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Low- and middle-income countries (LMIC) are standing at the beginning of an incredibly challenging vaccine roll-out. COVID-19 vaccine delivery poses unprecedented challenges in terms of delivery volume, reaching new target populations, diversity of delivery strategies, and sometimes complex product profiles—elements that must all be managed at rapid speed if effective coverage is to be achieved. ThinkWell contributed to global level modeled estimates which indicate that the delivery cost of COVID-19 vaccines in LMIC-settings could be several times greater than for routine childhood vaccines. However, these estimates are based on crude assumptions and global level parameters, and real cost evidence from countries is lacking.

ThinkWell is conducting costing studies of COVID-19 vaccine delivery in Bangladesh, Côte d’Ivoire, and Mozambique, and 3-4 other countries to generate rapid economic evidence to support the sustainable roll-out of COVID-19 vaccines. In each country, bottom-up ingredients-based costing and top-down analysis of financial expenditure budgets and reports will be conducted to estimate the cost of delivering COVID-19 vaccines through various delivery strategies, reaching different target populations, and using products with varying cold chain requirements. The studies will also map out the service delivery process and funding flows and capture the source and use of different types of paid and volunteer health workers mobilized to deliver COVID-19 vaccines. Semi-structured interviews will also be conducted with stakeholders to assess the roll-out and its challenges. The studies will follow a common research protocol based on guidance on routine immunization costing methods and the standardized campaign costing methodology developed by ThinkWell.  You can read about previous immunization costing studies here. The first results are expected by April/May 2022.

This project is part of the Economics of Last Mile Delivery Hub and supported by funding from the Bill & Melinda Gates Foundation. To find out more about this project, please click here.

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