1. Vaccine Transportation:Challenges & Innovations inDeveloping CountriesOctober 16, 2014

2. What is the cold chain?! The Cold Chain is concerned withmaintaining temperature-sensitivevaccines within a specific temperaturerange from the moment they leave themanufacturers until they reach the endconsumers! Cold chain logistics are imperative forthe handling and transportation oftemperature-sensitive vaccineswww.TemperatureAlert.com | (866) 524-3540 3. How does the cold chain affect thepotency of vaccines?! Developing countries without proper orreliable access to electrical powerface many adversities to keep the coldchain unbroken! When vaccines get too hot or freezethey become inactive or loose theirpotencywww.TemperatureAlert.com | (866) 524-3540 4. Challenges in developing countries! Some of the most importantvaccines in the world need tobe kept between 2 to 8Cwww.TemperatureAlert.com | (866) 524-3540 5. How does temperature affect thepotency of vaccines?! Without adequate monitoring theres no way to predict when thepotency of vaccines has been compromised! The impact on the potency of vaccines each time theyreexposed to ambient temperatures is cumulativewww.TemperatureAlert.com | (866) 524-3540 6. Limitations for cold chain logistics indeveloping countries! The biggest challenge isnt thesupply of the vaccines but ratherthe storage of the vaccines oncethey arrive to their final destinationwww.TemperatureAlert.com | (866) 524-3540 7. Limitations for cold chain logisticsaround the world! Millions of children die everyyear from vaccine-preventablediseases! The WHO estimates 1.5 millionchildren under the age of fivedie each year from diseasesthat could have beenprevented by routineimmunization.www.TemperatureAlert.com | (866) 524-3540 8. Limitations for cold chain logistics andthe Ebola virusEven if we found a cure for the current outbreak of Ebolavirus disease, the biggest challenge would still be how totransport and store vaccines in areas of developingcountries without reliable access to electricitywww.TemperatureAlert.com | (866) 524-3540 9. Limitations for cold chain logistics:Polio in Pakistan! Taliban militants currentlyprevent immunizationcampaigns to reachcertain regions and tribalareas in the country! After the father and uncleof a 2-year-old childsmuggled vaccines intotheir village for months, thechild contracted polio;despite receiving variousdoses of the vaccinewww.TemperatureAlert.com | (866) 524-3540 10. Limitations for cold chain logistics:Polio in Pakistan! Its likely he got infected because there was no reliablemonitoring being done during the transportation of thevaccines; and there was no way to be certain thevaccines had been kept among their recommendedtemperature range as the family smuggled them.www.TemperatureAlert.com | (866) 524-3540 11. Limitations for cold chain logistics:Faulty refrigeration in Hong Kong! A refrigerator stopped working at theTuen Mun Hospital! It wasnt until 2 days after the vaccineswere kept out of their temperaturerange when a nurse realized therefrigerator wasnt workingwww.TemperatureAlert.com | (866) 524-3540 12. Limitations for cold chain logistics:Faulty refrigeration in Hong Kong! During those 2 days, over 40 childrenwere vaccinated with BBC andHepatitis vaccines that came fromthat refrigerator! The event is still under investigation,but it was caused by inadequatetemperature monitoring during thestorage of vaccineswww.TemperatureAlert.com | (866) 524-3540 13. Limitations for cold chain logistics:Thread of epidemic in floodedKashmir! On September 2014 there wasa very tragic flood in theregion of Kashmir (India)! Heavy rainfall and theflooding of rivers has left thepopulation lacking properaccess to clean water andbrought overcrowding atmedical camps! The region of Kashmir is now athigh risk for suffering awaterborne disease epidemicwww.TemperatureAlert.com | (866) 524-3540 14. Limitations for cold chain logistics:Thread of epidemic in floodedKashmirWhen volunteers went to hospitals looking for vaccines, they gotthe same response from all hospitals: they didnt have anyvaccines because they didnt have electricity, and withoutelectricity or refrigeration all their vaccines were destroyedwww.TemperatureAlert.com | (866) 524-3540 15. How to maintain a successful coldchain without reliable access toelectricity? (Part I)! Solar-direct refrigeration:! First generation solar refrigerators workedwith an industrial battery that stored solarenergy! Limitations:! Battery system failures! If a battery replacement isntanticipated or theres not enoughfunding available the entire systemfailswww.TemperatureAlert.com | (866) 524-3540 16. How to maintain a successful coldchain without reliable access toelectricity? (Part I)! Second generation refrigerators dont require external batteriesand come with an ice battery that allows them to maintainacceptable temperatures for many days.The SunFrost is a battery free direct drive refrigeratorthat works with ice packs.www.TemperatureAlert.com | (866) 524-3540 17. How to maintain a successful coldchain without reliable access toelectricity? (Part I)! Passive-cooled cold boxes:! Theyre mostly used for the last mile ofthe cold chain (last stage of deliverybefore vaccines arrive to their finaldestination)! Cold boxes can be carried by humanwalking, bicycles, or motorbikeswww.TemperatureAlert.com | (866) 524-3540 18. How to maintain a successful coldchain without reliable access toelectricity? (Part I)! Regular cold boxes require ice packs orcold-water packs to keep vaccines cool.However they put vaccines at a high risk offreezing! The technology of new passive-cooled coldboxes allow them to keep vaccinesrefrigerated for up to 7 days before the iceinside needs to be replacedwww.TemperatureAlert.com | (866) 524-3540 19. How to maintain a successful coldchain without reliable access toelectricity? (Part II)! Energize the Chain (Non-Profit)! The mobile phone industry grows exponentially, especially indeveloping countries. Cell towers produce an excess of electricity thatis wasted; therefore, refrigerators can be co-located where the celltowers are and be powered by the electricity from cell towers! Energize the chain has installed over 110 refrigerators in Zimbabwethat work with the power from cell towers. This year they managed tovaccinate one quarter of a million childrenwww.TemperatureAlert.com | (866) 524-3540 20. How to maintain a successful coldchain without reliable access toelectricity? (Part II)! Temperature monitoring technologies! Modern monitoring technologies have evolved fromvaccine vial monitoring (VVM)! VVM consists of stickers that change colors in the eventof temperature fluctuations! VVMs are still widely used in thedeveloping world todaywww.TemperatureAlert.com | (866) 524-3540 21. How to maintain a successful coldchain without reliable access toelectricity? (Part II)The most relevant innovations on temperaturemonitoring include:! Notifications & Alerts:! When temperatures fall out of range, modernmonitoring devices send alerts through email,phone, or text messages! Notifications alert users of temperature fluctuationsso they can address any issues sooner! Battery backup:! When power outages occur it becomes difficult todetermine whether the vaccines fell out of range ornot since the monitoring device stopped workingdue to the power outage! In regions with common power outages, it would berecommended to have a monitoring device thathas a backup batterywww.TemperatureAlert.com | (866) 524-3540 22. Thank you.To learn more about Temperature@lerts Cellular Edition visit:http://www.temperaturealert.com/Wireless-Temperature-Store/ZPointCellular.aspxor call us at+1-866-524-3540