1. A RELIABLE
TEMPERATURE
CONTROLLED SUPPLY
CHAIN IN EMERGING
ECONOMIES
Chilukuri Maheshwar
Anglo Eastern Maritime Academy

2. Genesis
 1970s- LEDCs ( Less Economically Developed
Countries)
 Term changed to Emerging Markets or
Emerging Economies – indicates countries in
transitional stage between developing to
developed countries
 Regions of the world that are experiencing
rapid informationalization under conditions of
limited or partial industrialization: 2008
Emerging Economy Report

3. 2010: CATEGORY BETWEEN
FULLY DEVELOPED AND
DEVELOPING

4. Emerging Economies
 BRIC: Brazil, Russia, India & China
 BRICS: Brazil, Russia, India China & South
Africa
 BRIICS:
Brazil, Russia, India, Indonesia, China & South
Africa
 BRICKET
 BRICM
 BRICK
 Next Eleven
 CIVETS

5. Importance of Emerging
Economies
 Perceived as growth centres of the future
 Drivers of future economic growth
 Bullish investor confidence
 Show higher economic growth rate compared
to developed countries
 Expected to play a greater role in areas like
financial markets, consumption of goods and
services, trade and commerce, sustainable
development, innovation, infrastructure
development and research.

6. Features of Emerging
Economies
 Lower public health spending
 Competing expenditure needs and constrained
revenue raising capacity
 Asia has lesser public spending ratios
because of less extensive public insurance
coverage and benefit packages

7. Public Health Care Spending

8. Challenges of Emerging
Economies
 Lower average life expectancy and Higher
infant mortality
 Limited funds to improve health standards
 Less extensive health coverage
 Ill aligned incentives (motivation) for health
care providers
 Large informal labour market
 Lower General awareness levels about
sanitation and hygiene

9. Solutions for Emerging
Economies
 Increase public health spending
 Improve the general health safety net
 Importance to primary and preventive health
care
 Incentives for health care providers
 Expansion of basic health care
 Focus on providing most essential health
services
 Where already an extensive health care
system is in place, the improve efficiencies by
leveraging economies of scale.

10. Pharmaceutical Cold Chain
 Complex drugs and pharmaceutical products market
expected to grow to U.S. $900 billion by 2012 and $1.2
trillion by 2014.
 Life-saving products like vaccines : $35 billion market by
2015
 25 percent of all healthcare products are temperature-
sensitive, meaning they require refrigeration during
transportation and storage from manufacturer to end
user.
 By 2014, $16 billion worth of biological and vaccine
shipments will require temperature-controlled rooms
during transit.
 Short window of viability, which makes rapid transport
essential.

11. Pharma Markets
 Effective cold chain shipping is critical, as
pharma and biopharma cold chain shipments
in markets worldwide are expected to grow
dramatically in future.
 Emerging Economies are the drivers of
volumes
 South Asia seen as the fastest growing cold
chain shipment volume region
 Cold Chain Infrastructure less developed
here, losses maximum in this region

12. Vaccines
 One of the first and foremost tools for preventive
health care is Vaccination.
 In 2005, nearly half of all vaccines got ruined in
transit due to poor cold chain services: WHO

13. Degree of Knowledge about Vaccine
storage in Developed Countries: A
Case
 To assess the knowledge and practice of vaccine
storage and handling in primary care physicians'
offices, a cross-sectional study was conducted in
Canada from August to December 1992. Staff
responsible for vaccine storage were interviewed about
their knowledge and practices of vaccine handling and
storage. Refrigerators were inspected to document
refrigerator temperature and vaccine storage conditions.
 Out of a total of 135 respondents, less than 7 answered
all questions related to vaccine storage and handling
correctly, and only 11 refrigerators had thermometers.
1/3 of refrigerators had temperatures outside the
recommended range of 2-8 degrees C. Older
refrigerators were more likely to have inappropriate
temperatures than newer ones.
 The Study concluded that knowledge and practice of
vaccine storage and handling are often inadequate in

