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Concept: Supply chain


Vaccine exposure to temperatures below recommended ranges in the cold chain may decrease vaccine potency of freeze-sensitive vaccines leading to a loss of vaccine investments and potentially places children at risk of contracting vaccine preventable illnesses. This literature review is an update to one previously published in 2007 (Matthias et al., 2007), analyzing the prevalence of vaccine exposure to temperatures below recommendations throughout various segments of the cold chain. Overall, 45 studies included in this review assess temperature monitoring, of which 29 specifically assess ‘too cold’ temperatures. The storage segments alone were evaluated in 41 articles, 15 articles examined the transport segment and 4 studied outreach sessions. The sample size of the studies varied, ranging from one to 103 shipments and from three to 440 storage units. Among reviewed articles, the percentage of vaccine exposure to temperatures below recommended ranges during storage was 33% in wealthier countries and 37.1% in lower income countries. Vaccine exposure to temperatures below recommended ranges occurred during shipments in 38% of studies from higher income countries and 19.3% in lower income countries. This review highlights continuing issues of vaccine exposure to temperatures below recommended ranges during various segments of the cold chain. Studies monitoring the number of events vaccines are exposed to ‘too cold’ temperatures as well as the duration of these events are needed. Many reviewed studies emphasize the lack of knowledge of health workers regarding freeze damage of vaccines and how this has an effect on temperature monitoring. It is important to address this issue by educating vaccinators and cold chain staff to improve temperature maintenance and supply chain management, which will facilitate the distribution of potent vaccines to children.

Concepts: Vaccine, Temperature, Influenza, Segment, Cold, Logistics, Supply chain management, Supply chain


Global supply chains play a critical role in many of the most pressing environmental stresses and social struggles identified by the United Nations' Sustainable Development Goals (SDGs). Responding to calls from the global community, companies are adopting a variety of voluntary practices to improve the environmental and/or social management of their suppliers' activities. We develop a global survey of 449 publicly listed companies in the food, textile, and wood-products sectors with annual reports in English to provide insight into how the private sector contributes to advancing the SDGs via such sustainable-sourcing practices. We find that while 52% of companies use at least one sustainable-sourcing practice, these practices are limited in scope; 71% relates to only one or a few input materials and 60.5% apply to only first-tier suppliers. We also find that sustainable-sourcing practices typically address a small subset of the sustainability challenges laid out by the SDGs, primarily focusing on labor rights and compliance with national laws. Consistent with existing hypotheses, companies that face consumer and civil society pressure are associated with a significantly higher probability of adopting sustainable-sourcing practices. Our findings highlight the opportunities and limitations of corporate sustainable-sourcing practices in addressing the myriad sustainability challenges facing our world today.

Concepts: Sustainability, United Nations, Millennium Development Goals, Sustainable development, Supply chain, Privately held company, Public company, Form 10-K


{}This paper investigates a practical variant of the vehicle routing problem (VRP), called VRP with simultaneous delivery and pickup and time windows (VRPSDPTW), in the logistics industry. VRPSDPTW is an important logistics problem in closed-loop supply chain network optimization. VRPSDPTW exhibits multiobjective properties in real-world applications. In this paper, a general multiobjective VRPSDPTW (MO-VRPSDPTW) with five objectives is first defined, and then a set of MO-VRPSDPTW instances based on data from the real-world are introduced. These instances represent more realistic multiobjective nature and more challenging MO-VRPSDPTW cases. Finally, two algorithms, multiobjective local search (MOLS) and multiobjective memetic algorithm (MOMA), are designed, implemented and compared for solving MO-VRPSDPTW. The simulation results on the proposed real-world instances and traditional instances show that MOLS outperforms MOMA in most of instances. However, the superiority of MOLS over MOMA in real-world instances is not so obvious as in traditional instances.

Concepts: Management, Operations research, Transport, Problem solving, Logistics, Supply chain management, Supply chain, Vehicle routing problem


Fraud in the global food supply chain is becoming increasingly common due to the huge profits associated with this type of criminal activity. Food commodities and ingredients that are expensive and are part of complex supply chains are particularly vulnerable. Both herbs and spices fit these criteria perfectly and yet strategies to detect fraudulent adulteration are still far from robust. An FT-IR screening method coupled to data analysis using chemometrics and a second method using LC-HRMS were developed, with the latter detecting commonly used adulterants by biomarker identification. The two tier testing strategy was applied to 78 samples obtained from a variety of retail and on-line sources. There was 100% agreement between the two tests that over 24% of all samples tested had some form of adulterants present. The innovative strategy devised could potentially be used for testing the global supply chains for fraud in many different forms of herbs.

