Assessing the Shift in Global Health Care Equity Following the Peaks in the Devastation From COVID-19

Pharmacy Times interviewed Daniel Gagnon, VP of Global UPS Healthcare, on a vaccine equity panel discussion at the UPS Impact Summit in Atlanta, which was held at the National Center for Civil and Human Rights.

Alana Hippensteele: Hi, I’m Alana Hippensteele with Pharmacy Times. Joining me is Daniel Gagnon, VP of Global UPS Healthcare, who is here to provide details from the vaccine equity panel discussion at the UPS Impact Summit in Atlanta. This inaugural event at the National Center for Civil and Human Rights looked to explore the rapidly changing intersection of environmental, social, and corporate governance (ESG), with equity and economic empowerment.

So Daniel, what is UPS healthcare, and how is it working to address vaccine equity in developing countries?

Daniel Gagnon: Well, first off, thanks for having me. UPS has been around for a long time. UPS Healthcare, specifically, has really only been around for 2 and a half years. We've had a focus on health care for about 16 years, but I would say the last 2 and a half years is really when we brought that to market. And what I mean by that is, we brought all of the folks under 1 division. So, we have our facilities, our staff, our finance, our sales, our solutions people, all under 1 group. Really what that does is that allows us to be very, very specific to the customer need. And when I say customer, obviously, it's a wide range within health care—whether it's a pharmaceutical manufacturer, whether it's a centralized lab, even tissue banks, lots of opportunity here. Again, we have people that actually know health care, know that there's a patient at the other end of the supply chain, and we understand the regulations and criticality of what we're moving.

Regarding the equitable distribution of vaccines, UPS to date has delivered almost 1.6 billion doses around the world. What folks do not know is that over a billion of those doses have been outside of the US. When we talk about equitable distribution, there are some very, very difficult countries out there. Africa is a great example. Even the African population is very, very under-vaccinated, even to this day. But when you talk about serving those communities, you have to get creative. A lot of the vaccines are required to be stored within 2 to 8 degrees Celsius—in some cases, frozen, -80° C. So, we’ve got some very creative ways of getting vaccines to some of these remote villages. As a matter of fact, we’ve got almost 150,000 doses—sorry, we have almost 1 million doses delivered via drone. That’s a pretty unique application of new technology, drone technology, to serve villages. The reason we use drones is you can get 50 miles straight as an arrow, get these doses, frozen doses, to a rural community and get them administered very, very quickly, versus trying to go on road—of course, in the heat and everything else, it takes quite a quite a toll on the vaccine.

Alana Hippensteele: What were some of the key takeaways from the virtual panel discussion addressing moving the needle on equity and economic empowerment?

Daniel Gagnon: I mean, first off, there’s universal agreement that just more needs to be done. I think a lot of the world’s attention was really on some of the westernized countries, the countries that had the money, had the health care systems that could actually execute a fast and swift inoculation. I think a key takeaway around the world is that importance of collaboration with public and private organizations. We have the responsibility to get populations vaccinated—really fall under the public sector. And the public sector did not have, at the time and in many countries, a lot of experience with crisis management with distributing a frozen vaccine throughout their populations. There weren’t the assets, the ultra-low temperature freezers in these communities. There weren’t even systems in order to tabulate who got a dose and which dose that they get, and did they get 2 doses. So, that collaboration with public and private partners I think was a key takeaway. The countries that were the most successful had groups come together and really work very, very closely together.

I think another takeaway, too, was really the importance—2 things—the importance of technology, in making sure that a lot of what was happening from medical records, to inventory of vaccines, inventory of needles, was tracked, that there was a clear understanding of where the supplies were, where patients were, and where they needed to be a vaccinated. Technology really played a real important role with what took place. And lastly is—and this is going to be an interesting one, because it's a little outside of the world of logistics—but the importance of communication, public awareness. There’s a lot of communities that had vaccines at their disposal, but for whatever reason decided not to go in and take them. Maybe there was rumors that a vaccine wasn’t as effective as another vaccine. So, that public prominence, making sure that messaging is going to the community about the efforts, where they can get vaccines, and even the efficacy of a vaccine, in both pros and cons, is an important piece, especially for some of these communities that still aren't there yet.

Alana Hippensteele: Right. How has the intersection of environmental, social, and corporate governance, or ESG, and health care equity and economic empowerment shifted in recent years, and what is the impact of this shift?

Daniel Gagnon: There has been an interesting influx in terms of—again, I'm going to include technology in this—but technology, government, the vaccine manufacturers, local communities, just to help facilitate the move of vaccines via drone. We used an organization Zipline in Rwanda, Ghana, Cameroon, in order to deliver vaccines. That just doesn't happen. You need a lot of authorities weighing in, whether it's an FAA equivalent, whether it's those responsible for the efficacy of the medicine, whether it's the logistics provider. So, you talk about having a lot of hands in the pot, in order to be able to do something like that, I think really intensifies not only the parties that need to be available to say yes but also their flexibility and their ability to collaborate and work together.

Alana Hippensteele: Absolutely. It was predicted that the divide between the developed and developing nations would be quite clear in the overall impact that the pandemic would have on each nation's public health and economy. Based on the data we have now, would you say this prediction at the beginning of the pandemic came to pass?

Daniel Gagnon: I would actually say that I think there was some predictions that those that are in lower- and middle-income countries might not have the right access. I would think that it came out a little worse than projected. And I think you can blame it on a lot of different things, politics, infrastructure within the countries, maybe even the government's ability to collaborate with parties that are outside their country—death by a thousand cuts, quite frankly. There's lots of reasons why it took place. But I would say the gap is probably a little wider than originally predicted. Now, having said that, I do think that the world recognizes it and companies like UPS are very, very aggressive to try to make sure that we're bringing down the barriers that we can, whether it's some of the logistics challenges, working with regulators in order to make sure that we can get these vaccines to the right location.

Alana Hippensteele: Right, absolutely. As developed nations continue to move towards a post COVID world, what may be the impact on developed nations or developing nations? And what are the implications of this impact on the future of public health more broadly speaking?

Daniel Gagnon: I love this question because I think I'll use this quote, and I've talked about this before. With COVID, it forced a lot of logistics companies to heavily invest in a process to get vaccines out and into arms. And it wasn't just a one-time investment, because when we look at the drug pipeline, there's lots of great temperature controls, vaccines, and biologics that are going to follow through. So, the logistics industry just did not build the church for Sunday, right? At the end of the day, what's happened here is the investments that have gone through not just UPS but all providers are going to be used for really, really good medicines. When you look at the future of medicines, most were pill form or what we actually call small molecule, the normal medication we think, but it has lots of side effects depending upon your genetics. We moved to biologics, which are a lot more targeted within the system, and developing countries are going to be able to benefit from that. They have cold chain infrastructure, at least some. They have providers that are willing to go and bring assets. They now have a tracking system so they can actually track who's ill, who's getting the right medication. So, I do think that the tide has risen as it pertains to health care logistics in a lot of these countries.

Alana Hippensteele: Right, absolutely. Any closing thoughts, Dan?

Daniel Gagnon: At the end of the day, COVID has really changed some things for the better. There is a silver lining in many different areas of our lives, right? And we're going to specifically talk about health care here today, but there's a lot of things that changed that needed to be changed. I think for health care, it has really driven changes in health care looking more to e-commerce, there's more direct patient care, more diagnostics happening at the home. And of course, with our lower middle-income countries, there's a stronger infrastructure and, quite frankly, knowledge on how to combat a crisis like this. So, I think there has been a silver lining in these clouds. It's just up to us to make sure that it gets used.