Community Vaccination Program: Vaccination solutions and key capabilities

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Community Vaccination Program: Vaccination solutions and key capabilities
Community Vaccination Program:
                               Vaccination solutions and key capabilities
      E2E vaccination
      programme tailored
      to community needs

      Our experience
      supports the smooth
      and efficient roll-out
      of programs at scale

      We have all elements
      of a large scale
      vaccination program
      in place

      We have also
      designed a solution
      for the private sector

      A vaccination
      program of this
      design can be scaled
      across multiple
      geographies

©2021 Right to Care NPC                                                     1
Community Vaccination Program: Vaccination solutions and key capabilities
We have all necessary capabilities, partners and an end-to-end
                               vaccination program fully designed and ready to aid communities
                               With an integrated supply chain, clinic management, tracking and communications solution, we can assist in
                               providing community vaccine access with minimal effort

      E2E vaccination
      programme tailored
      to community needs                        Context and rationale                                                                Primary objectives

      Our experience           • A nationwide vaccination roll-out is expected to be the                        1• Ensure effective and efficient running of a community
      supports the smooth
                                 largest national health undertaking in the history of                              vaccination program by deploying a readily available
      and efficient roll-out
      of programs at scale       any country                                                                        E2E “plug-and-play” vaccination program managed
                                                                                                                    by RTC
      We have all elements
      of a large scale
      vaccination program      • Governments are likely to require extended time
      in place                   period to set-up vaccination programs with the workforce
                                 relegated to many other communities
      We have also                                                                                              2• Operationalize a large-scale vaccination blueprint that
      designed a solution                                                                                           can be leveraged across the private and public
      for the private sector                                                                                        sector
                               • Rapid “plug-and-play” solutions are required to
      A vaccination              effectively mitigate community risk
      program of this
      design can be scaled
      across multiple
      geographies                                                                                                • Get all community members vaccinated as soon as
                                                                                                                 3
                               • Fully integrated E2E vaccination program has been
                                 developed and can be readily launched with minimal effort,                         possible to respond to the COVID-19 pandemic
                                 rapidly responding to community needs

                                       Disclaimer       Extent and timing of vaccination program is dependent on vaccination availability and allocation

©2021 Right to Care NPC                                                                                                                                                      2
Community Vaccination Program: Vaccination solutions and key capabilities
Utilising our world-leading large-scale comprehensive HIV care and treatment and
                               disaster medicine experience we can successfully roll-out a program of this scale
                               We have successfully responded to several national healthcare and disaster emergencies, both recently and
                               in the distant past, as such the team has all relevant experience to appropriately respond

      E2E vaccination
      programme tailored                                                                       Our experience
      to community needs
                                               Massive SA                                      Urgent disaster                         Logistics and mass vaccine
      Our experience                       healthcare solutions                                 management                                 program planning
      supports the smooth
      and efficient roll-out   • Pioneered HIV treatment in SA                    • National surge capacity for oxygen, beds     •   Implemented post-disaster vaccine
      of programs at scale                                                                                                           programs, rapid screening and
                               • Now running the largest treatment site in        • Disaster Medicine and critical care              treatment in Ebola
      We have all elements       the world out of Helen Joseph Hospital             training
      of a large scale                                                                                                           •   Large scale courier chronic medicine
      vaccination program      • Built Africa’s largest NGO/NPC                   • Facility readiness for COVID support             program for HIV/TB
      in place
                               • First African Global HIV Organization            • Equipment provision (vents, CPAPS)           •   Pharmacy lockers and parcel delivery of
      We have also               (supporting multiple countries)                                                                     medicines.
      designed a solution                                                         • Testing for COVID waves 1 & 2
      for the private sector

