Power of vaccines: Vaccinating the world against COVID-19

Season 3, episode 4

Power of vaccines: Vaccinating the world against COVID-19

A behind the scenes look at what goes into ensuring COVID-19 vaccines reach countries around the world. We will bring you into the world’s largest humanitarian warehouse in Denmark. You’ll learn why the UNICEF Supply Division warehouse is key our work supporting the COVAX Facility through an interview with Eva Kadilli, UNICEF’s Director of Supply Division. Then we’ll hear from one of our key COVAX partners, Gavi, about what goes into making a historic vaccination effort of this scale successful, through an interview with Dr. Anuradha Gupta, the Deputy CEO of Gavi.

Producers: Victoria Ptashnick, Priyadarshini Mitra

Composed and Mixed by: Chandra Bulucon

Episode Transcript: 

[00:00:00.30] Welcome to the UNICEF Global Supplier Hub.

[00:00:04.20] What's that?

[00:00:05.94] That's Big Robert, the robot. It packs things for children once they get ordered for emergencies. Carla, Big Robert moves things faster than you or I can. We have many robots just like Big Robert in the warehouse.

[00:00:19.23] Can I please see more robots?

[00:00:21.62] [LAUGHS] Yes, of course. And now we are at the packing line. Say hi to the hard workers below.

[00:00:28.53] Hi!

[00:00:29.97] Down there, they're packing school supplies for children all over the world.

[00:00:34.17] Really?

[00:00:35.04] Yes.

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[00:00:40.12] I'd like to start this episode off with a riddle. Let's see if you can figure it out. Hey, you ready? Here we go. What is located in Copenhagen, Denmark, is almost four football fields in size, and has a team of robots who work the night shift to keep things moving? Any guesses? OK. The answer is UNICEF's Supply Division, the largest humanitarian warehouse in the world.

[00:01:10.72] That clip you just heard was of six-year-old Carla, who got a tour of the facility last year. And her reaction after seeing the impressive place sums up how most people feel when they get a tour.

[00:01:23.46] Wow!

[00:01:25.42] Wow indeed. In this episode, we will bring you into our Supply Division Warehouse and learn why the facility is key to UNICEF's work supporting the COVAX facility. Then we'll hear from one of our COVAX partners, Gavi, about the secret sauce that goes into making a historic vaccination effort successful. I'm David Morley, the president and CEO of UNICEF Canada and your host of the For Every Child podcast.

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[00:02:10.01] Hi. My name is Gisela Henrique, and I'm joining you from UNICEF's Supply Division here in Copenhagen at the largest humanitarian warehouse in the world. In a normal year, UNICEF procures about 2 billion doses of vaccines to fight some of the world's most deadly childhood diseases. Now try adding another 2 billion doses of COVID-19 vaccines on behalf of the COVAX facility. That's one of our major tasks at Supply Division in 2021. I cannot emphasize how incredible this effort is, what a massive task it is, and how we all have to put our creative problem-solving hats on.

[00:02:54.96] That clip is of one of our colleagues in Copenhagen describing the work they're doing in 2021. It tells you a bit about the massive undertaking Supply Division is tackling these days. Ordinarily, the warehouse is where emergency and other types of supplies like food, supplements, vaccines and water purification tablets are kept. The first step in UNICEF's emergency response procedure is to call on the warehouse to deliver the tools and products we need to deliver lifesaving treatments to children and families that need them.

[00:03:31.42] They're still doing that, but now with the added element of supporting the COVAX facility too. To join me in discussing what unique role Supply Division plays in bringing an end to the pandemic, we have Eva Kadilli, UNICEF's director of Supply Division here. Welcome, Eva.

[00:03:50.68] Hello, David.

[00:03:52.21] Let's start with some fun questions. Supply Division is the largest humanitarian warehouse in the world at 20,000 square meters. That's huge. Tell us some of the most interesting facts about your workplace that our listeners may not know about.

[00:04:08.89] David, absolutely. Let me tell you that, first of all, this the largest humanitarian warehouse in the world that is situated here in Copenhagen. Its size is almost four football fields. And with all the automated machines in place, it kind of feels sometimes like being in a Disneyland. So it is really a large operation.

[00:04:31.93] It is having more than 900 different products that are stored in the warehouse. They go to different kits that we produce here for taking it to the children around the world. Supplies are shipped from here to children in every corner of the world. While waiting to be shipped, the supplies are stored in our high bay, which is 25 meters high and has the capacity of over 36,000 pallets which are carefully placed on racks by robot cranes. So it's really a very big warehouse.

