When Oghenetega Iortm, CEO of GRICD, a cold chain and logistics company spoke at the 2019 Health Watch Forum in Abuja themed “Prevent Epidemics: Immunise,” he focused on challenges facing distribution of vaccines maintaining the right temperature in Nigeria and strategies to address them. But inside their production hub located in the Ikosi area of Oregun in Lagos State, something interesting is happening. His team has developed a solution that might hold the key to addressing Nigeria’s cold chain problems, one of the key determinants of delivering immunisation services.
The solution, a grey box about the size of an office 3-in-1 printer, is called the Gricd Frij, a smart and affordable cold chain container for transporting temperature-sensitive materials. The Frij, as they call it, could be especially beneficial to rural areas where access to steady power supply is a challenge.
Nigeria’s healthcare system is poorly funded with many rural health facilities bearing the brunt as they are unable to provide basic services. Consequences include complications and deaths of vulnerable populations such as pregnant women and children under five years old. Deaths from vaccine-preventable infectious diseases continue to be recorded.
Nigeria has developed a National Action Plan on Health Security (NAPHS). The costed plan involves all government agencies and departments that have significant roles to play to prevent, detect and respond to infectious disease outbreaks. The plan adopted some of the action points from the Nigeria Strategy on Immunisation and Primary Health Care Systems Strengthening (NSIPSS) developed by the National Primary Healthcare Development Agency (NPHCDA).
One key limitation identified by the plan is inadequate cold chain capacity at national, zonal, state, local government and ward levels. For vaccines to retain their efficacy from when they are manufactured to when they are used, they must be kept the recommended temperature. This is where Gricd’s cold chain Frij holds significant potential as it helps maintain vaccines, biological samples and other temperature-sensitive materials intact until the point of use.
The making of a smart fridge
“Blip! Blip! Blip!” The Frij beeps. “It’s very simple to use. Just put the item in the Frij. Turn it on, set the temperature for transportation and close it up. That’s it,” Iortm demonstrates in the simple hub his team runs.
But simple is far from the experience Iortm and his team faced while coming up with the product. It didn’t actually start as a solution for healthcare, he says.
After graduating as a Communication Engineer, he took the popular advice then to “find a problem and proffer a solution”. He ventured into agriculture by raising funds for smallholder farmers but most of the produce went bad before they were sold, so he could not recover the invested funds. He then set out to solve this problem by leveraging the cooling effects of clay to prolong the life of the produce in the next harvest. “We finally had a product but it was crude, so scaling was a problem. We decided to go back to the drawing board,” he said.
In the process of refining and applying the principles of design thinking by listening to people who have the problem, a veterinary doctor suggested they could adapt the concept to help him store his vaccines while transporting them from Lagos to his farm in Kogi State, a journey that ended up birthing the Gricd Frij.
Since 2017, the team has been involved with researching, prototyping, and testing. They launched the units in early 2019. So far, 10 units have been produced and are in use across the country with 30 more in production based on orders from clients.
The unit keeps contents at temperatures ranging from -25OC to 15OC and has a communication module that can monitor and send out real-time information on the state of the contents. The owner accesses this information via a mobile app or a desktop application if they have multiple units in the field. “This means that the fridge is Internet of Things (IoT) compliant,” Iortm explains. The fridge has an alarm feature which sets off once it goes above the temperature set by the owner. These features make it possible to know the exact location and temperature of the unit as it travels.
The company’s Embedded Systems Engineer, Godwin Ogboye, inspects a Printed Circuit Board (PCB) under a big magnifying glass. The PCB is the main component that controls how the unit functions and is used to power on and adjust various settings including temperature. He says the schematic of the PCB is designed by the GRICD team and sent to a Chinese company for bulk printing. The same goes for the grey box that encloses the entire unit and the communication module. The prototype is first designed, modelled and printed by Samuel Tsombul using a 3D printing machine. This helps them know the exact specification to buy from the market to house the fridge.