      A vaccination                     Pharmacy regulatory &                            Rapid launch of COVID-19                       Grant funding governance
      program of this
      design can be scaled
                                    importation of medicines/vaccine                   respiratory support & mental                            experience
      across multiple                                                                    health resilience training
      geographies
                                •    Right to Care, Wits Health Consortium have   •   Right to Care (with FPD and NDOH) worked   •   20 years of grant funding experience,
                                     completed the importation of Section 21          to design an interactive online training       (current R1.7Bn/yr, from USAID, Global
                                     medicines for over 50 medicines in               program for doctors and nurses                 Fund, CDC and GIZ)
                                     various situations:
                                                                                  •   Training program set up as a massive       •   No findings of fraud or mismanagement,
                                       • named patient basis, clinical research       online open course
                                         and early treatment programs                                                            •   We can manage funding monies safely
                                                                                  •   Right to Care and FPD enrolled more than
                                                                                      10 000 participants by end of January
                                                                                                                                 •   Audited by BIG4 audit firms
                                                                                      2021

©2021 Right to Care NPC                                                                                                                                                       3
Community Vaccination Program: Vaccination solutions and key capabilities
Proposed –
                                                                                                                                                                                 to be confirmed

                               Our solution will be integrated into any community with ease
                               We have thought through the complete end-to-end solution for HCWs, high risk containment populations,
                               and are well positioned to finalise design and costing

      E2E vaccination
      programme tailored                           Our design incorporates a number of participants across all stages of the plan
      to community needs

      Our experience
      supports the smooth       Operational
      and efficient roll-out    management
      of programs at scale

      We have all elements
      of a large scale
      vaccination program
      in place

      We have also
      designed a solution
      for the private sector                               1                     2                     3                   4               5                  6                     7
                                                   Training of nurses    Import, warehousing   Vaccination site           Client          National    Approved nurses to        Healthcare
      A vaccination                               to administer COVID-   and distribution of   design and roll out   management and   communication    administer vaccine       economics
                                E2E Process
      program of this                                19 vaccinations      vaccines to sites                             tracking         strategy                           tracking throughout
      design can be scaled
      across multiple
      geographies

                                   The proposed program will be overseen by Right to Care, with all identified players already indicating a willingness to progress the
                                                                                              opportunity

©2021 Right to Care NPC                                                                                                                                                                           4
Community Vaccination Program: Vaccination solutions and key capabilities
Management: We have a proven track record in program
                               management across numerous countries and programs
                               We have the capabilities and knowledge to support the Programme Implementation and Management of the
                               vaccine rollout in numerous countries

      E2E vaccination
      programme tailored                                                               Our program management expertise
      to community needs
                                   Typical PMS structure: strategic layer with 8 strategic                   RTC has an excellent track record in Programme Implementation and
      Our experience               layer functions and operational layer                                     Management, having implemented, amongst other programmes, the
      supports the smooth                                                                                    EQUIP Programme in many countries with multiple partners, utilising
      and efficient roll-out                                                                                 effective systems which include:
      of programs at scale

      We have all elements
      of a large scale                                                                                                          •    Tracktech
      vaccination program                                                                                                       •    Datastore
      in place                                                                                                                  •    MIE
                                                                                                                                •    Emergency growth
                                                                                                                                •    SAGE People 300
      We have also
      designed a solution                                                                                      Financial             HR employee           Risk                Project
      for the private sector                                                                                  management             management         management           management
                                                                                                               systems                 systems            system               system
      A vaccination
      program of this
      design can be scaled                                                     Current projects and experience amongst others
      across multiple
      geographies
                                         COVID response:                          Right ePharmacy:                         E-Lab solutions:                     Knowledge Centres:
                               •     Emergency medicine                   Drug distribution innovation in:        •   Zambia                              •   South Africa
                               •     Equipment enhancement and                                                    •   South Africa                        •   Zambia
                                                                          •   Zambia
                                     supply                                                                       •   Nigeria                             •   Zimbabwe
                                                                          •   South Africa
                               •     Oxygen distribution                                                          •   Tanzania                            •   Malawi
                                                                          •   Lesotho
                               •     GIS mapping                                                                  •   Liberia
                               •     Vulnerability index mapping
                               •     Community mobilisation
                               •     Predictive modelling

©2021 Right to Care NPC                                                                                                                                                                   5
Management: We will respond to perceived issues for vaccination
                               roll-outs using total continuous quality improvement (TQCI)
                               Using our tried and tested TQCI approach we will effectively respond to all perceived issues efficiently and
                               effectively