[00:05:15.85] Our kit packing operations makes this warehouse and this operation really special. It makes us all proud because this is what we do here ourselves with our colleagues and our staff. We pack different kits for children to address their needs being on health, education, water, and sanitation.

[00:05:40.81] Let me tell you, David, that in one day, we can produce 2,000 school-in-a-box kit. And each of these has sufficient school supplies for 40 children for a period of three months. This means that in one day, we can produce sufficient school supplies for 80,000 children for three months. So this, I feel, is really very unique and is one of the main reasons why I'm so excited about our humanitarian warehouse here.

[00:06:13.84] Wait, wait. Did you just say robots? Tell me about what they do.

[00:06:20.86] Yes. So robots are picking up the supplies that are arriving in this warehouse. They are storing them to the high bay at the-- let's say a location that needs to be stored, because this high bay has a temperature control from 5% to 25% degrees. And robots are already given-- it is automated, of course. They are robots. So they are storing the supplies depending on the required temperature control. So those that need, actually, lower temperature of 5%, for example, are put at that storage level, and others are put in according to the storage and capacity that is required.

[00:07:11.29] But these robots also, which is unique as well, is that they are able to go around to move supplies from different racking system. And they work also during night as well to increase as well the efficiency and the response, of course, to the emergencies and to the programs that we have.

[00:07:37.28] Back to our main focus. What is Supply Division's role in distributing COVID-19 vaccines through the COVAX facility?

[00:07:46.01] So the syringes are still here, but not only syringes. The PPEs are also stored here. The safety boxes are also stored here. So in the warehouse here, we have, as I said, stockpiled the syringes, but not only in this warehouse. We also oversee-- this is the Global Humanitarian Warehouse, but we also oversee the warehouse in Dubai, in Shanghai, and also in Panama as well. So in order for us to respond to this big pandemic, we had to stockpile not only here in Copenhagen, but also in Dubai, so that we can address the needs.

[00:08:32.07] So we're talking about really massive stockpiles of syringes, cold boxes, and also safety boxes as well. So let me also explain our role beyond the vaccines. On the onset of the pandemic when it became very clear that the PPEs were in short supply globally, supply division contacted a large number of suppliers, almost 1,000 suppliers, to obtain access to PPE while we already had contracts in place because we had been delivering and addressing the Ebola emergencies.

[00:09:19.61] But that was not enough. Even though we had a strategic stockpile that was already prepositioned here in Copenhagen, that wasn't enough to be able to respond and address the needs for this global pandemic because the size and the scope was really massive. So from last year alone, we shipped PPE to more than 130 countries, including more than 200 million face masks, 200 million gloves, and gowns and coveralls. So besides PPEs, we have been also distributing diagnostics and therapeutics as well.

[00:10:03.41] Only today, we have shipped more than 7 million molecular diagnostics in support to 139 countries. So we have really worked with partners to help countries to start getting ready. And we have also started being preparing and getting ready ourselves with the stockpile that I was mentioning earlier that we put here in our warehouse in Copenhagen.

[00:10:30.92] What has been the most rewarding and inspiring part of the work you're doing?

[00:10:35.96] I feel inspired to have been part of this monumental effort with our partners by opening the door to affordable, equitable, and rapid access to vaccines on a global scale. It is really a very uplifting moment when the first delivery of COVID-19 vaccine arrived in Ghana. All of us-- myself, my team-- we are all watching live the Ghana television, looking at how the plane was landing.

[00:11:10.19] This was really so rewarding because we could see how our efforts for months, for planning and putting those vaccines into the contract and getting those shipments out, finally was translated into reaching the countries, and not only reaching the countries, but getting into the arms of the health workers, so really protecting those health workers, social workers, and now teachers. So this is giving me hope, is giving my team hope. And we are all inspired by the colleagues, and we feel incredibly lucky, I will say, that we have lived this moment in history.

[00:11:53.85] Thank you, Eva.

[00:11:55.37] And David, thank you so much for having me here. I really enjoyed having this chat with you.

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[00:12:12.43] I am the only one here working as a nurse. So because of this pandemic, I wasn't able to go home for them. For almost four months, because of the lockdown quarantine protocols, I wasn't able to go home in Pangasinan to be with my husband, to be with my son, which is the biggest challenge for me because I have now [INAUDIBLE]. I have this-- I don't know-- the hope that I will go home soon. I am protected, and I have this-- I'm [INAUDIBLE] here. I can hug them. I can kiss them. That's the advantage of this vaccine for me as a health worker.

[00:13:04.49] In the last couple of months, COVID-19 vaccines are reaching countries all over the world through the support of the COVAX facility. And they are first going to frontline health care workers like [? Karin, ?] who you just heard from there in the Philippines.

