Energize the Chain

Key Idea:

There is a real need in the global immunization movement, and that need is for sustainable energy. Up until now vaccine distribution in developing countries has been in the domain of philanthropy and government; we need to get away from that to make it sustainable. The best way that we can think of doing this is to link on to an absolute juggernaut of technology - cell phones.

Contents:

1. Is the cold chain really the missing link?
2. Have you considered other solutions like cold storage, diesel generators or refrigerated cars to help deliver vaccines?
3. What about security?
4. How do you know the cold chain will be maintained all the way from the source to the tower?
5. How do we ensure that we have a steady supply of vaccines getting there on an ongoing basis? Who runs that? Are we counting on philanthropy?
6. Who covers the cost of the power usage?
7. Have we identified any cell providers at this point?
8. Have we planned a timeline or milestones?
9. Do we envision this company as being for-profit or non-profit?
10. Are there vaccines being developed that won’t need these refrigerators?
11. How is coordination of the teams and program management going to work?
12. Why not just connect directly to the electric grid instead of the cell towers?
13. Are there any examples of siphoning power off of cell towers right now?
14. We know a lot of the end users are not going to be paying money for the vaccine. How do we make sure we're not relying on charity to get the vaccines inside the refrigerators?
15. Are we in a stealth mode on this project?
16. What expectations do we have about backgrounds and capabilities, especially for leadership positions? Who's quarterbacking?

Q: Is the cold chain really the missing link?

A: Clearly this is a complex situation. There will always be complicating parts of the problem – poverty, lack of education, government, vaccine stability and others are all responsible for the poor performance of vaccines in developing countries. This project started when we were alerted to deaths from diphtheria in Haiti. We started talking to people and found out these deaths were not because vaccines weren't there, but because there was no energy. In times of disaster this becomes an especially big problem. The cold chain is not the only problem, but it is a major part of the problem.

Q: Have you considered other solutions like cold storage, diesel generators or refrigerated cars to help deliver vaccines?

A: Every one of those potential solutions has been thought of and tried. Because there is no central unifying force, however, they exist only in a temporary way. They work for a while, and they work in a certain area if someone is dedicated to making it work in a private way. The real benefit of our approach is that there will always be a central unifying force that will exist whether or not there are vaccines – the growth of the cell phone industry.

Q: What about security?

A: This is a topic we need to continue discussion on. For starters though, the first thing you see at every cell tower is a chain link fence around the tower. To some extent, the security is built in.

Q: How do you know the cold chain will be maintained all the way from the source to the tower?

A: This is a missing link. What we will solve is the local temperature control, but there will still be the chain. We want to look into monitoring devices that have a continuous read out of temperature conditions throughout the cold chain. The cell towers could also become an integral part of the chain itself, not just the final destination. The vaccines could go to a cell tower that provides coverage to a large population, use that as first port of entry, and then travel down the network of cell towers to the more rural areas. The cold chain could build on the availability of the cell towers.

Q: How do we ensure that we have a steady supply of vaccines getting there on an ongoing basis? Who runs that? Are we counting on philanthropy?

A: Pharmaceutical companies are the ultimate providers, and this project benefits them too. Pharmaceutical companies will have more takers for the uptake of their vaccines. For initial transportation to the countries, we are relying on the fact that the pharmaceutical companies' existing method is reliable. The India study cited in the PowerPoint shows that cold chain degradation occurs when the vaccine moves away from the primary health center.

Q: Who covers the cost of the power usage?

A: We think, although we would love to hear from cell phone companies themselves, a lot of this will have to do with how much energy we are actually using. Preliminary calculations done by engineers show that it will not be that much (this is just for cold chain, clean water may be different story), but we think this will be the cost of doing business with the cell towers. This is something we have to talk about – open to comments.

Q: Have we identified any cell providers at this point?

A: Some of the emails we have received have given us names and contacts. This is at the top of our list of action item – we have to identify cell phone tower owners and the physical cell tower structure. We want to do a few pilot projects to see if this works.

Q: Have we planned a timeline or milestones?

1) The most important thing right now is for folks to identify what team(s) they want to be on and take the leadership role. Hopefully this project will have a life of its own in a very globally networked way with some central organization – we're happy to play that central role until someone else steps up.

2) Get in touch with cell tower owners and figure out energy availability and talk to engineers about engineering and power needs. Once we have that everything should be straightforward.

Q: Do we envision this company as being for-profit or non-profit?

A: For now to be as legitimate as we can and to negotiate with a clear mission, we want to be non-profit. But even non-profits need strict organizational structure.

Q: Are there vaccines being developed that won’t need these refrigerators?

A: Ideally down the line there will be some technology for just that, however there is nothing on the horizon and it will take a while to develop non-heat sensitive vaccines; clinical testing takes 5 years. For the foreseeable future we will have very heat sensitive vaccines.

Q: How is coordination of the teams and program management going to work?

A: We can do it for a little bit but are happy to have people step into that role. This project is so exciting that we anticipate many people will want to step up for this position.

Q: Why not just connect directly to the electric grid instead of the cell towers?

A: The electrical grid is unreliable and expensive to expand. Cell towers that do draw energy from the electrical are required to have a backup energy storage in case the electrical grid goes down. Cell towers have already expanded beyond the grid; there are some towers on their own electric grid, some using solar power, some using other power sources. In general, cell towers are more reliable and cover more territory than the electrical grid.

Q: Are there any examples of siphoning power off of cell towers right now?

A: Yes, a group we've been in touch with in South America has been working with an aerospace company interested in putting national defense issues on top of cell towers. We'd like to think this is a novel idea, but in fact many people have had similar ideas.

Q: We know a lot of the end users are not going to be paying money for the vaccine. How do we make sure we're not relying on charity to get the vaccines inside the refrigerators?

A: We will be piggybacking on the existing healthcare distribution system in the developing countries. We need to learn a little bit more about this policy. Usually the government pays for the vaccines. We plan to tell the government that they're spending a lot of money on vaccines, and maybe 1/2 of them are going to waste. If we succeed in developing this technology, we can tell them that now every vaccine they buy (or whatever target success rate we set), will now get to the destination in the most efficacious form. We hope the government will say ok, at least now I'm spending my money on something that's useful.

Q: Are we in a stealth mode on this project?

A: No. This is open to the public. Feel free to forward along all our emails and try to get as many people involved. This is not something that is going to be solved by any one group. There could be 1 or 2 people that have the special insight or connections to make this happen. If that one person is missing it could be pretty devastating.

Q: What expectations do we have about backgrounds and capabilities, especially for leadership positions? Who's quarterbacking?

A: Reading some of the emails that have come our way, there are a lot of people with tremendous expertise and connections that could certainly step into the lead of quarterback. The most important qualification is someone who is dedicated to solving the problem. We're not necessarily looking for the perfect resume. Although connections and expertise are looked for, the highest quality on our list is passion. Ultimately, we need people who are real doers.