14. Maintenance of Vaccine Cold
Chain in Developed Countries – A

Case the vaccine cold chain is an essential part of a
Maintaining
successful immunization programme, but in developed
countries faulty procedures may occur more commonly than is
generally believed.
 A survey was conducted in 1999 in a health district in central
Italy to assess the methods of vaccine transportation and
storage. Of 52 primary vaccination offices inspected, 39
(76.5%) had a refrigerator for vaccine storage but only 17
(33.3%) kept records of received and stored doses.
 None of the seven main offices selected for monitoring had a
maximum and minimum thermometer and none monitored the
internal temperature of the refrigerator.
 Moreover, other faulty procedures, such as the storage of food
and laboratory specimens in vaccine refrigerators and the
storage of vaccines on refrigerator door shelves, indicated
that the knowledge and practice of vaccine storage and
handling were often inadequate

15. India: Polio Vaccination
Movement
 1996: Polio Eradication 2500
Program started
 2000: Expected Global 2000
Eradication of Polio
 2007: 866 Polio cases 1500
reported
 Fresh Polio cases are still 1000
being reported. No. of Polio
Cases reported
 One of the reasons for the 500
failure of Polio Vaccination
program in India is the 0
absence of an effective cold
Year 2003
Year 1998
Year 2000
Year 2001
Year 2002
Year 2004
Year 1999
Year 2005
Year 2006
Year 2007
chain which rendered the
vaccine ineffective

16. Why such losses in this region?
 High Ambient temperature
 Poor transport infrastructure
 Lack of knowledge and awareness
 Poor roads and poor connectivity
 Dusty atmosphere
 Non availability of refrigerated carriers
 Difficult Geographical terrain
 Cold Chain Infrastructure is a Non priority sector for the
administration as there are more important priority areas
where funds need to be deployed
 Less evolved cold chain shipment regulations
 Unreliable grid power

17. Challenges
 Multiple international and country specific cold
chain shipment regulations
 Set up a cold chain infrastructure in place
 Training of the various stakeholders including
public at large
 Establishing a network of partners who can
look after the cold chain shipment at various
stages before reaching the end consumer

18. Distribution Chain

19. Distribution Challenges
 Distribution in emerging markets presents three
particular challenges:
• Improving forecast accuracy and data reliability
for estimating vaccine or drug demand
• Maintaining product stability throughout the
distribution chain, including requirements for cold-
chain continuity
• Managing the dispensing of medical products to
patients in the “last mile” of the distribution chain
(i.e., the stage where products are delivered from
the wholesaler or pharmacy to the consumer).

20. How to handle the Last Mile?
Challenges Opportunities
 Smaller Quantities  Extension of Cold Chain
 Lack of availability of right till the end
recognised Cold Chain  Innovative Methods of
 Field Difficulties Maintaining Cold Chain
 Dusty atmosphere  Indigenous Methods of
Preservation
 High ambient Heat  Innovation and use of
 Language Barrier Technology in
 Social Barriers communication
 Unavailability of Grid
Power

21. A seamless gap-free cold chain
 This can be achieved at the Last mile using
Refrigerated Containers for the final last mile
transportation of the drugs and vaccines.
 Already Refrigerated Containers are being used in
ocean transportation of the export of pharma
products.
 However, for applications over land in the local
terrain, to suit the local environmental and climatic
conditions, with the present power availability and
road infrastructure, they need to be adapted
suitably with necessary modifications.

22. Specifications Of A Standard 20 Feet
Refrigerated Container
 External Dimensions: 20x8x8.5 Ft.
 Internal Dimensions: 18x7.5x7 Ft.
 Internal Volume: 1000 Cu. Ft.
 Payload Capacity: 21350 Kgs
 Gross Weight: 24000 Kgs
 Temperature : -25 To +35 Deg C
 Power Consumption: 3 Kwh

23. Solar Powered Refrigerated
Containers
Why Solar Power
 Depleting Fossil
Fuels
 Growing
Environmental
Concerns
 Erratic and
Unreliable Grid
Power
Myth about Solar Power
 Solar PV power is
very expensive

