* Any views expressed in this opinion piece are those of the author and not of Thomson Reuters Foundation.
A COVID-19 vaccine that requires cooling will require a dramatic expansion in cold supply chains
While countries focus on building their economies and societies back better from the coronavirus pandemic, there is a climate and development challenge beneath the surface that has not received as much attention as it should: sustainable cooling.
A COVID-19 vaccine that requires cooling will also require a dramatic expansion in cold supply chains. Getting this wrong threatens the most vulnerable and poses great risks to the climate.
Last month, the heads of government from Canada, Ethiopia, Sweden, Tunisia, South Africa, New Zealand and others called for a COVID vaccine to be equitable, saying “manufacturing and distributing it (a vaccine) while leaving no one behind will truly put global cooperation to the test”.
Cold chains are essential for vaccine distribution. Most vaccines require cooling between 2°C and 8°C. However, almost half of the COVID-19 vaccine candidates currently in Phase 1 or later trials will require storage in a chain as low as -80°C.
This means that to distribute a vaccine, cold chains around the world may need to expand rapidly, and across developing countries, new cold chain systems may need to be built completely. To put the challenge into perspective, current vaccination campaigns focus on children, and reach 116 million infants annually, far fewer than the estimated 4.7-5.5 billion people who may need a COVID-19 vaccine.
Vaccine cold chains were already insufficient prior to the pandemic. The World Health Organization (WHO) has estimated that more than 50% of all vaccines are wasted due to temperature control, logistics and shipment issues.
The pandemic has also exacerbated vast inequities in vaccine delivery. By April 3, only 23 days after the WHO declared a global pandemic, some 13.5 million people in the world’s least developed countries had already missed routine vaccinations due to travel and import restrictions and supply chain disruptions. A further 117 million children are at risk of missing their measles vaccine.
Failure to deliver sustainable and climate-friendly cold chain solutions could also lock in energy inefficient equipment that relies on super-polluting refrigerants, which can be thousands of times more damaging to the climate than CO₂ and stay in the atmosphere for 10-15 years. We must make sure that solving one global crisis does not inadvertently contribute to another.
Beyond the vaccine challenge, the lack of access to sustainable cooling undermines quality of life for populations vulnerable to COVID-19.
Sustainable Energy for All (SEforALL) data shows that over one billion people globally still do not have access to cooling. For residents of a hot urban slum, an inability to cool their home means staying in it during a heatwave is not an option. Yet the public health measures typically used to deal with heat - public cooling centers, gathering in green spaces and checking on the vulnerable – run afoul of social distancing requirements.
Residents of dense urban centres also have among the worst COVID-19 outcomes due to air pollution exposure that compromises respiratory and cardiac systems.
COVID-19 is creating challenges for nutrition too, with lack of access to cooling compounding the problem. Before the pandemic, 135 million people - over half in Africa - were facing crisis or emergency levels of food insecurity, a figure that could rise 59% if global GDP falls by 10%. For a rural household in India, a country where only 30% of people have access to a refrigerator, a lack of access to cooling may further encourage them to prioritize cheaper, less nutritious foods which can cost one-tenth of nutritious foods that require refrigeration.
The opportunities to recover better and reduce vulnerability with sustainable cooling are clear.
First, we must recognize that any COVID-19 recovery plan cannot truly be delivered without cooling and cold chains. To do this equitably, we must invest in sustainable – energy-efficient and climate-friendly – cold chain infrastructure now so that it can be ready as soon as a vaccine is proven to be effective.
Gavi, UNICEF, the WHO, and the Gates Foundation are among the larger organizations involved in the procurement of cold chain equipment and have already laid the groundwork for sustainable health cold chains through promotion of technologies like solar direct drive refrigerators.
Second, governments and development agencies should bolster our food systems with sustainable cooling solutions, including assessments of supply chain gaps and where stimulus funding can support smallholder farmers. This supports better nutritional outcomes and local economic development through jobs that are created or preserved through access to cold chains.
Finally, we must ensure that protecting the most vulnerable from extreme heat does not put them at risk of contracting COVID-19. Governments should, as a priority, revise heat action plans to factor in necessary pandemic measures and provide financial support to make efficient household cooling solutions affordable.
By Jessica Brown, Executive Director, Kigali Cooling Efficiency Program, Brian Dean, Head of Energy Efficiency and Cooling, Sustainable Energy for All, Antonella Risso, International Climate Technical and Research Manager, Health Care Without Harm and Toby Peters, Professor, Cold Economy, University of Birmingham.
