Eveksia: Smart and resilient vaccine and health supply chains

Leveraging blockchain technology, we will transform and digitize COVID-19 vaccine and health supply chain systems to ensure end-to-end visibility from port of entry  to the end user.

Dr. Elfatih Abdelraheem

CEO and Co-Founder

Eveksia Ltd

drfat78@gmail.com 

eveksialtd@gmail.com 

Health supply chain systems in low and middle-income countries (LMICs) are characterized by weak governance, complex structures, diffused accountability and poor visibility of the health commodities along the chain. This has led to the weakening of health systems in these countries, as a strong health supply chain is one of the building blocks of robust health systems. This situation led in 2014 to the outbreak and rapid spread of Ebola Virus Disease (EVD) and is adversely affecting countries with COVID-19. Given its delicate nature, the rollout of COVID-19 vaccines and other vaccines (for outbreak -such as polio- or routine immunization) is in dire need of resilient supply chain systems for the successful delivery and administration to eligible individuals. WHO and UNICEF are working to fill the gaps on the cold chain equipment, but lack visibility of the precious COVID-19 vaccines and assurance over vaccine delivery to eligible individuals. Building and embedding strong and resilient health systems with digital health supply chains would expedite recovery from COVID-19 pandemic and future outbreaks. 

The solution will support the national authorities responsible for managing deployment, implementation, and monitoring of COVID-19 vaccines. Beneficiaries of the solution are divided into two groups (depending on the level of interaction with the platform);

(1)Direct beneficiaries - represent the health officials, managers, logisticians and supply chain managers,

(2) Indirect beneficiaries (a disaggregated beneficiary details are provided below) - represent population segments who are expected to benefit from the services provided successful implementation of the platform. we anticipate the following indirect beneficiaries to gain from the solution*:

Newborns (0-28 days) and/or infants (up to 1 year of age): 1336508

Children (13 months - 5 years of age): 5344176

Qualified Health Professionals (e.g. physicians, nurses, and physicians' assistants): 3500

Women (other than described above): 1353465

Men (other than described above): 1203468

Health System and/or Facility Administrators: 150

Supply Chain Managers: 300

We are currently in collaboration with (Director of Maternal and Child Health department in the MOH and the Deputy dean of the faculty of mathematical science of Khartoum University) responsible for monitoring and evaluation and vaccine digitization respectively to understand their current mandate, challenges faced, and constraint and limitations with deploying an effective immunization program.

Eveksia can be considered as a public good at the global level. As COVID-19 has many negative health and socioeconomic impacts, the vaccine is the only way out of this pandemic. However, many LMICs lack the technology and skills to successfully cover all of their population with the COVID-19 vaccine. The pilot phase that will be implemented in Sudan, will be quickly scaled up to the rest of the country and other countries, mainly in Africa. We will document and share the results of the pilot with continental institutions such as the African Union, to potentially implement it in other African countries. The knowledge products such as the solution white paper, infographics and evaluation reports will be available at our website for sharing. Eveksia is built on an open source technology, so no license fees will be charged from countries. The business model will be built on cost-recovery of the additional services post deployment, such as analysis, extensions and upgrades. Eveksia team is proud to support the pioneers addressing the challenge of the COVID-19 and other pandemics through upgrading health system capacities. 

Eveksia is designed to support the COVID-19 vaccine equity. Sudan will receive 20% of its vaccines needs through the COVAX partnership. Based on a vaccine strategy and the National Deployment Plan (NDP) that prioritized the target population through a phased approach. The first group include healthcare workers and people above 60 years with co-morbidities. Second target will include other frontline workers and specially vulnerable groups such as refugees and displaced people. There is no database in Sudan that would allow the categorization and/or monitoring of this targted approach. Eveksia will support the implementation of this strategy through its functional features; track and trace of the vaccines and have precise and real time information about the vaccines stock, upfront registration and verification of beneficiaries, generation of infographics in a form of heatmaps and graphs that demonstrate the vaccination campaign coverage and the gaps, including at micro level. Evidence from the eVIN (electronic vaccine intelligence network) in India clearly demonstrates the efficiency gains and equity achieved on the vaccination of children through India when digital track and trace solutions were used (https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0241369) . Finally, Eveksia will be lasting solution that will be used as part of strengthened health system post COVID-19. 

