A good cold chain and some reliable electricity production, as well as reliable drug fridges are pretty important out bush. I’ve even written a few posts on the subject (listed at bottom of post). I even have a couple in draft form so watch out!
I was very interested in this news article Spoonful of sugar helps the medicine keep cool. There is a lot of work being done on a couple of viruses, pox and adenovirus to be able to use them as a platform for a range of other vaccines including HIV-Aids, tuberculosis and malaria.
Live vaccines need to be refrigerated. And of course the parts of the world where these diseases are most prevalent are the more remote and poorest areas without electricity.
By using a couple of sugars currently used as biological stabilisers, and slowly drying this virus-sugar mix they can vitrify (basically wrap it in “glass”) the product so it retains its stability without refrigeration at up to 45C for six months. You then take it to the remote location, reconstitute and start vaccinating. Now this has only been done in a lab but is exciting for the future.
Of course it will change the way we handle vaccines around the world, not just in the Third World. Out bush our temperatures during transport can get quite high. This graph is the temperature monitored by a data logger on it’s way from remote central Australia to Tasmania.
It will also dramatically cut costs. The World Health Organisation estimates it costs 20% more than other drugs in cold chain transfers and storage (logistics).
Out where I am we might have a refrigeration mechanic out every few months. He may or may not have the right parts. If not, we wait a month until they arrive and then another few months until a refrigeration mechanic is out again. I try to minimise this delay by having a number of spares already out bush to be available when required.
But I’m in a first world country and can afford to do this.
Reference: R. Alcock, M. Cottingham, C. Rollier, J. Furze, S. D. De Costa, M. Hanlon, A. Spencer, J. Honeycutt, D. Wyllie, S. Gilbert, M. Bregu, A. V. S. Hill, Long-Term Thermostabilization of Live Poxviral and Adenoviral Vaccine Vectors at Supraphysiological Temperatures in Carbohydrate Glass. Sci. Transl. Med. 2, 18ra12 (2010).