The Frij In Action
During the 2018 Lassa fever outbreak in Edo State, there was a need to transport human samples from remote areas to the laboratories of the Nigeria Institute of Medical Research (NIMR) in Lagos State. The practice was to place the samples in boxes containing ice packs for transportation. Most of these rural locations don’t have a steady power supply to freeze the ice packs so this meant the packs had to be transported from city centres to the villages and back again. The possibility of the ice packs melting before the boxes got to the laboratory in Lagos was high.
The NIMR team recently received one of the Gricd Frij units to transport samples from Edo to Lagos. Iortm said NIMR also used the Frij to transport tuberculosis samples from Northwest Nigeria to Lagos.
The Frij’s ‘One Health’ Potential
The uses for the Gricd Frij go beyond human to veterinary possibilities, and this is important in light of the World Health Organization’s (WHO) One Health approach to ensure multiple sectors work together to improve the public’s health through prevention of infectious diseases. The approach is prominently featured in the action plan for health security launched by the Nigeria Centre for Disease Control (NCDC) in 2018. Good animal health and safe handling of animal products can mean the difference between a healthy human population and a potential disease outbreak.
For Femi Kayode, a Veterinary Doctor based in Lagos, the Frij was a life-saver when he had a disease outbreak amongst the over 100,000 cattle he managed in Kogi State in June 2019. He said the Frij helped them keep the vaccines they needed potent from Lagos to Kogi, and he could keep an eye on the product throughout the trip. “With the Frij, you can monitor the transportation process from take-off point to delivery point. The monitoring is important because the person transporting can do something along the way, and you won’t know because you are seeing the normal temperature when they deliver it to you,” he said.
Iortm said his team is now planning to sell the communication module as a stand-alone product because it has numerous logistical applications for the safe and effective delivery of healthcare commodities.
It’s not always ‘Cool’
Just because they work in the cold chain space doesn’t mean everything is cool with Iortm and his team. One of the challenges they face is funding, and as much as he wants the product to be used widely, the cost of production is a limiting factor. A unit currently sells for an estimated N100,000 ($275) and this is likely to increase due to higher production costs and other economic factors.
They currently do not have the funds to automate the assembly of a unit, which meant they manually assemble each unit once all the components are complete and certified to work well.
Perhaps one of their biggest challenges is getting WHO’s Performance Quality and Safety (PQS) certification in order to transport human vaccines. Iortm said this could cost around $70,000. But despite the challenges with finance, they have big plans for the Frij.
More Money to Keep out Infections
The Joint External Evaluation (JEE) in 2018 determined that Nigeria is not ready to find, stop and prevent epidemics after the country scored 39 out of 100 in its evaluation. There have been improvements since then as NCDC has acted on some of the action points such as establishing a network of laboratories and the development of a robust and costed plan to ensure the nation’s health security.
One of the JEE’s priority actions is to develop a robust sample and specimen transportation system for an effective cold chain. The NAPHS is designed to address some of the gaps identified in the assessment including that of cold chain. But funding is very crucial as 134 billion Naira is the estimated cost of implementing activities mapped out in the plan between 2018–2022. Immunisation bears a major cost in the plan at 81 billion Naira while activities related to appropriate specimen referral and transportation will cost around 1.7 billion Naira.
If Nigeria’s legislature and executive appropriates and releases funds for the implementation of the policy, it will prevent disease outbreaks instead of responding when they happen. Prevention is always cheaper. Hopefully, the present administration gives epidemic preparedness the desired attention to ensure Nigerians don’t die from preventable infectious diseases.
The Gricd team can look at other models to ensure this important innovation gets to more hands. They can look at models used by other innovators to get their products to more people. An example is the CribA’Glow solution that is helping jaundiced babies. One of their revenue models is leasing out their equipment to those who need them but cannot afford to purchase. Perhaps the Gricd team can explore this for potential users who are unable to buy the unit outright.
It is important to get innovations like the Gricd Frij into more hands because livestock forms a major source of protein for Nigerians and ensuring they are healthy and free from infectious diseases contributes significantly to national health security. Also, ensuring that human samples get to laboratories intact for confirmation of infectious agents is pivotal to detecting and nipping potential disease outbreaks in the bud. And it all starts with our ability to keep things “cool.”
Do you know of any other innovations in the cold chain space that are exciting? Let us know via our social media platforms, or send us an email at firstname.lastname@example.org