      E2E vaccination
      programme tailored                                                     Our program management expertise
      to community needs
                                          Potential issues                                              Our solution and TQCI elements
      Our experience
      supports the smooth      • Unclear and ineffective management of
      and efficient roll-out     vaccine roll out plans (across countries)     Using our tried and tested solutions, we will create a platform for tracking processes and
      of programs at scale                                                     outcomes across the value chain
                               • Vaccine availability                          This will include:
      We have all elements                                                     • Risk management system
      of a large scale         • Ineffective logistics management              • Quality assurance
      vaccination program        including:                                    • Issue logs and interventions
      in place                        • Recipient prioritisation               • Overall program co-ordination
                                      • Cold chain management
      We have also                    • Storage and distribution              TQCI elements:
      designed a solution             • Vaccination site access
      for the private sector          • Scheduling                                       1                         2                      3                      4

      A vaccination            • Lack of country infrastructure                    Recruitment            Budgeting and             Monitoring and         Stakeholder
                                                                                    (personnel and
      program of this                                                                                      expenditure               evaluation            engagement
      design can be scaled     • Insufficient human resources including:         management of human
                                                                                                        (tracking and monitoring)                          (& management)
                                                                                      resources)
      across multiple                 • Available vaccinators
      geographies                     • Lack of training

                               • Ineffective quality assurance systems                   5                         6                      7                      8
                                                                                 Agile contracting         Effective data              Effective         Risk management
                               • Management of adverse events                        and legal                systems                procurement
                                                                                   management                                         processes
                               • Monitoring and reporting

©2021 Right to Care NPC                                                                                                                                                     6
Regulatory: We have the necessary knowledge and capabilities to
                               support regulatory agencies on vaccine roll-outs
                               We have the capabilities and knowledge to support regulatory agencies’ readiness to expedite vaccine
                               approval ensuring that our vaccination program adheres to the necessary standards and regulations

      E2E vaccination
      programme tailored
      to community needs                                                       Current vaccine and regulatory status

      Our experience           1• South African Health Products and Regulatory Authority (SAHPRA) has adopted a priority review approach for all COVID-19 vaccine
      supports the smooth        applications supported by dedicated technical committees
      and efficient roll-out
      of programs at scale     2• SAHPRA has enabled mechanisms that allow rapid approval and availability of vaccines to the national vaccination effort
      We have all elements
      of a large scale         3• Approved vaccines are subject to batch release by the National Control Laboratory for Biological Products and quality monitoring
      vaccination program
      in place                 4• Vaccines are required to adhere to stringent cold-chain requirements and monitoring throughout the supply chain

      We have also             5• Adverse Event Following Immunization (AEFI) and related safety reporting and monitoring in line with the pharmacovigilance plan
      designed a solution        for COVID-19 vaccines
      for the private sector

      A vaccination
      program of this                                                             Our support to SAHPRA and the DOH
      design can be scaled
      across multiple
      geographies               Streamlining processes          Regulatory reliance                                         Quality assurance &            Pharmacovigilance
                                                                                             Technical assistance
                                and procedures                  procedures                                                  reporting                      training and support

                               • To improve efficiency of   • Development of             • To support vaccine cold-     • Quality assurance            • For vaccine and medicine
                                 decision making for          procedures and work-         chain logistics and supply     surveillance and reporting     safety reporting and
                                 health products and          sharing methodologies to     chain management               systems at facilities          monitoring
                                 vaccines                     expedite review              systems

©2021 Right to Care NPC                                                                                                                                                             7
Response: Our response will be aligned to government’s vaccine
                                allocation and roll-out requirements
                                Government’s vaccine roll-out plans have remained relatively unclear, leading us to planning and positioning
                                ourselves to be ready, supported by donors, should government engage the private sector

      E2E vaccination
      programme tailored                       SA Government’s planned roll out                                              SA Government’s reported vaccination supply
      to community needs
                                 Government is believed to have secured >30m vaccine doses
      Our experience             from various sources
      supports the smooth
      and efficient roll-out     Details of timing and how the roll-out will take place remains
      of programs at scale       unclear