24.  Following the Moore’s law, it is expected that with the
new generation technology with concentration equivalent
of more than 1,600 times the sun's energy onto solar
cells, it would be possible to produce electricity at a
wholesale cost of US $0.05 per kilowatt-hour (kWh)

25. SOLAR CHILL PROJECT
 Affordable, easy to use refrigerators
that can keep vaccines at safe
temperatures within the infrastructure
limitations of developing countries
are an important tool in improving
vaccine delivery.
 Already some inroads have been
made in the direction.
 Solar Chill is a global initiative that
has developed a climate- and ozone-
friendly portable vaccine cooler that
is powered by solar energy and
which will directly help improve the
health of children in developing
countries when used to transport
vaccines and drugs to the remote
and inaccessible parts.

26. PATH (Programs for Appropriate
Technologies in Health)
 An international, nonprofit organization and a
partner in Solar Chill project
 Develops safer injection technologies such as
auto-disposable syringes, pre-filled injection
devices, and medical waste systems making
injection safety an attainable goal for many
struggling health systems.
 Helping to refine the vaccine distribution cold
chain including identifying cold chain
weaknesses, finding ways to overcome cold chain
problems, and identifying improved cold chain
refrigeration systems.
 Developed affordable, easy to use refrigerators
that can keep vaccines at safe temperatures within
the infrastructure limitations of developing

27. Vaccine Vial Monitor (VVM)
 Conceptualized the vaccine vial monitor
(VVM), now used globally to increase vaccine
efficacy and reduce wastage.
 A heat-sensitive label changes color as it is
exposed to heat and helps health workers
decide whether or not the vaccine has been
damaged by heat. It also reveals breaks in the
vaccine distribution cold chain.

28. Overcoming Distribution
Challenges
 Improving demand  Alleviating
planning and forecast dependency on
accuracy temperature control.
 Improving market  Shortening the last
reliability mile of distribution
 Using Information  Supply-chain
technology tools. innovations
 Setting up  Alternative delivery
Information networks. systems.
 Innovative Cold-chain  Strengthening local
distribution strategies health systems.
 Maximizing existing
infrastructure

29. Agricultural Sector vs
Pharmaceutical Sector
 Economic Losses more severe in Pharma
sector
 Administering a damaged vaccine or drug is
far more dangerous
 Erosion of the sense of security in vaccination
 Pharma Volumes smaller to justify air
transportation over ocean transportation
 Urgency of requirement in case of vaccines
and drugs

30. Features of an Effective Cold
Chain
 Temperature
Measurement, Monitoring, Control and
Recording
 Traceability
 Accountability
 Transparency
 Effective Communication
 Networking and Involvement

31. 360 Quality Code and Zero
damage Concept for Perishable

Cargo standards for specialised reefer shipping lines and
Set of voluntary
their service providers.
 Launched by a group of specialised reefer operators (Specialised
Reefer Shipping Association - SRSA) including Great White Fleet
Ltd, Green Reefers ASA, NYKLauritzenCool AB, Seatrade Group
N.V., STAR Reefers Ltd. (Blue Star Line) and Universal Reefers
Ltd./Cape Reefers in 2006
 Aims to meet customer needs by promoting the highest standard
of quality and cargo care; on reefer vessels, in port terminals and
in liner trades.
 Recognises that the specialised reefer shipping lines and their
service providers have to work jointly to achieve this goal.
 Brings transparency in the supply chain of perishables on the
basis that in a collaborative supply chain everyone involved should
assume responsibility for their activities and take corrective action
to eliminate defects.

