In March 2021, 1.02 million doses of the AstraZeneca-Oxford COVID-19 vaccine arrived at Jomo Kenyatta International Airport, Nairobi, Kenya. However, distribution issues that obstruct vaccine access for many Africans may hamper these vaccines from reaching the estimated number of beneficiaries. Approximately 24.0 per cent of adults in Kenya are fully vaccinated, but vaccination rates vary across the country. The vaccination rate in Nairobi is 43.1 per cent, compared to less than 7.5 and 8.0 per cent in remote, sparsely populated counties such as Wajir and Mandera.
In a predominantly rural country like Kenya, poor road networks, poorly equipped public health facilities, lack of vaccination distribution centres and cold chain infrastructure hamper vaccine uptake. Cold chain infrastructure is particularly important for vaccine distribution. The COVID vaccine and some other health products contain biological products and are temperature-reactive; the wrong temperature can degrade active ingredients and render the drug unviable for users. Norah Magero, a Kenyan engineer and innovator, uses her innovation to alleviate this.
Recently nominated for the Royal Academy of Engineering Africa Prize, Magero is the CEO of Drop Access. She established Drop Access in 2018 to bridge the energy access gap in low-income and off-grid communities across Kenya. As part of her sustainable solutions initiative in far-flung communities, she designed a solar-powered VacciBox to help regulate the temperature of vaccines in Kenya.
However, she didn’t start with the creation of VacciBox. She got inspired by two crucial incidents. First, she was approached by a group of dairy farmers looking for a sustainable solution to keep their milk from turning sour during transit to the market. She then came up with an innovative product called Koyo – meaning cold in her native language. Koyo is a portable solar-powered cold storage system used by small-scale farmers to curb post-harvest losses.
Secondly, after she gave birth to her daughter, she found it challenging to immunize her in the rural area. “I decided there needs to be a practical solution that makes these rural communities have seamless access to immunization and vaccines if will ever talk about quality healthcare in Kenya,” Magero said. When COVID hit, she realized that the cold storage system could also transport and keep vaccines. “In 2019, we rolled out a few more solutions for the farmers, but COVID hit soon after that period. So in 2020, we focused on the healthcare space. A healthcare fridge is very complex. There are strict criteria to store vaccines safely and with confidence. We designed and engineered the Vaccibox fridge specifically to meet that standard,” she said.
Asides from vaccine vials, the Vaccibox is designed to transport and store blood, and other medications. It has a capacity of 40 litres and a temperature range of two to 10 degrees celsius. Its integrated tracking system monitors a vaccine’s temperature during transportation. “You can monitor the temperature of the vaccine because if you do not, vaccines could go bad without you knowing.” One of the challenges of cold storage infrastructure is electricity. Access to electricity is still a problem for many African countries. Vaccibox is solar-powered, and it gets charged within two hours and can last up to nine hours. “We have optimized these capabilities, so when the sun sets in the evening, the fridge has a bit of cooling capacity that enables it to be cold till morning,” she explained.
The Vaccibox has a USB port for mobile phones and is small enough to be mounted on a motorbike, bicycle, or boat. But Magero says a bigger version of Vaccibox is in the pipeline and hopes to execute it before the end of the year. “When we get financing, we will be able to scale up our operations and production.”
Besides financing, getting direct technical expertise to build a VacciBox unit is challenging. The technical expertise is not readily available in Kenya but abroad. “As a pretty young organization dependent on prize money from pitching and small grants. We don’t have much of a robust budget or sufficient financing to pay for this technical expertise.”
COVID also made doing business uneasy for Magero. The prices of materials skyrocketed, and getting them into local communities was stressful. Also, tax and government policies in many African countries do not favour business owners and local manufacturers. Magero seems to be bearing this brunt as well.
Speaking about impact, Magero explained that the level of Koyo’s influence on the agricultural sector might be tricky to predict, owing to the unprecedented outbreak of COVID. However, in the healthcare sector, Vaccibox has made significant strides. Before VacciBox, Usungu Dispensary, located in Makueni County, transported vaccines twice a week from Makindu Sub County Hospitals and returned leftovers when ice packs began to melt. But now, they can stock over 1000 vaccines on-site, and immunization has increased by 45 percent.
In Merrueshi Village Health centre, they used an icebox to transport vaccines. That always results in vaccine wastage during field vaccination. With VacciBox, they can now transport vaccines to the immunization grounds without the worry of spoilage. “We do not know how many people managed to be vaccinated, but we are working with our beneficiary health care facility to do a bit of traceability and get the data right,” she explained.
Magero hopes to roll out more fridges and impact lives in at least 15 rural communities in Kenya, targeting at least three thousand vaccines per community. Although still physically present in Kenya only, most of the orders for Vaccibox are from other countries in east Africa like Malawi, Uganda, and Tanzania. “This is because Kenya is quite advanced in terms of energy access. We hope that when we scale our production and have our workshop for producing these fridges, we will scale to other West African countries,” she stated.
If not for being a VacciBox innovator, Magero would be known for building hospitals and training doctors in Kenya. She is passionate about providing affordable healthcare services for every Kenyan, irrespective of their health insurance status. “The NHIS in Kenya is limited to a few facilities. If you go deeper into villages, people cannot access healthcare in the hospitals. They suffer if they don’t have the cash to pay. The facilities are insufficient to support all these people,” she lamented.
Norah Magero is looking to have her production workshop in a few years, from where she will be producing and supplying beyond east Africa to the whole continent. “We want to be available for the whole African market and eventually the Asian market,” she concluded.