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The Covid-19 pandemic demonstrated the need for robust last-mile delivery of medical supplies at a global level, and established a non-negotiable urgency to address healthcare delivery for all.

Governments across the world understood the importance of ensuring that life-saving supplies, including vaccines, cancer medications, and biologics such as insulin, arrive at their final destinations in good condition. This is a necessity that extends beyond just India, affecting every developing nation where healthcare infrastructure frequently faces significant challenges.

The last-mile delivery of healthcare relies heavily on cold chain logistics as a critical aspect to ensure the efficacy of temperature-sensitive healthcare materials. The World Health Organization (WHO) reports that approximately 50% of vaccines are wasted globally each year due to inadequate temperature control during transportation and storage. This emphasises the critical need for better cold chain solutions to reduce waste and ensure that medical supplies remain viable.

Temperature-sensitive medical supplies that require adequate cold chain solutions down to the last mile can be broadly classified into four categories:

1. Vaccines: This type of medical equipment is one of the most sensitive to temperature, which is why it is normally stored at a temperature of 2-8°C. The vaccines are sensitive to temperature fluctuations and may lose efficacy if exposed to temperatures beyond the optimal range, therefore temperature control is important, especially towards the final mile of distribution.
2. Cancer medication: Most cancer medicines, especially biologicals and chemotherapeutic, are known to be prone to being affected by temperature. They need to be stored at low temperatures to retain their functionality; they are usually stored between -20°C -80°C.
3. Diagnostics: Diagnostic reagents and samples include blood and tissue specimens which need to be kept in certain temperatures to show the right results when tested. Variations in temperatures along the course of its shipment can cause incorrect readings on the equipment, which negatively affects patients.
4. Other temperature-sensitive supplies: Other sensitive health care necessities including insulin, hormones and antibiotics require strict temperature regulation to maintain their functionality.

In a typical developing nation scenario, cold chain logistics are at times the most challenging to strengthen and maintain. This can be attributed to various challenges that spring from low-resource settings:

1. Infrastructure limitations: many developing countries do not have the right infrastructure base that involves necessities like proper and consistent electricity supply and storage equipment to support the cold chain. This deficiency hampers the ability to guarantee that medical supplies are properly preserved and distributed at the correct temperature.
2. Geographical constraints: The geographical barriers such as mountainous regions, forests, and remote villages as part of the last-mile delivery of health care certainly pose a challenge in countries like India and many developing ones. Additionally, problems such as monsoons can even exacerbate supply chain disruption amongst other things.
3. Logistical complexities: Getting products from the last mile means crossing areas that are hard to access and reach because of poorly developed transportation systems which slows down the process as well as changes in temperatures which compromise the overall quality of health care.
4. Regulatory challenges: Stringently varying regulations from country to country can act as a barrier to the smooth, efficient delivery of medical needs, disrupting health care system delivery.

Thus, more specific approaches, effective and promising advanced delivery models at the last mile with reference to optimisation and achievement of affordable and sustainable solutions are to be found. The international community must join hands to increase the pace of implementing better last-mile healthcare delivery solutions.

A few critical areas where such new tech-based solutions will be helpful are:

1. Innovation in Packaging Materials: New packaging techniques and other newer and better forms of packaging can be used to maintain the required temperature for as long as possible. Phase change materials (PCMs) and vacuum insulation panels (VIPs) are some of the novelties in the field.
2. Enhanced Monitoring: Currently, there is a plan to use surveillance equipment such as temperature indicators and GPS to monitor the movement of medical supplies. This will assist the healthcare administrators in preventing and responding to any fluctuations in temperature and taking necessary corrective actions.
3. Sustainable Solutions: Sustainable and efficient refrigerator systems can also ease the problem when it comes to infrastructural barriers in remote regions. It is, therefore, favourable to use solar-powered units because they can efficiently provide coolness, especially in areas with inconsistent power sources.
4. Public-Private Partnerships: Such partnerships will call for local governments, industries, NGOs, and international bodies to develop the necessary infrastructure and regulatory frameworks. These collaborations would also assist in knowledge transfer to build well-functioning last-mile delivery systems for healthcare.
5. Capacity Building: Efforts towards training the last-mile healthcare and logistics workers on the criticality of the cold chain and the use of advanced technologies are important to ensure robust longevity of the last-mile cold chain for healthcare delivery.

The demand for advanced last-mile delivery solutions for delicate medical supplies is undeniable. By addressing infrastructure constraints, improving monitoring capabilities, and fostering partnerships, we can significantly improve last-mile healthcare delivery and, ultimately, health outcomes for all.

(Ankita Mittal is the CEO of Enhanced Innovations)