VacciBox

According to WHO, Over 3 billion people globally live where temperature-controlled storage is insufficient. In Africa alone, over half a billion people do not have access to affordable cold storage  because they live in rural and remote communities that lack access to reliable electricity or are connected to a weak grid. This translates to the continent being the majority contributor of the 1.5 million children who die each year of vaccine preventable diseases. It is also documented that about 140,000 health facilities in Africa do not have reliable cold storage for vaccines due to unreliable energy access and high cost of electricity. 

In African countries like Kenya, all vaccination data is manually recorded in books first then transferred to other electronic media since monitoring is pegged on the actual availability of the health worker to record the data. This data capture method is prone to errors and inaccuracies posing a threat to provision of quality healthcare, especially in rural, remote and underserved communities. An example is the failure to record vaccine fridge temperature all times implies that there could be an erratic  temperature fluctuation that goes unnoticed In such a case, the vaccine potency is normally lowered or even completely rendered non-viable, but still this vaccine is issued. This contributes to missed vaccinations in children who get this vaccine since they receive a placebo.

This challenge that negatively impacts neonatal and infant immunisation and the cold chain for blood also has greatly affected Covid-19 vaccination. According to WHO, about 50% of vaccines are wasted globally due to a broken cold chain at storage and in logistics. 70% of this wastage occurs in Africa. In Malawi for example, 16,000 doses of the AstraZeneca vaccine expired after failing to administer them before their expiry date and the Democratic Republic of Congo has opted to return 1.3 million of the 1.7 million doses of AstraZeneca it received from the COVAX Facility. These are all due to the lack of appropriate cold chain storage of vaccines. As African countries roll out vaccination programs for Covid-19, the inadequacies in the cold chain could potentially waste 1 billion vaccines. With a subsidised value of 10 USD per vaccine, Africa is bound to lose at least 10 billion USD as a result.

Our solution, VacciBox is a portable solar powered fridge that can easily be mounted on a motorbike, bicycle or boat, to store and transport vaccines, blood for transfusion, drugs such as insulin and other medical items to any rural, off-grid and hard to reach communities. It is lightweight, 20kgs and 40 liters in internal capacity to enable its portability. Other than operating on solar energy, it comes complete with a 12 hour battery power backup to ensure that it is still in operation at night and periods of low solar resource. Its operating temperature is +2 to +8 degrees celsius to permit storage of a wide range of child based vaccines.  

Our fridge is integrated with a remote data collection and monitoring capability that can tell real time temperature, location, stock and fridge operations from any place on earth. This feature is enabled with a PCB circuit board that supports functions such as: recording temperature, recording battery voltage, charge level and isolating the fridge compressor from the battery if the charge is too low, maximising battery life and optimised charging even in periods of little sun. The circuit also sounds a buzzer if the fridge door is open for too long, if the temperatures are not within the acceptable range of  +2 to +8 degrees celsius. All this data is collected through GSM and SD Card, then transmitted via bluetooth, WIFI and SMS. The data is received in our backend platform/website where it can be synthesised into graphs and other trends. This feature also enables us as developers to monitor the fridge running at all time, to remotely troubleshoot and avoid failures, ensuring reduced downtimes and providing quick and easy technical support using data to make informed decisions.  For the user, the healthcare worker, they can access the fridge stock using a mobile application that also alerts them though SMS whenever there is a fault with the fridge.  In the future, we plan to develop this IoT feature to conduct automatic stock monitoring and management,  as well as enable supply and logistics of vaccines from one facility to another.

Our target population is children. The full immunisation coverage for children aged 0 to 14 years in Kenya is 77%, 56% in Tanzania and 50% in Uganda. This means that 26.3 million children aged 0 to 14 years have not received the full schedule of vaccines as recommended by WHO. 

According to UNICEF, the consequences and risks associated with incomplete  vaccination of children are:

1. Children are more likely to get serious illnesses such as hepatitis, tuberculosis, whooping cough, measles etc and complications such as diarrhoea.

2. Other family members are also more likely to get seriously ill 

3. The children and family members may contribute to a disease outbreak in the community

4. Catastrophic health expenditures in the management of diseases and their complications could have far-reaching implications especially in low-income settings

5. Decrease in the quality of life. Vaccine-preventable diseases could lead to lifelong disability, for example, measles could lead to blindness. Paralysis is the most severe symptom associated with polio because it can lead to permanent disability and death.

6. Risk of decreasing life expectancy. Incomplete vaccination contributes to a decrease in life expectancy, while complete vaccination among toddlers influences the increase in life expectancy.

7. Travel restrictions and school enrolment. More and more schools list ‘complete immunisation status’ as one of the admission criteria to ensure all children and school residents are protected from vaccine-preventable diseases and students can fully enjoy their rights to learn at school.