      We have all elements       The following planned phases for the vaccination roll-out have
      of a large scale           been identified                                                                               9m doses secured1             1.5m doses secured1
      vaccination program
                                       Phase 1                    Phase 2                    Phase 3
      in place                                                                                                                                      1m doses arrived 1 February 2021
                                  • 1.2m frontline           • 2.5m essential           • 22.5m other
      We have also                  healthcare workers         workers                    persons over 18
      designed a solution                                    • 1.1m people in
      for the private sector                                   congregate settings
                                                             • 5m people >60
      A vaccination                                          • 8m people >18 with
                                                                                                                               12m doses secured1            12m doses secured1
      program of this                                          co-morbidities
      design can be scaled
      across multiple
      geographies

                                   We will be
                                  ready to act
                                                           • Concern that government will                   • It is believed private sector           • Donors safe in the knowledge
                                                            fail to deliver on its promises                  involvement will be required                  RTC handling funds

©2021 Right to Care NPC        Source: SA department of health, Deloitte Analysis, Business Tech, The Globe and mail 1)IOL                                                             8
Logistics: We have partnered with SA’s largest and leading
                               pharmacy logistics company, support could cover other regions
                               Orion, a SAHPRA approved cold-chain logistics and distribution provider will act as the backbone of the
                               South African vaccination program, with the possibility for expansion to other regions

      E2E vaccination
      programme tailored                                   Orion’s logistics cold-chain network                                      Why Orion:
      to community needs
                                                                                                                                     • Orion’s SA distribution
                                                      Orion ‘s warehousing facility in Bloemfontein and
      Our experience                                  Johannesburg is SAPHRA licenced                                                  network comprises of 14
      supports the smooth                                                                                                              branches (2 SAHPRA
      and efficient roll-out                                                                                                           approved) – biggest SA
      of programs at scale                                                                                                             healthcare logistics provider

      We have all elements                                                                                                           • Strong outlying area
      of a large scale                                                                                                                 coverage
      vaccination program
      in place                             truck          Product is delivered       Vaccines stored          Vaccine is picked by   • Orion is SAHPRA licensed
                                   collects from        to Orion central local       at Orion's local        Orion and delivered
      We have also                 manufacturer                 depot                     depot                   to site/clinic     • Current Orion network
      designed a solution                                                                                                              includes hospitals,
      for the private sector                                                                                                           clinics, SANBS,
                                                                                                                                       pharmacies etc. amongst
                                                                                                  Additional African Coverage
      A vaccination                                                                                                                    others (public and private)
      program of this
                                               Fleet > 400 vehicles      3.5k drop points               Orion footprint includes:    • Orion has no 3rd party
      design can be scaled
      across multiple                                                                                                                  dependence
      geographies
                                                                                                                                     • Services run 24/7 and
                                  Key                                                                                                  include live temperature
                                Figures            >450 staff         >500k parcels weekly                                             monitoring
                                                                                                 •   International logistics is
                                                                                                     supported through Courier IT    • Highly secure network
                                                                                                     (group company)
                                                                                                 •   Strong links with FedEx could   • Ability to integrate with
                                               Cold chain fleet 150
                                                                      Additional 50 in 2021          be utilised to support            other systems in real-time
                                                     vehicles
                                                                                                     international supply chain        (API integration)

©2021 Right to Care NPC                                                                                                                                                9
Clinics: Drawing on our world-leading Comprehensive HIV Care and
                               Treatment experience, we bring the mobile clinics to you
                               We bring the mobile clinic solution to you, minimising barriers to service and creating an ensuring rapid
                               community vaccination

      E2E vaccination
      programme tailored                                                         Onsite vaccination process
      to community needs

      Our experience                           A simple E2E process design which we can simply recreate in other African countries
      supports the smooth
      and efficient roll-out
      of programs at scale

      We have all elements
      of a large scale
      vaccination program
      in place
                               Vaccines delivered      Container clinics set-   Community members to          Clients present their         Nurse administers
      We have also                to clinic site          up outside sites      register for vaccination      voucher at container           vaccine at mobile
      designed a solution                                                        (incl. potential timeslot            clinic                       clinic
      for the private sector                                                             booking)

      A vaccination                                                                                                                      RTC to appoint and
                                                                                    Mezzanine booking system to be
      program of this                                                                                                                    manage qualified nurses
                                                                                    utilised based on voucher process
      design can be scaled
      across multiple
      geographies