Eveksia is designed to leave a lasting and sustainable impact on a large number of people, especially in the LMICs. The main intervention that Eveksia supports is the COVID-19 vaccine distribution and delivery, of which a minimum of 60% of the population needs to be covered to stop the pandemic. Evekisa is designed to support Ministries of Health achieving their full potential when it comes to vaccines and immunization not only for COVID-19, but other vaccine-preventable illnesses. In Sudan, Eveksia will facilitate the distribution of 17 million doses of Oxford/AstraZeneca vaccine to about 8.5 million beneficiaries that include the front line workers and vulnerable population above 45 with comorbidities. The same system will be used to cover additional population as more vaccines come through the supply chain. Sudan is one of few countries globally that have active polio cases which requires multiple vaccination campaigns every year to eradicate the disease. In 2020, Sudan vaccinated over 4 million children against polio and similar goal is planned for 2021. Evekisa will help improving the efficiencies and effectiveness of the vaccination campaigns (both COVID and non COVID) in addition to the routine immunization which will eventually benefit a large number of the population. 

Monitoring of Eveksia’s impact  will be processed through the platform itself and will include the indicators included in the national vaccine deployment plan. The process indicators include: the number of vaccine doses received, allocated and successfully administered; number of eligible beneficiaries registered (by demographic categories) and receive the full vaccination doses. The outcome indicators will include: the percentage of the vaccine waste and percentage of vaccine stockout. As they these are the most important metrics for the success of the planning and implementation of the national vaccination programme.

The platform is currently used for registration for COVID-19 vaccine (http://covax.fmoh.gov.sd/covax-reg/) however, it needs to be significantly improved to add the functions that can allow greater information and indicator analysis as per the vaccination plan. Currently, the platform provide basic descriptive demographic information.

The evaluation of the impact will be carried out through special research that will analyze the improvement in the vaccination campaign and the coverage reached by mid 2022, compared to the baseline  (April 2021). The impact indicators will cover: the percentage of cost-reduced after using the system, the number and type of health facilities reporting successful use of the platform.  

The challenges and barriers that are expected include: poor telecommunication infrastructure, especially internet, lack of knowledge and awareness among the policy makers about the importance of digital technology in the public sector, limited resources, and the lack of skilled developers for continuous maintenance.

For the telecoms limitation, we will ensure to work collaboratively with the ministry of telecoms and digital transformation to gain access to the mobile operators and internet providers to enable offline accessibility that can be integrated with the solution (e,g local private networks). For the lack of knowledge, we are currently working with senior and mid managers at the Ministry of health in Sudan and the continuous engagement improves the knowledge. The resources challenge will be initially addressed by working collaboratively with the governments to raise funds from donors and the private sector as this solution is considered as a public good that needs to be supported by all community stakeholders. Finally, for the challenge of unavailability of the required talents, this will be addressed by excessive training of the special talents that could be sourced from the local community and advocate to retain them.

Eveksia is formally registered at the House of Companies in UK under registration number (13192057).

Trinity challenge is a great opportunity for eveksia team and will help addressing the barriers and challenges of limited resources that usually face start ups, especially those like eveksia which is trying to support the recovery from COVID-19, especially in the Low and Middle Income countries. The financial award from Trinity will provide immediate access to resources to hire the required expertise and engineers to develop and produce and MVP that will be tested in the two project countries and will be used to mobilize additional resources.

The partnership opportunity offered by Trinity members would also be an invaluable asset for eveksia, in form of guidance and advisory services will help addressing the knowledge challenger and barrier and might avail some key technical resources, even for short period of time.

At Eveksia we always value partnership and make the best use of the accumulated knowledge in the market. This what would make the Trinity challenge is an important resource because of the broad base of founding members of the challenge. Eveksia is seeking partnership with the following members and for the specific purposes: 1) Google, for supporting the provision of cloud hosting services for the solution; 2) Microsoft, provision of advisory services for the solution integrity and compatibility with other software; 3) Bill & Malenda Gates foundation, for expanding and reaching to more countries; 4) Institute for Health Metrics and Evaluation, who will help eveksia in refining the KPIs for the operational and organizational performance.