Vaccibox will ensure that child based vaccines, essential drugs and other items like blood for transfusion have an increased shelf life and also increase the geographical areas of access, to reach more children. The impact of this is:

1. an increase of Vaccination coverage by 70% on both outreach and walk-ins children. This is attributed to the fact that the medical practitioners will be able to work efficiently despite the unreliable electricity. The Vaccibox runs 24 hours a day without power interruptions. This signifies how much of a game changer the Vaccibox is in Healthcare as a high impact solution. Rolling it out to more institutions means a rapid increase in vaccine coverage both nationally and globally.

2. Digital technologies have particularly proven essential and particularly mobile phones, which are extremely beneficial in areas with limited infrastructure. Through strategic partnerships with mobile network providers in the efforts to ensure that Healthcare providers are equipped with smartphones to enable access to the app to monitor and collect healthcare information in real time.

3. We are reducing neonatal and infant mortality by increasing access to vaccines in remote and low-income communities in Kenya. According to UNICEF, most childhood deaths in Kenya are largely preventable and occur before the first birthday. Three in 10 children are not fully protected against the scheduled vaccine-preventable childhood diseases by the age of one year hence contributing to the annual 74,000 deaths of children under five years. We are reducing maternal deaths in Kenya by improving the logistic and cold chain for blood for transfusion. Postpartum haemorrhage is one of the leading causes of deaths in new mothers. 

The founders have all experienced the challenges of the lack of sustainable cold storage within Africa. Norah had her baby in 2018 and moved to live in the rural town in Kenya. Several times when she took her daughter to be vaccinated, she was turned away because the vaccines had spoiled or were not available. James is a healthcare manager at a rural hospital and his constant challenge is running against time to keep vaccines cold because of weak power grids that are not stable enough to run vaccine fridges throughout the year. Abigail lives in a rural and underserved area and had to walk fora long distance to get vaccinated.

VacciBox is locally designed and made in Kenya. It was built through design thinking in collaboration with rural health workers in Kenya, who continually take part in defining its design, performance and deliverables. It was also built by rural Kenyan youth and women who, after children, will be the most beneficiaries of the impacts of the fridge. This innovation is meant to promote quality healthcare for all, create thousands of jobs for Kenyans and increase the share of renewable energy in Africa's healthcare space. It will form the pathway to more healthcare innovations developed in Africa and adopted around the globe.

When we conducted design thinking exercises with healthcare workers, administrators and newborn mothers in Kenya, they informed us that they needed a portable cold storage vaccine storage solution that can reach all communities, even in hard to reach areas. All the rural hospitals that we engaged stated that they needed a data capture method for vaccines, beyond cold storage. Immunisation managers complained that one big challenge was inaccurate data collected from various hospitals.

Restrictions under WHO PQS (Performance, Quality and Safety) requirements is our biggest barrier that we hope the MIT Solve program will help us overcome. Currently, our local market Kenya cannot allow us to pilot more fridges until we meet all the WHO PQS standards. Acquiring this standard is expensive and takes time. This could potentially derail and delay our progress. We need to comply with all these requirements by building a more robust and stable fridge and piloting more units in Kenya. We need more skilled engineers and expertise to partner with us and advise us on how to  build the second version of VacciBox that complies with the required standards.

Our fridge is integrated with a remote data collection and monitoring capability that can tell real time temperature, location, stock and fridge operations from any place on earth. This feature is enabled with a PCB circuit board that supports functions such as: recording temperature, recording battery voltage, charge level and isolating the fridge compressor from the battery if the charge is too low, maximising battery life and optimised charging even in periods of little sun. The circuit also sounds a buzzer if the fridge door is open for too long, if the temperatures are not within the acceptable range of  +2 to +8 degrees celsius. All this data is collected through GSM and SD Card, then transmitted via bluetooth, WIFI and SMS. The data is received in our backend platform/website where it can be synthesised into graphs and other trends. This feature also enables us as developers to monitor the fridge running at all times, remotely fix and avoid failures, ensuring reduced downtimes. This feature is also important for governments that need to accurately plan healthcare programs.

The data management system of the fridge as it identifies weak links in the supply chain. It has sensors that identify and monitor time and temperature changes in the box at a specific point in the route. Stakeholders in the supply chain can track and monitor the vials as they move and eventually know those stolen or delivered to the wrong location. If the vaccines are not stored in the required temperature range, it sends an alert back to them notifying them of any violations, with information on temperature specifics and the location of the fridge. This is important in ensuring increased shelf life of vaccines and reducing administration of placebos to children. Vaccine data storage is cloud based. When a healthcare facility receives vaccines, health admins can check the dashboard to confirm that the number of vaccines received is correct and in the right condition, before signing them off for use. This significantly reduces the wastage of vaccines and costs incurred and helps in conducting automatic stock monitoring and management,  as well as enable supply and logistics of vaccines from one facility to another.

In the next one year, we need to develop a more robust design of vacciBox that complies with the WHO Performance Quality and Safety. This certification will enable us to roll out VacciBox into more health centres in Kenya. We will achieve this by conducting a large-scale pilot with at least 50 fridges in 50 public health facilities in Kenya. We will collect data on the fridge performance and stability in storing vaccines. This will be done in partnership with the ministry of Energy in Kenya, the Kenya Bureau of Standards and the National Vaccine Centre. This pilot will also promote access to immunisation to at least 20,000 children in one year.

