Ngo Billong Berthe, a vaccine manager at the Cite Verte health district, in Cameroon’s capital, Yaoundé, is getting more sleep now, after months of restless nights interrupted by frequent power cuts, and requests for vaccines which could not be delivered with ease because of logistical challenges.
The 53-year-old woman has been a vaccine manager for 11 years, spending a good number of these years grappling with inadequate storage facilities.
« We used to manage vaccines without knowing exactly how to arrange them in the small homologated refrigerators, coupled with frequent power cuts, » Ngo Billong told a team from Africa CDC in July during an evaluation of the Saving Lives and Livelihoods (SLL) project in Cameroon.
Working as a vaccine manager amidst frequent power cuts, and limited storage facilities was a herculean task for vaccine managers in Cameroon.
« We once had a blackout for two months, and I was forced to transfer the vaccines from my health district to the Djoungolo Health District. It was quite stressful for me because each time I received a call for vaccine supply, I had to go and collect the vaccines from the Djoungolo Health District before delivering them to the health district in need. I did that for about two months, and I can tell you that I lost about two kilios because making the runs so often was not easy for me, » Ngo Billong said.
‘The SLL changed our way of Life’
In the wake of the COVID pandemic, Cameroon’s vaccine supply chain was strengthened with 159 solar vaccine refrigerators; gifts from Africa CDC and the Mastercard Foundation.
The solar-powered refrigerators were the fruit of the Saving Lives and Livelihoods ( SLL) project , initiated by Africa CDC in 2021 to facilitate COVID19 vaccination and improve vaccination services in Africa.
« The SLL project changed our way of life. With these solar refrigerators, we can sleep peacefully because we know the vaccines are well preserved, » the vaccine manager said.
The refrigerators did not only facilitate work and step up work ethics for the vaccine managers, but prevented waste, and guaranteed the quality of the vaccines rolled out to the public.
« A vaccine badly preserved is a poison, it’s no longer a vaccine to be administered. I am so happy now because the solar refrigerators permit me to conserve the vaccines in the right temperatures, » Ngo Billong Berthe, explains.
A solar powered refrigerator has a capacity of 350litres and stores about 120,000 vaccine doses ; a-two-months vaccine supply. The SLL era ushered in a period of rest for vaccine managers like Billong Berthe who previously spent sleepless nights battling with thoughts of losing vaccines as a result of poor storage facilities and power cuts.
« I manage these solar refrigerators jealously and with love. I can sleep peacefully when I know my solar panels and refrigerators are working well, and my vaccines are well preserved, » the vaccine manager said.
Upon reception, these solar refrigerators were set up in health districts serving as vaccine depots across the country. Africa CDC also provided financial support for the purchase of two refrigerated trucks to transport vaccines to the regions.
Simon Atangana, head of logistics at the Expanded Programme on Immunization (EPI) told CRTV WEB that the solar powered refrigerators from Africa CDC have « moved the country’s vaccine storage capacity from 35% to 45%, while the two refrigerated trucks have reduced vaccine delivery time from 21 to 7 days for the East-Adamawa-North-Far North stretch of road. »
Opportunity for Capacity Building
Alihou Pantami, a vaccine manager at Djoungolo District Hospital also grappled with power cuts, limited storage facilities and little knowledge on cold chain management. She shares the joy of the SLL initiative which permitted her to acquire the required knowledge and made life easier.
« I didn’t know how to monitor vaccine temperatures, but during the training, we were shown how to manage our vaccines to avoid losses and how to properly store the vaccines. We were also taught how to record temperatures with the fridge-tag, » Alihou Pantami said.
The World Food Programme (WFP) an implementing partner of the SLL project also strengthened the capacities of vaccine managers and other professionals on temperature sensitive logistics, and fleet management.
« We planned to do 5 training sessions, but the feedback from the training spurred us to organize 11 training sessions. We were able to train 385 participants on temperature sensitive logistics and fleet management, » Magaret Akota, Head of the Supply Chain at WFP Cameroon said.
Regarding transportation, the WFP successfully dispatched 14million doses of vaccines to all the 10 regions. The UN organ also provided fuel and financial payment for loading, daily subsistence allowance for drivers and the focal points that accompanied the vaccines to the various health centres.
Another implementing partner of the SLL, the Global Health Systems Solutions (GHSS), trained 591 agents and deployed 609 mobile teams, to administer vaccines in the country between 2022 and 2023.
The GHSS was able to administer more than a million doses of vaccines in Cameroon, despite the abrupt end of the project in May 2023 after WHO announced that COVID19 was no longer a public health emergency. A total of 11,030 mobile activities were carried out, and 1,063,272 doses administered in Central Africa according to Dr. Elvis TAJOACHE Amin, Lead Monitoring and Evaluation Officer for the SLL project at the GHSS.
Figures from the Expanded Programme in Immunization show that more than 253 people were trained on heat-sensitive logistics, including 20 at the central level, 30 at the regional level and 203 district vaccine managers. Simon ATANGANA, head of the logistics at the EPI-Cameroon said this training « inspired confidence in mothers and children to take the vaccine. »
From 3% to 11% vaccination rates
The SLL project accelerated Cameroon’s COVID19 roll out; increasing community involvement in the deployment of vaccines and surveillance of vaccine security.
« Before the SLL, we had a low vaccine coverage for COVID19, just about 3%, logistical challenges partly owing to resentment from the population. The SLL accelerated Cameroon’s roll out of the COVID19 vaccine. We ended up vaccination against the disease with over 4million people, representing 11% of the population. Dr. Shalom Ndoula Tchokfe , Permanent Secretary of the Expanded Programme on Immunization said.
Before the SLL, Cameroon had only about 20metres square storage capacity, but the African-led health initiative tripled this storage capacity at the central level for vaccines preserved in negative temperatures.
The first phase of the SLL project is over and the second phase is well on course. The vaccine managers have been able to organize trainings sessions to transfer knowledge on cold chain management to colleagues. They however express hope that Africa CDC will continue to partner with Cameroon to improve vaccination services, and working conditions for especially vaccine managers in enclaves zones.
» If we can have more trainings monthly or every semester on cold chain management, it will go a long way to strengthen our vaccination services, Alihou Pantami, a vaccine manger at Djoungolo District Hospital said.
According to the Africa CDC, the second phase of the SLL will « expand its scope and scale, focusing on completing the vaccination of healthcare workers and vulnerable groups, building a robust workforce of community health workers, ensuring pandemic preparedness by bolstering national public health institutions, laboratory capacities, data access and quality, local manufacturing of vaccines, therapeutics and diagnostics ».
Kathy Neba Sina
