Table A3

Level 2 resilience sub-factors supporting agility

Level 1 sub-factorLevel 2 sub-factor capabilities
Agility – product flowExpediting of in-country and cross-border flows
 Rapid ramp-up of supplier and manufacturer capacity to meet production volume requirements
 Implementation of redundancy strategies in vaccine development, manufacturing and logistics
 Rapid ramp-up of vaccination capacity
 Capability for flexibility, substitutability and interchangeability of materials, equipment, infrastructure
 Continuous improvement of speed (takt time, cycle time)
 Rapid ramp-up of warehouse, logistics and distribution capacity
 Implementation of national and international policies and actions to facilitate the flow of inputs and vaccines
 Parallel performance of critical activities
 Selection of vaccine technology to support speed, scalability and accessibility
 Government negotiation of real options to expand manufacturing, procurement and distribution capacity
Agility – financial flowInvestment at risk in vaccine development and production
 Availability/ability to access funding for vaccine promotion, procurement, rollout, administration, and waste management
 Ability to access government subsidies for rapid building of capacity
 Ability to access emergency funding to subsidize and expand cold chain capacity and transportation
 Use of intermediary international organizations to procure vaccine doses
 Simplification of processes for accessing and deploying finances
 Ability of private sector to raise funds for air cargo and shipping capacity expansion
 Government coordination of subsidies for cross-border vaccine supply chains
Agility – information flowProcess simplification, integration, and digitalization using advanced technologies to increase speed and efficiency
 Information sharing via physical and electronic platforms for decision-making
 Implementation of data Lakes and databases for data collection to support data analytics
 Cross-sector, cross-border data exchange through implementation of global interoperability standards
 Communication of standard operating procedures (SOPs) and key performance indicators (KPIs)
 Implementation of policies, contractual terms, standards and incentives to access vaccine supply chain information
 Communication of procedures for assessing and approving vaccines
Agility – vaccine recipient flowUse of diverse vaccine advertising and promotion strategies
 Implementation of mandatory and prioritized vaccination
 Establishment of diverse, accessible vaccination administration sites
 Implementation of seamless user-friendly registration methods
 Availability of assistants to assist potential recipients with registration
 Administration of single rather than multiple dose vaccines
Agility – knowledge flowCross-border transfer of technology
 Training in regulatory requirements, manufacturing, inventory management, cold chain logistics, and immunization processes
 Training in data analytics for strategic and operational decisions
 Training of volunteers and students in health professions to serve as vaccinators and assistants
 Training in vaccine administration and post vaccination monitoring
 Training in information technology and information system skills
 Training in the application of international conventions, instruments, and standards to facilitate cross-border flows
 Training in best practices in cross-border flow of goods
 Training in healthcare system readiness and resilience
 Training in biomedical waste management
Agility – skilled worker flowUse of non-traditional labor pools to meet immunization demand requirements
 Facilitation of cross-border free flow of skilled workers
 Expansion of traditional skilled labor pools through recruitment
 Maintenance of substitute labor pools in event of sickness and attrition
 Maintenance of multilingual immunization worker pool
 Immunization of public health workers to minimize illness
Agility – waste flowExpansion of waste infrastructure and capacity
 Implementation of strategies for handling and disposing of biomedical waste
 Planning for adequate waste management resources
 Planning of unused vaccines to prevent wastage
Source: Author’s own creation/work

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