In the next 5 years, our goal is to ensure access to vaccines to at least 1 million children. We will achieve this by equipping 1500 rural hospitals with VacciBox fridge as well as the VacciBox IOT system. This will be made possible by our increased production capacity, since we plan to have our own manufacturing plant in Kenya

SDG 3, Good health and wellbeing- We are promoting quality healthcare for children living in rural, remote and off-grid communities by ensuring access to vaccines at all time

Through an increase in vaccinations, we generally improve the health of the patients and hence reduce the amount of money that would have been spent on getting treatment. This is a long-term solution.

Most of the patients have to travel long distances to access healthcare facilities with the necessary vaccines needed. VacciBox reduces the cost incurred and distance traveled to access the vaccines, by enabling effective field and door-to-door vaccinations for a wide reach.

We are reducing maternal deaths by providing access to cold storage for blood for transfusion in times of maternal haemorrhage during childbirth. 

We are monitoring and recording vaccine fridge data such as temperature to enable tracking and traceability of issued vaccines as a way of promoting quality healthcare for all communities.

We are collecting data that can be used by governments and development organisations to appropriately plan healthcare immunisation programs for countries like Kenya.

SDG 5, Gender equality- Promoting gender equality to women in low-income families by reducing the time they spend on unpaid care work, taking care of children and relatives who got sick from vaccine preventable disease.

SDG 8 Affordable and Clean Energy- VacciBox is solar powered hence guarantees use of clean energy within the healthcare sector. 

SDG 8 Decent Work and Economic Growth- Ongoing VacciBox production and assembly guarantees to provide at least 200 direct and indirect jobs for Kenyan youths and women in the next 5 years.

 We are reducing vaccine loss and spoilage, a challenge that costs African Countries millions of dollars every year. This saving can be channeled to backing up other healthcare programs and also to reduce economic loss for the countries.

SDG 9 Industry, Innovation and Infrastructure- We are locally manufacturing our fridge here in Kenya, a move that will create countless more jobs, directly and indirectly for women and youths. This will not only promote decent employment but also contribute to developing Kenya’s manufacturing sector through local innovation.

SDG 10 Reducing Inequality- Drop Access predominantly serves rural communities that are disenfranchised by energy poverty and poor healthcare. We are improving access to equitable healthcare for the rural-poor, offgrid and hard to reach communities. 

SDG 13, Climate Action-We are contributing to reducing carbon emissions caused by gas powered vaccine refrigerators in Africa and Asia. Our solar fridge is environmentally friendly and increases the use of clean technology in healthcare.

Theory of change

VacciBox is a 60-liter internal capacity fridge made of stainless steel g201, 1.2mm body, The insulation is polyethylene and internal lining is fiberglass. The condensing unit's voltage rating is 12/24v and wattage 55-75W paired to a digital temperature and Voltage monitor, inbuilt thermostat. Power is supplied through two 12V, 5A 40Ah lithium-ion batteries to supply a total capacity of 80Ah. The fridge has a power demand of 60W ,12h running time and a total energy demand of 360Ah, hence it is paired with two 100W mono-crystalline solar panels of Vmp 18V and Imp 4.44A. The charge controller for this assembly bears PWM technology with a charging voltage of 12/24v and a maximum current of 20A. Refrigeration is through a compressor.

The fridge utilizes  the Internet of Things (IoT) to enable the easy and swift provision of data-driven technical support and data management through  online, remote monitoring and troubleshooting. This is enabled by a fitted PCB circuit board with various functions that senses and collects data, which is then stored on a cloud and accessed through websites and a phone application.

Drop Access is women led and youth led. The founding team has 3 women and 1 man. All of them are youths. The CEO is a Woman. The organization primarily provides jobs to youths in rural communities. All the contractors are youths from rural communities  in Kenya.

VacciBox Business Model Canvas

-Sale of fridge units to health facilities

-Lease of fridge units to users, long and short term

- Subscription fee for VacciBox/ healthcare use application, paid by government bodies, development and other organisations.

Directors, Family and Friends have so far contributed USD 5,000 towards startup capital.

RES4Africa foundation granted us 6,000 Euros to develop 3 prototypes of our fridge in 2021.

Kenya Climate Innovation Centre under the Government of Kenya and DANIDA is providing technical and financial support of USD 50,000 in 2022 to develop our business model further.

Villgro Africa has granted us USD 21,000 to develop a more robust design of the fridge in preparation for scaling by July 2022 in Kenya.

Solar Energy Foundation is granting us 10,000 Euros to supply and conduct monitoring and evaluation for our next fridge design. This will be conducted in Uganda.

Acumen through the Acumen Angels program, has granted us USD 50,000 do supply and monitor at least 15 more fridges in various parts of East Africa in 2022.