32. Main Features of 360 Quality Code
 Implementing practices and using equipment in terminals and
ships that will prevent damage to cargo
 Uniform way of establishing damage and following an agreed
action plan when damaged cargo or cargo with exceptions is
presented to the terminal and ship
 Uniform way of recording exceptions at
reception, loading, unloading and delivery of cargo.
 Establishing local working procedures for ports of loading and
unloading which are compatible with the requirements of the
Code
 Establish quality teams in ports who will analyse the damages
their cause and introduce preventive measures
 Provide feedback upstream in the supply chain

33. 360 Quality Association
 A body dedicated to improving Food Safety and Food Quality in
the specialised reefer shipping has been formed.
 Main task - to develop guidelines for the implementation of the
360 Code and develop it further to meet the needs of the
market.
 Developed Uniform Guidelines for auditors and certification
bodies that will audit the terminal and ships.
 Classification societies and other accredited bodies that meet
the approval of the 360 Quality Association will certify the
shipping lines and the port terminals according to certification
procedures.

34. Checkpoints in the supply chain
& feedback to partners
 Checkpoints are established in the supply chain to
monitor the condition of the cargo and prevent
damaged cargo from coming onboard and recording
accurately the exceptions at the time of delivery.
 The terminals and stevedores record the exceptions at
the checkpoints in a properly structured database
which allows to analyse the exceptions to reach the
Six Sigma method for improving quality.
 Lays down the conditions for inspection and recording
of exceptions, for measures taken, and communication
to everyone involved of the results – all in a uniform
way and by using properly structured data.
 Makes the transport process transparent and provides
a firm base for taking corrective action at one or more
points in the supply chain.

35. Zero Damage Concept
 Zero Damage - a mindset in which we develop respect
for the products we carry along with the livelihood of all
partners in the production and supply chain.
 Zero Damage is an industry standard adopted by
SRSA members and is a part of 360 degree Quality
Initiative of SRSA.
 Motivates people to take care of the cargo all along the
way.
 A drive against reefer cargo claims and aims to
enhance Customer Satisfaction.
 Reminds about respect for cargo and equips the crew
members with the knowledge and expertise in cargo
care, Reefer Cargo losses have been reduced
substantially by use of Zero Damage Concept.

36. Zero Damage Concept
 Procedures have been clearly spelt out so that the
cargo is handled
economically, efficiently, professionally and
carefully.
 Checkpoints in the supply chain ensure that
responsibility is handed over smoothly removing
any ambiguity and enhancing transparency.
 Whenever any cargo damage occurs, answers
are sought as to WHY, WHERE and WHEN the
damage had occurred reinforcing the commitment
“Whoever is responsible for damage is
accountable for the damage”.

37. Reefer Cargo Export Supply
Chain

38. The various partners who can influence
the supply chain are:
 Farmer/grower  Vessel
 Packing Station  Stevedore in
 Truck Discharge port
 Terminal or Cold  Terminal or Cold
store in Load Port Store in Load Port
 Stevedore in Load  Truck
Port  Distribution Centre
 Port Captain  Supermarket

39. Start of the Supply Chain -
Farmer
 Being his
livelihood, the
grower/farmer takes
very good care of the
cargo.
 Regular quality checks
will be carried out
during the various
stages of the growing
or production process.

40. Start of the Supply Chain
 Refrigeration of the product at the grower’s end is
highly recommended as the grower has no control
over its handling and storage after it is sold and
leaves his hands.
 It buys the growers that extra shelf life time that the
wholesaler and retailer might reduce with poor
handling procedures.
 A grower who can meet the challenges of preserving
the quality from field to dinner table will be able to
expand his marketing opportunities and will be able
to compete better in the market place.
 If a product does not hold up in the distribution
chain, often the grower is blamed for poor handling

41. End of the Supply Chain -
Supermarket
 Even the truck driver
who takes the cargo
to the final
destination point - a
supermarket or a
local grocery store
has a role to play in
the Quality System.

42. Introspection
 Do we have something identical in Pharma Supply
Chain?
 Do we have a clear understanding of the export
process?
 Have we identified and enpowered all the partners
in the Supply Chain?
 Have responsibilities been clearly identified?
 Is there Transparency?
 Is there Accountability?
 Is there Traceability?
 Does free flow of communication exist?
 Finally, are we always keeping the end consumer
in sight all through the process?

43. End Consumer
This could be our End Consumer!

44. Namaste
THANK
YOU