Concepts: Software testing, Supply chain management, Adulterant, Supply chain


International efforts to eradicate smallpox in the 1960s and 1970s provided the foundation for efforts to expand immunization programmes, including work to develop immunization supply chains. The need to create a reliable system to keep vaccines cold during the lengthy journey from the manufacturer to the point of use, even in remote areas, was a crucial concern during the early days of the Expanded Programme on Immunization. The vaccine cold chain was deliberately separated from other medical distribution systems to assure timely access to and control of vaccines and injection materials. The story of the early development of the vaccine cold chain shows how a number of challenges were overcome with technological and human resource solutions. For example, the lack of methods to monitor exposure of vaccines to heat during transport and storage led to many innovations, including temperature-sensitive vaccine vial monitors and better methods to record and communicate temperatures in vaccine stores. The need for appropriate equipment to store and transport vaccines in tropical developing countries led to innovations in refrigeration equipment as well as the introduction and widespread adoption of novel high performance vaccine cold-boxes and carriers. New technologies also helped to make injection safer. Underlying this work on technologies and equipment was a major effort to develop the human resources required to manage and implement the immunization supply chain. This included creating foundational policies and a management infrastructure; providing training for managers, health workers, technicians, and others. The vaccine cold chain has contributed to one of the world’s public health success stories and provides three priority lessons for future: the vaccine supply chain needs to be integrated with other public health supplies, re-designed for efficiency and effectiveness and work is needed in the longer term to eliminate the need for refrigeration in the supply chain.

Concepts: Immune system, Public health, Vaccine, Vaccination, Smallpox, Logistics, Supply chain management, Supply chain


Medicines use related challenges such as inadequate adherence, high levels of antimicrobial resistance and preventable adverse drug reactions have underscored the need to incorporate pharmaceutical services to help achieve desired treatment outcomes, and protect patients from inappropriate use of medicines. This situation is further constrained by insufficient numbers of pharmaceutical personnel and inappropriate skill mix. Studies have addressed individual capacity building approaches of logistics, supply chain or disease specific interventions but few have documented those involving such pharmacy assistants/professionals, or health workers/professionals charged with improving access and provision of pharmaceutical services. We examined how different training modalities have been employed and adapted to meet country-specific context and needs by a global pharmaceutical systems strengthening program in collaboration with a country’s Ministry of Health and local stakeholders.

Concepts: Pharmacology, Medicine, Drug, Corticosteroid, Adverse drug reaction, Pharmaceutical drug, Pharmacy, Supply chain


The circulation of poor-quality medicines continues to undermine the fight against many life-threatening diseases. Anti-malarial medicines appear to have been particularly compromised and present a major public health threat in malaria-endemic countries, negatively affecting individuals and their communities. Concerted collaborative efforts are required from global, regional and national organizations, involving the public and private sectors, to address the problem. While many initiatives are underway, a number of unmet needs deserve urgent and increased multisector attention. At the global level, there is a need for an international public health legal framework or treaty on poor-quality medicines, with statutes suitable for integration into national laws. In addition, increased international efforts are required to strengthen the governance of global supply chains and enhance cooperation between national medicine regulation authorities and law enforcement bodies. Increased investment is needed in innovative technologies that will enable healthcare teams to detect poor-quality medicines at all levels of the supply chain. At the regional level, a number of initiatives would be beneficial-key areas are standardization, simplification, and reciprocal recognition of registration processes and development of quality control capacity in regional centres of excellence that are better aligned with public health needs; improved surveillance methods and creation of a framework for compulsory and transparent reporting of poor-quality medicines; additional support for national medicine regulation authorities and other national partner authorities; and an increase in support for regional laboratories to boost their capabilities in detecting poor-quality medicines. It is vital that all stakeholders involved in efforts against poor-quality anti-malarial medicines extend and strengthen their actions in these critical areas and thus effectively support global health development and malaria elimination programmes.

