How does DKSH navigate regulatory hurdles and drug approval lags to ensure timely access to vaccines in the Asia Pacific region? 

Several factors delay the introduction of vaccines in some Asia Pacific countries, with drug approval lag being a primary reason. This lag stems from various factors, including drug characteristics, such as molecular type or therapeutic class, and regulatory aspects such as registration and review procedures. 

Furthermore, unlike our western counterparts in Europe and the United States, Asia Pacific lacks a central regulatory approval process for vaccines. The diverse regulatory requirements and procedures across the region often delay market authorisation for vaccines and other medical products. 

These are precisely the circumstances in which DKSH comes into play. As a market expansion service provider, we specialise in regulatory affairs, helping healthcare partners bring life-saving products to relevant markets. We have a strong team of regulatory affairs experts, who provide regulatory consulting and registration services across Asia for pharmaceuticals, biologics, over-the-counter (OTC) and consumer health products, among others. Our team of experts also maintain ongoing liaisons with local and regional regulatory authorities to ensure efficient and compliant registration of healthcare products like vaccines.  This expertise and experience allow us to overcome challenges in the markets together with our customers.

Can you elaborate on the specific challenges of vaccine hesitancy faced in different socio-economic contexts within Asia Pacific, and how DKSH addresses these challenges?

Vaccine hesitancy is a significant global health issue, and in fact, the World Health Organisation (WHO) declared vaccine hesitancy as one of the top ten threats to global health in 2019. 

Understanding challenges with regards to vaccine hesitancy can be seen in the varied responses to Covid-19 immunisation efforts. A study led by The Vaccine Confidence Project, commissioned by WHO, found that factors affecting vaccine acceptance differed across regions. In countries like Fiji, Japan, and the Philippines, stay-at-home mothers represented a large portion of vaccine-reluctant people in their study. For this demographic, social media information has a strong impact on their vaccination choices. In Laos, Malaysia, and the Republic of Korea, low vaccine acceptance stemmed from distrust in authorities.

A separate study on hesitancy for routine vaccines in South Asia exposed other concerning findings — parents and caregivers within the region reported perceived low need, limited understanding, and fear of adverse side effects of vaccines. 

To address these issues, we have collaborated with partners on various initiatives rooted in our overall patient-first approach. For example, we supported the introduction of the CoronaVac vaccine, developed by Sinovac, in Hong Kong. Our partnership with Sinovac aimed to educate doctors and healthcare professionals about the vaccines, including updates on research and clinical trials, which ultimately translated to greater education and awareness among patients. In Thailand, we launched a campaign in 2022 to educate local pharmacies and consumers about essential medicines and healthcare products healthcare products that should be in every household to mitigate the risk of contracting Covid-19 and promote a healthy lifestyle. 

Beyond Covid-19, we recognise patient hesitancy and fear towards injections or needles as a challenge. To that end, our nurse educator service, available in several markets across the region, has seen a high uptake, offering one-on-one guidance for patients uncomfortable with home injections or medical devices, such as those with diabetes or other chronic conditions. During the pandemic, we provided virtual support to ensure the continuity of care and proper technique for insulin injections, for example, enhancing the patient experience and safety.  

In what way does DKSH ensure the integrity and efficiency of the distribution chain, especially when reaching remote and marginalised communities?

The delivery of vaccines and similar life-saving products to people across Asia Pacific is not as straightforward as it seems. It requires an extensive network of shipping, storage, freezing, communication, and healthcare services to achieve the “last mile” of the journey. 

We focus on two key areas to maintain supply chain integrity, regardless of rural or urban areas: ensuring product safety through proper stewardship and upholding the highest standards of ethics and integrity in our business conduct.

All our healthcare distribution facilities are approved by respective local health authorities with the appropriate internationally recognised quality management system certification, to ensure the highest levels of product safety. Besides that, we make sure to work with business partners who share our values and meet our requirements regarding ethical business practice. Together with our partners, we have developed a robust supply chain operation to ensure that high quality life-saving healthcare products reach patients all the way to the last mile, on time.  

Today, our extensive capillary network reaches more than 160,000 hospitals, clinics, pharmacies, doctors, and drugstores in Asia — supported by a solid infrastructure and commitment to compliance and quality to safeguard the integrity and efficiency of our services. 

Can you share any innovative strategies or technologies DKSH employs to overcome logistical challenges and enhance vaccine accessibility in hard-to-reach areas? 

Distributing medicine and vaccines can be challenging, especially in rural areas with poor infrastructure. We adopt a “last mile delivery” approach in our distribution, where we deliver directly to hospitals and pharmaceutical outlets, not just to ports or warehouses. This requires strict storage and temperature controls to maintain product quality, especially for hard-to-reach areas. 

During the pandemic, in anticipation of logistical issues, we developed the Brilliant Box (B-box), a temperature-controlled cold chain box designed for most cold chain products. The B-box, derived from our extensive healthcare experience and familiarity with markets in Asia Pacific, is robust, stackable, and more durable than traditional Styrofoam boxes. In the context of rural or hard-to-reach areas, the B-box plays a key role in ensuring medicines are delivered safely and efficiently, in their intended quality, by meeting the specific requirements of cold chain products like Covid-19 vaccines, among others. 

What are some notable trends or advancements in vaccine distribution and accessibility that DKSH has observed in Asia Pacific in recent years? 

We’ve seen several key trends take shape in recent years. One area that we are especially excited about is cold chain innovation. Advanced cold chain technologies, such as temperature-controlled packaging and real-time monitoring systems, have ensured safety, reliability, and stability in the delivery of vaccines and other life-saving medication. Our B-box is one example, and it is also reusable, allowing us to minimise waste within our supply chain operations. 

Another area that has seen commendable progress is in the regulatory landscape. Notably, in ASEAN, the harmonisation of standards, conformity assessment procedures, and technical regulations, will see reduced barriers to deploying registered healthcare products across the region. While still a long way to go, continued efforts will facilitate greater movement of life-saving healthcare products like vaccines across borders. 

Lastly, increased partnerships and collaboration between players across the private and public realms has played a massive role in expanding distribution networks and driving community engagement. We would not have been able to successfully distribute hundreds of millions of doses during the pandemic if it weren’t for our extensive capillary network, with partners committed to our purpose of delivering healthcare for all. Not to mention, the power of coming together to educate large populations on the benefits and potential of vaccines to save lives. It is heartening to see more collaboration within the healthcare landscape, which will ultimately help players across the ecosystem cater to diverse healthcare needs across the region and enhance patient outcomes for all. 

Considering the recent Covid-19 pandemic, how had DKSH adapted its approach to vaccine distribution and access, particularly in light of evolving public health needs and challenges? 

The pandemic has inspired us to innovate multiple areas across our distribution value chain — which will significantly transform how we distribute vaccines now and in the future. As an example, we recently opened an automated healthcare distribution facility in Taiwan, designed with automated features such as automated storage and retrieval system (ASRS), autonomous case-handling robots (ACR) system, and paperless processing technology. These features will require less manpower and enable us to optimise resources, and in fact, the centre significantly enhances scalability by 25% and overall operational efficiency within our healthcare supply chain.

Capabilities such as the ASRS have been replicated across other distribution centres, including Singapore, for efficient selection and dispensing of medicines. 

Furthermore, during Covid-19, we adapted some of our operations and put systems in place to ensure delivery of healthcare products can happen within short windows, e.g. three-hour delivery timeframes. Combined with investments in new radio frequency systems for tracking, monitoring, and managing the internal logistics movement of the products, these systems and investments have enabled us to remain to resilient amid disruptions — ultimately ensuring vaccine distribution and access remain robust.