                                • Less Covid-related downtime/disruption to community

                                • Visible community clinics to drive up peer acceptance (proven in HIV epidemic)

                                • No congestion at clinic (due to social distancing and booking system) to reduce risk of COVID spread

©2021 Right to Care NPC                                                                                                                                            10
Clinics: Our sites will be designed using a disaster medicine
                                approach and rollouts across sites confirmed using a simple model
                                Using our experts and existing data we will rapidly identify priority sites for roll-out, thereby ensuring
                                appropriate coverage in hotspots as well as an efficient program roll out

      E2E vaccination
      programme tailored                                                                We have already prepared preliminary vaccination plans as follows:
      to community needs
                                                                                                                                                                          Site management plans and designs in
                                    Roll-out vaccines to HCW and public                                                    Hospital prioritisation and roll out
                                                                                                                                                                                        place
      Our experience                     facing employees at scale                                                                      approach
      supports the smooth
      and efficient roll-out
      of programs at scale
                                 Two-layered prioritisation method is                                                   We prepared a roll-out schedule to cover      Command and control will be co-ordinated
      We have all elements       proposed:                                                                              the top 150 hospitals in SA                   using a disaster medicine approach with the
      of a large scale                                                                                                                                                establishment of 3 command levels
      vaccination program        1. Prioritisation based on population group
      in place                                                                                                                                                        •    Gold : Central co-ordination centre
                                 2. Second layer: prioritisation based on                                               We can perform similar assessments and
                                 hospital                                                                               modelling for any country in order to         •    Silver : Co-ordination within geographical
      We have also                                                                                                      prioritise and enable an efficient roll-out        area
      designed a solution
      for the private sector                                                                                                                                          •    Bronze : Local command structure

      A vaccination
      program of this           Priority         Description                              Estimated Population
      design can be scaled      First tranche
      across multiple                     1      Medical practitioners1                                   62 000
                                          2      Nurses2                                                 400 000
      geographies               Second tranche
                                          3      EMS personnel1                                           53 000
                                          4      Hospital cleaning staff                                  20 000
                                          5      Lab personnel1                                           20 000
                                          6      Other medical personnel1                                 74 000
                                          7      Critical oxygen supply chain workers                      5 000
                                Third tranche
                                          8      Food retailer employees3                                276 000
                                          9      School teachers4                                        450 000
                                         10      Prisoners5                                              155 000
                                         11      Police                                                  193 000
                                         12      Taxi drivers and operators                              400 000
                                         13      Persons over the age of 75 years                      1 030 000

©2021 Right to Care NPC        Sources:    1   MPCSA;    2   SANC;        3   Retailer Integrated Reports;         4   World Prison Brief                                                                               11
Data management: We will utilise a fully functional m-Vaccination
                               control tower through digital services
                               Mezzanine has a widely established vaccination control tower allowing centralised visibility, real time data
                               availability & analytics for action and decision-making, data review rooms supported by the IS unit

      E2E vaccination
      programme tailored                                                                  M-Vaccination control tower
      to community needs
                                                   1                                                                                                         5
                                   Register and validate eligible                                                                                  Manage bulk, targeted
      Our experience
                                     vaccine beneficiaries and                                                                                   communication to subsets of
      supports the smooth
      and efficient roll-out         capture critical information                                                                                    population groups
      of programs at scale

      We have all elements                         2                                                                                                           6
      of a large scale             Manage a central database of                                                                                    Link patients to individual
      vaccination program          patient/beneficiary information                                                                                vaccine products to support
      in place                          and eligibility criteria                                                                                      pharmacovigilance

      We have also
      designed a solution                           3                                                                                                          7
      for the private sector         Allocate vaccination slots                                                                                     Manage vaccine service
                                       (place, time, vaccine) to                                                                                platforms, including payment to
      A vaccination                           individuals                                                                                              service providers
      program of this
      design can be scaled
      across multiple                             4                                                         9                                                 8
      geographies                  Track vaccine administration,                                                                                  Manage vaccine and related
                                                                                              Centralise master facility list
                                    support follow-up vaccinations                                                                                 commodity availability,
                                                                                                    administration
                                      and reminders to patients                                                                                    ordering and receipting