Concepts: Health care, Medicine, Health, Law, Management, Collaboration, Need, Supply chain


This paper presents the results of a stepwise investigation of the quantity and quality of food losses along the Swiss potato supply chain. Quantitative data were collected from field trials, from structured interviews with wholesalers, processors and retailers, and from consumer surveys in combination with a 30-day diary study. The “Swiss trade customs for potatoes” pose the basis for the qualitative evaluation of losses. The influences of technological, institutional (business and economy; legislation and policy), and social drivers on the generation of fresh potato and processed potato products losses were assessed. Losses due to quality standards driven by food safety and consumer preferences for certain aesthetic standards have been evaluated too. Across the entire potato value chain, approximately 53-55% of the initial fresh potato production and 41-46% of the initial processing potato production are finally lost. Losses between organic and non-organic supply chains differ from 2% to 5%. From the total initial fresh potato production, 15-24% gets lost during agricultural production, a further 12-24% at wholesalers, 1-3% at retailers, and 15% at private households. In comparison, 5-11% of the initial production gets lost at wholesalers, a further 14-15% during processing, 0% at retailers, and 2% at private households. Losses during agricultural production do not vary much (13-25%) between fresh and processing potatoes. Approximately half of total potato losses occur because potatoes do not meet quality standards. 25-34% of these quality-driven losses are caused by food safety reasons, and the remainder are caused by consumer preferences or suitability for storage. In total, social drivers (e.g., consumer preferences, behavior, or socio-demographical factors) are responsible for two-thirds to three-fourths of all fresh potato losses and 40-45% of all processing potato losses. Technological drivers cause circa one-third of the total processing potato losses. The majority of the rejected potatoes are used as animal feed (67-90%) in Switzerland. Approximately 30% of all fresh potato losses are disposed while just 4-5% of all processing potato losses are thrown away. The interviewed experts stated that lower quality specifications might cause lower loss rates at the first stages of the supply chain but higher ones at the later stages due to worse storage or processing abilities of potatoes with defects, which also might affect proper tubers.

Concepts: Causality, Management, Marketing, Potato, Supply chain management, Production and manufacturing, Supply chain, Value chain


Senegal’s government has pledged to reduce contraceptive stockouts, which have been frequent in public sector health facilities. An innovative distribution system called the Informed Push Model (IPM) addresses supply chain obstacles through direct regional-to-facility delivery of contraceptives and use of private sector logistics operators. Following promising pilot results, Senegal’s Ministry of Health and Social Action committed to a three-year (2013-2016) expansion of IPM to all public health facilities nationwide.

Concepts: Birth control, Family planning, Economics, People's Republic of China, Abortion, Government, Sex education, Supply chain


The need to keep vaccines cold in the face of high ambient temperatures and unreliable access to electricity is a challenge that limits vaccine coverage in low and middle-income countries (LMICs). Greater vaccine thermostability is generally touted as the obvious solution. Despite conventional wisdom, comprehensive analysis of the value proposition for increasing vaccine thermostability has been lacking. Further, while significant investments have been made in increasing vaccine thermostability in recent years, no vaccine products have been commercialized as a result. We analyzed the value proposition for increasing vaccine thermostability, grounding the analysis in specific vaccine use cases (e.g., use in routine immunization [RI] programs, or in campaigns) and in the broader context of cold chain technology and country level supply chain system design. The results were often surprising. For example, cold chain costs actually represent a relatively small fraction of total vaccine delivery system costs. Further, there are critical, vaccine use case-specific temporal thresholds that need to be overcome for significant benefits to be reaped from increasing vaccine thermostability. We present a number of recommendations deriving from this analysis that suggest a rational path toward unlocking the value (maximizing coverage, minimizing total system costs) of increased vaccine thermostability, including: (1) the full range of thermostability of existing vaccines should be defined and included in their labels; (2) for new vaccines, thermostability goals should be addressed up-front at the level of the target product profile; (3) improving cold chain infrastructure and supply chain system design is likely to have the largest impact on total system costs and coverage in the short term-and will influence the degree of thermostability required in the future; (4) in the long term, there remains value in monitoring the emergence of disruptive technologies that could remove the entire RI portfolio out of the cold chain.

Concepts: Immune system, Vaccine, Vaccination, Influenza, Logistics, Supply chain management, Cold chain, Supply chain