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Direct Relief Prepares for Covid-19 Vaccine Distribution, Investing $2.5 Million to Expand Cold-Chain Capacity

Direct Relief's California headquarters features a 155,000-square-foot pharmaceutical warehouse, the largest in the U.S. run by a charity, and includes validated cold-storage capacity, pictured here in 2019, for vaccines and other temperature sensitive medications.  (Lara Cooper/Direct Relief)
Direct Relief's California headquarters features a 155,000-square-foot pharmaceutical warehouse, the largest in the U.S. run by a charity, and includes validated cold-storage capacity, pictured here in 2019, for vaccines and other temperature sensitive medications. (Lara Cooper/Direct Relief)

Direct Relief has committed $2.5 million to expand its cold-chain pharmaceutical distribution capacity, preparing to assist public health authorities and other health partners in the global distribution of Covid-19 vaccines.

The $2.5 million investment aims to triple Direct Relief’s medical refrigeration and freezer capacity. Direct Relief’s current validated-for-vaccine cold-storage warehousing can hold up to 40 million doses of vaccine in 10-dose-per-vial packaging within the typical 2-8-degree Celsius temperature range but lacks larger-volume freezer capacity that some Covid-19 vaccines may require.

The organization is in discussions with national and state health authorities, the National Association of Boards of Pharmacy, and pharmaceutical donors about Covid-19 vaccine distribution plans.

Direct Relief is one of the world’s primary channels for distributing donated charitable medications—including vaccines and other cold-chain medications (those requiring constant, carefully controlled refrigeration)—to people who otherwise would not have access. In the United States, Direct Relief is a central conduit for distributing such medications to nonprofit safety-net providers, including community health centers. These providers are critical in reaching underserved communities, and specifically people of color, who have been disproportionally affected by Covid-19.

Direct Relief’s state-of-the-art pharmaceutical distribution center, which opened in 2018 in California, is one of 665 facilities in the United States accredited by the National Association of Boards of Pharmacy as an Accredited Drug Distributor and is the only one operated by a global humanitarian aid organization.

While the specific temperature-management requirements for various Covid-19 vaccines remain unknown, Direct Relief believes global cold-chain capacity is far below what is needed for rapid, mass-vaccination efforts to immunize the U.S. population, much less the global population.

“Direct Relief is taking this step with urgency, recognizing the pressures that exist in getting approved vaccine to people who need it in a safe, secure way,” said Thomas Tighe, Direct Relief President and CEO. “Existing cold-chain channels were not built to support this scale of activity. The situation echoes the severe challenges that arose with the allocation and distribution of PPE—which did not require specialized licensing to handle, store, or track, as do prescription drugs and vaccines.”

Direct Relief has extensive experience working with the world’s largest medical manufacturers to distribute cold-chain prescription drugs, vaccines, and biologic therapies connected with humanitarian and emergency-response efforts.

In the fiscal year ended June 30, Direct Relief completed 2,103 cold-chain deliveries of such products, managing end-to-end distribution to health facilities across the United States and 33 other countries. These deliveries included 738,000 vials of insulin from Eli Lilly, Novo Nordisk, and Sanofi for patients with Type-1 and Type-2 diabetes; cancer treatment drugs from Amgen, Teva, Takeda, and Baxter; blood-clotting hemophilia treatments from Bayer, Takeda, Pfizer, and Kedrion Biopharma; and biologic therapies from Takeda and Biogen for patients with rare genetic diseases.

Direct Relief has been responding expansively to Covid-19 since reports first arose in January of cases in Wuhan, China, and the Western United States. Since Direct Relief’s first Covid-19 aid delivery on Jan. 27, the organization sent 21,083 medical aid shipments to 2,786 health facilities in 54 U.S. states and territories and 88 countries. These shipments contained 3.2 million lbs. (1,600 tons) of medical essentials, including more than 38 million N95 and surgical masks, more than 7 million gloves, more than 1 million face shields, and tens of thousands of protective suits and other items to help safeguard health workers and care for patients, as well as including 76.9 million Defined Daily Doses of medications, with a value of $747.6 million (wholesale acquisition cost).

“Because Direct Relief is a public-benefit nonprofit with the specialized licensing, capacity, and experience required for cold-chain vaccine distribution, we will do whatever we possibly can to pitch in and backstop public agencies that have their hands more than full,” Tighe said. “We also want to ensure that those most in need, whom our organization supports every day and have suffered disproportionate effects from Covid-19, have a channel to support them.”

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