry ice or wet ice have been used to maintain the temperature of these shippers. Although versatile and with the benefit of being easy to tailor for specific shipping requirements, disadvantages with these insulated shippers are: the amount of cooling medium needed due to its passive nature, which increases weight and volume and therefore air freight costs; and the amount of labor associated with the preparation of such a system prior to its utilization.

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Research in this area is critical to establish a self sustaining distribution company. In particular to identify current solutions both equipment and products and solutions under development.