[00:13:21.17] Here at home in Canada, Canadians strongly support equitable access to COVID-19 vaccines as well. UNICEF Canada conducted a poll recently to better inform the work we are doing with the COVAX facility. We learned through this survey that there's widespread recognition that mass vaccination at a global level is the only way to stop COVID-19 and protect Canadians from its impact. Three quarters of the Canadians in the survey said mass vaccination is the only route forward, and 84% agree that it has to be done in all countries, not just here in Canada.

[00:14:03.78] The COVID-19 vaccines are bringing relief and hope, and a great role in it is played by the COVAX facility, a partnership between UNICEF, the WHO, Gavi, and others to ensure equitable access to COVID-19 vaccines. To tell us more about this historic effort, I want to welcome Dr. Anuradha Gupta, the deputy CEO of Gavi, on our podcast to talk more about the work and impact it has. Welcome, Dr. Gupta.

[00:14:35.88] Thank you, David. Thank you so much for having me.

[00:14:38.28] Well, it's a pleasure for us that you're joining our podcast today. And I'd like to start by talking a bit about the vision of COVAX. How would you say it is making fair and equitable access to COVID-19 vaccines a reality?

[00:14:55.06] So that's a great question. As you are aware, this is really the first time a global solution to a pandemic has been envisioned in this manner. A pandemic creates anxiety in every part of the globe, and that leads to a scramble for limited tools and solutions. It is typically the poor countries that are left behind, as we saw with H1N1 in 2009.

[00:15:23.79] So COVAX, this time, sought to preempt the repeat of H1N1 situation and make sure there is global collaboration to ensure equitable global access to COVID-19 vaccines and that all relevant agencies come together to accelerate rapid development, manufacturing supply, and delivery of vaccines, thereby reducing fragmentation of effort and also inequity in terms of access. And you are aware that COVAX is co-led by Gavi, a coalition for epidemic preparedness innovations-- typically, we call them SEPI-- and WHO.

[00:16:04.77] We work in very close partnership with UNICEF, the World Bank, vaccine manufacturers, CSOs. And though COVAX is a global initiative, of course we are working so closely with country governments to ensure that COVID-19 vaccines are available worldwide to both higher-income and lower-income countries. The result is that COVID-19 vaccines have been developed and approved for use at an unprecedented pace and are being rolled out in low-income countries within weeks of vaccine launch in the most advanced economies. We have seen remarkable technological breakthroughs, innovative financing mechanisms, and some wonderful collaborations that we never imagined would be possible.

[00:16:52.21] And finally, David, just one key thing to remember is that nobody is safe until everyone is safe because infectious diseases do not respect borders. And therefore, protecting health workers and high-risk vulnerable populations in every country is vital to exit out of this pandemic and not have it prolonged. And this is something that COVAX is very keen to ensure.

[00:17:18.81] And what would you say are some of the biggest challenges in this journey of ensuring that COVID-19 vaccine equity happens? And how have we overcome those challenges?

[00:17:33.70] So the road to equitable, fair, rapid access has been, no doubt, paved with several challenges, right from securing political support to the whole idea behind COVAX to mobilizing funding to procure and deliver vaccines. I think we were lucky that we could build off the comparative advantage of several organizations. For example, Gavi brought huge expertise in the areas of global demand pooling, procurement, and also vaccine delivery. And UNICEF has always been such a valued partner for us because UNICEF actually procures on behalf of Gavi and supplies to countries.

[00:18:27.13] And I think COVAX could be stood up very quickly, building off this comparative advantage. But the whole COVAX ambition to deliver 2 billion doses in 2021 alone really makes it the largest deployment of vaccines in human history. And we have seen challenges around production ramp-up, indemnification liability issues, regulatory pathways, export licenses, vaccine nationalism, and also prioritization of populations at risk. Therefore, though, we are very encouraged to see more than 32 million doses delivered to more than 60 countries already, which is a huge achievement. We are also very worried about the supply disruptions, and we are trying to address them as quickly as possible.

[00:19:20.45] I think sometimes, we can forget what you just said-- that this is the largest endeavor of its kind in human history. So we're meeting challenges that just 18 months ago, I bet, we had never thought of. And as we work together on ensuring the delivery of COVID-19 vaccines, we also are continuing our work on routine immunization. This work is going on as well, and it is important. And we know that routine immunization is crucial to make sure children are protected against a host of preventable diseases-- polio, measles, pneumonia, others.

[00:20:10.85] Can you tell us why keeping up those routine vaccinations is so important? And what would happen if we didn't?

