Kavya Hari – Sr. Associate, Intellecap & Ankit Gupta – AVP, Intellecap
Need and importance of off-grid solar refrigeration for storage of vaccines
In India, reliability of grid electricity remains a significant challenge despite an electrification rate of 99.93% as per the Saubhagya Dashboard. According to the 2019-20 Rural Health Statistics, 28.4% of the sub-centres and 4.3% of the primary health centres (PHCs) in rural areas lack electricity supply; severely affecting the efficacy of health service delivery. A reliable source of electricity is required to enable refrigeration of medical supplies (like vaccines, blood, biological samples etc.) and ensure appropriate functioning of medical equipment.
In India, about 20-25% of all temperature sensitive health products (including vaccines) are spoilt or wasted due to insufficient refrigeration facilities. In terms of Covid-19 vaccination, the national average wastage is 6.3%, while the rate varies across states from 15% to less than 1%. Vaccine wastage occurs at both service and delivery levels – during storage, transportation and at vaccination centres. Majority of the vaccines (including Covishield and Covaxin) require a controlled temperature range from 2oC to 8oC to protect their potency. A vaccine’s efficacy is dependent on its potency, which can be reduced due to lack of proper storage and transportation facilities at the requisite temperature. Vaccine efficacy can be maintained by provision of reliable source of electricity through off-grid solar refrigerators.
Cost-effectiveness of off-grid solar refrigeration technologies
Solar direct drive (SDD) with phase change material (PCM) thermal battery and solar with battery (SWB) systems for ice lined refrigerators (ILRs) are the two most common types of technologies deployed in India. Technologies like SDD require only eight hours of sunlight to store thermal energy for a minimum of 78 hours of autonomy at an ambient temperature and a holdover time of 91 hours. SDD is also a more cost-effective technology mainly due to lower operational and maintenance costs at $8/litre compared to $16/litre for a SWB system. The higher cost for a SWB system is attributed to regular replacement of solar batteries.
In the absence of grid electricity supply, majority of the rural health centres use diesel generators that have higher operating costs (~$37/litre) due to recurring expenditure on fuel. Diesel generators also contribute to air pollution and have a detrimental impact on health and the environment. Typically, replacement of a diesel generation with solar technology for a 100-litre vaccine refrigerator (~1.9 kWh per day) can eliminate up to 720 kg of carbon dioxide emissions annually. Off-grid solar refrigerators thereby directly contribute to SDG 7 (clean energy) and SDG 13 (climate action).
Value chain of vaccine storage in India
The value chain for vaccine cold chain consists of a series of links that are designed to keep vaccines within WHO recommended temperature ranges, from the point of manufacture to the point of
administration. In India, vaccine distribution network is managed by four government medical store depots (GMSDs) located in Karnal, Mumbai, Chennai and Kolkata. GMSDs procure vaccines from the manufacturers and supply it to ~53 state vaccine stores. These stores then distribute the vaccines at 114 regional, 736 district and 26,268 sub-district level cold chain points via insulated vans. There are limited vaccine transportation and refrigeration facilities at each of these stages which inhibit immunization services. According to the government, the country requires augmentation of cold storage from ~5.2 million in 2020 to 11 million in the next 5 years. The demand is highest for ice packs (44 lakhs in next 3 years) and vaccine carriers (5 lakhs in next 3 years), followed by demand for ILRs, cold boxes, among others. Innovative solar powered refrigeration technologies can reduce the existing supply chain gaps across cold chain points. A recent report by GOGLA and Intellecap mapped the total addressable market for off-grid solar vaccine storage at $811 million for last-mile delivery of services (i.e. health centres, chemists and ambulances) across rural India.
Ecosystem support for uptake of solar technologies
Given the ongoing pandemic, there has been a recent push from the government and development agencies for upscaling and deploying efficient solar technologies for vaccine storage as well as Covid-19 sample collection. In December 2020, the government announced usage of 29,000 cold chain points, 45,000 ILRs, and 300 solar refrigerators, among other applications for Covid-19 vaccine storage. By 2017, UNDP’s Electronic Vaccine Intelligence Network (eVIN) program had supported installation of 20 solar refrigerators and 45 solar equipment systems across nine states. There is application of new solar technologies such as solar-powered swab collection kiosks by SELCO India at various PHCs in Karnataka. The government is also driving the agenda of proper storage and utilization of vaccines through its policies like the “National Vaccine Policy” and “National Health Mission” and its agreement under the global “COVAX Facility”.
Key challenges and recommendations regarding off-grid solar refrigeration
The main challenges hindering the growth of the off-grid solar refrigeration market for vaccines are the long and cumbersome process of government tendering and limited awareness among stakeholders at the ecosystem level. The government agencies at the national/state level procure vaccine storage units through a tender process based on the least cost bidder criteria. Some of the early-stage entrepreneurs with innovative solar technologies are unable to compete at low prices or provide scale for participating in these tenders. Additionally, delays in approval and difficulty in payment clearance from the government discourages entrepreneurs and impacts their financial viability. Lack of awareness among policy makers and financiers on types and application of off-grid solar technologies and limited information on commercial viability further impedes uptake of these technologies.
The key recommendations for promotion of off-grid solar refrigeration pertain to three overarching themes of (i) generating awareness among stakeholders and end-users; (ii) enhancing the policy regime for solar cold chain in health care sector; and (iii) improving financial assistance for high cost (upfront) solar refrigeration facilities. Few specific recommendations include:
· Conduct knowledge sharing sessions to highlight benefit of solar refrigerators over diesel and other technologies especially based on lifecycle costing.
· Establish a digital platform with data on technology applications and potential market segments to enhance knowledge about off-grid solar refrigerators.
· Empanel solar companies providing off-grid solar refrigerators through a bi-annual selection process to enable quick deployment of technology.
· Provide disincentives to health care centres for usage of diesel generators in favour of solar technologies (like off-grid solar refrigerators and solar PV systems).
· Provide a dedicated budget for implementation of DRE systems at health care centres through the existing national/state level policies.
· Aggregate financial assistance at the national/state level through external funds from development agencies, CSR funds, private foundations etc.
· Deploy/use innovations like blockchain to provide real-time visibility of vaccine distribution from manufacturing to administration and eliminate supply chain gaps.
It is evident that the need of the hour is to improve health service delivery specially to reduce vaccine wastage through sustainable and cost-effective innovations. Thus, implementation of traditional initiatives (policy, awareness) along with innovative solutions (blockchain) can improve the overall effectiveness of off-grid solar refrigeration that can revolutionize the vaccine sector in India.