[00:20:20.45] Yeah, so we have been very, very worried about the knock-on impact of COVID-19. So among the catastrophic effects of the pandemic, of course, the huge risk posed to child survival is really something that we can hardly overlook. So we have been very concerned about the widespread disruption of health services in countries, including immunization services.

[00:20:51.83] We have been so proud of the progress that we have made in terms of reducing child mortality because of vaccine-preventable diseases. And you know we have seen a decrease of more than 70% in VPD-related child deaths. But I think this is really the time when those hard-won gains are at severe risk.

[00:21:16.47] We also know now that by sustaining routing immunization services, countries can save 84 children lives at the risk of one COVID-related death. And therefore, it is important that these services are maintained. And that is why we have been doing very vigorous advocacy with countries with this message that immunization services and other services need to be restored and resumed as quickly as possible, because we can't afford to see a spike in child deaths and also outbreaks.

[00:22:01.76] There were certain projections which were very scary which would showed that within a span of six months, more than 1 million additional children could die. Now, that's something that the world can ill afford. We are also seeing, for example, in Gavi, supported countries that you know are among the lowest income countries, that we have increased incidence of outbreaks. So 43% of Gavi countries are now reporting disease outbreaks, which is a sign of continuing gaps in service delivery despite the fact that immunization services are gradually getting restored in many countries.

[00:22:47.33] Just one more reflection that I would want to share is that as we analyze the impact of COVID-19, we see that the pandemic has hit the poorest and the most marginalized vulnerable population the hardest. Actually, COVID-19 has exacerbated pre-existing health inequities. So therefore, children who are living in those communities that are bereft of the most essential services are at the most severe risk of getting illnesses but also not being able to access health care in time and eventually dying. And that's something that has all of us very worried. And therefore, we are working with countries to make sure that as COVID-19 vaccines get rolled out in parallel, a lot of attention is paid to essential health services and their restoration.

[00:23:51.23] When you've talked about some of the projections that we've been seeing, I know after many years, decades of improvement in under-five mortality rates, it is scary, to say the least, that these could be turning the turning the other way because of this COVID pandemic. One last question. I don't want to take more of your time. The World Immunization Week is the last week of April, and it has a new significance for all of us this year with the COVID-19 vaccines bringing such hope. What would your message be to celebrate the power of vaccines?

[00:24:38.01] So I would want to begin by saying vaccines are a marvel of science, medical science. Vaccines save lives. We have seen the power of vaccines when smallpox was wiped off the face of this Earth. And we have also seen the power of vaccines with polio, which we are on the verge of eradicating. As I said earlier, we have seen that scale-up of vaccines in some of the poorest countries of the world has enabled us to reduce vaccine-preventable diseases, related child deaths, by a stupendous 70%.

[00:25:21.33] So immunization is something that we need to maintain because it is the most cost-effective preventive public health intervention. And within our endeavor, we have to bring equity front and center of all our efforts. Because I do want to remind us that there are close to 15 million children who do not receive even a single dose of the most basic DTP vaccine today.

[00:25:54.59] These are our zero-dose children. They are children who are markers of acute societal inequities. They are a gateway to those communities that are suffering from multiple deprivations and compounded vulnerabilities. And immunization can actually be a pathfinder for a lot of sectors to come together and make sure that these communities receive what they really deserve, which is basic nutrition, education, sanitation, water, hygiene, and, of course, lifesaving interventions such as vaccines.

[00:26:33.16] I like that image of immunization as a pathfinder towards greater equity. And I also believe that as a global society, we can rally around better health for our children, all children everywhere. And certainly, I think the partnership that we have between Gavi and UNICEF and others is making its way along that path. And so I'd just like to thank you and Gavi, but thank you particularly for spending the time with us today, Dr. Gupta. Thank you very much.

[00:27:11.24] Thanks a lot. Thank you, David. I really appreciated this conversation.

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[00:27:18.01] This World Immunization Week, the message is very simple-- vaccines save lives. Thanks to our years of experience in providing vaccines for almost half of the world's children, UNICEF knows that immunization is one of the most cost-effective public health interventions. It is critical that children continue to have access to routine vaccinations in order to prevent outbreaks of vaccine-preventable diseases alongside the COVID-19 pandemic.

[00:27:51.10] The COVID-19 vaccine distribution through COVAX is helping put an end to a pandemic that creates serious threats to children. By supporting it, you are helping UNICEF protect children's futures. To find out more about how you can play a role and follow our work, please go to unicef.ca. That brings us to the end of our episode for April. Thank you for listening.

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