                                         Data review rooms
                                                                             Similar approach in          Transition interventions                                 Improved data
                                      (platform for decision making and                                                              Strengthen program
                                                                           terms of operationalising     by using real-time data
                                     change tracking – technical support                                                               performance and               analytics
                                                                           SRs in HIV programs to        from multiple sources
                                   from the implementation science (IS)                                                              workforce management            & insights
                                                                                  be adopted                with a holistic view
                                                      unit)

©2021 Right to Care NPC                                                                                                                                                            12
Data management: Simple implementation modules ready to go and a
                               99% service level availability, a truly world class enterprise solution
                               Mezzanine is a widely established vouchering & beneficiary management system, which will efficiently
                               manage an individual’s vaccination journey, and can be easily integrated into employee databases (via APIs)

      E2E vaccination
      programme tailored                      Mezzanine footprint                                                                    Implementation modules
      to community needs
                               Mezzanine technology stack is an ISO 27001 approved
                               and GDPR compliant offering that has been used across         Supply chain visibility and management are recommended for initial implementation (A);
      Our experience           healthcare services across multi-country and multi-partner    thereafter, vouchering and beneficiary management to manage demand amongst priority cohorts
      supports the smooth      deployments                                                   (B), + other functionality
      and efficient roll-out
      of programs at scale
                                                                                            A
      We have all elements                                                                         1. Inventory management
      of a large scale                                                                             2. eOrdering
      vaccination program      Mezzanine                                                           3. eReceiving
      in place                 leverages mobile technology to enable                               4. Cold chain monitoring*
                               transformative policy & business
                               interventions in low resource settings
      We have also                                                                          BB
      designed a solution
                                                Offering benefits
                                                                                                   1. Beneficiary management
      for the private sector                                                                       (Eligibility & Patient Records)
                                                                                                   2. Vouchering (Scheduling)
                               mVacciNation includes a 99% service level                           3. Laboratory track & trace
      A vaccination
                               availability due to world-class Software as a                       4. Workforce digital training
      program of this
                               service provision
      design can be scaled
      across multiple           • Network provider agnostic
      geographies               • A web app provides real-time online access
                                  for managers
                                • Cloud hosted full technology stack
                                  (infrastructure, hosting, network)
                                • World class security and data governance
                                                                                                 Beneficiaries loaded                   Beneficiaries checked    Analytics and bulk
                                • Dedicated support desk
                                                                                                  onto system through                  against system, receive     communication
                                • Digital workflow and configurable modules                          batch upload                        SMS with details and    through cloud based
                                • Business intelligence platform and                              (self register to opt-in)             presents themselves at         system-
                                  framework                                                                                                 service point
                                • Interoperability
©2021 Right to Care NPC                                                                                                                                                                    13
Comms: Effective comms is required to create positive vaccination
                               sentiment
                               These communications should be transparent and demonstrate a clear grip of the issues at hand in order to
                               garner trust and disperse fears regarding the vaccine

      E2E vaccination
      programme tailored        UJ-HSRC Survey Results– If a COVID-19 vaccine was available, would you take it?                             Key Insights
      to community needs

                                                                                                           67%
      Our experience
                                                                                                                                   • The UJ-HSRC findings show
      supports the smooth
      and efficient roll-out                                                                                                         67% of South Africans
                                     52%                                                                                             surveyed agreed that they
      of programs at scale
                                                                                                                                     are either definitely or likely
      We have all elements                                                                                                           going to take the vaccine
      of a large scale                                                                                                               according to the survey
      vaccination program                                                                                                            conducted in the first week
      in place                                                                                                                       of January 2021
                                                                                                                         18%
      We have also                                14%                                   15%
                                                                            12%
      designed a solution
      for the private sector                                   6%                                                                  • This is higher than the
                                                                                                                                     53% for South Africa per
      A vaccination               Yes, I would     I would    I would    No, I would (Don’t know)        Total % -   Total % -       the latest IPSOS survey
      program of this             definitely get probably get probably    definitely                       Yes,         No,          (December 2020), but
      design can be scaled         the vaccine the vaccine not get the   not get the                     definitely definitely /     closer to the IPSOS global
      across multiple                                          vaccine     vaccine                      / probably probably not      average of 66%
      geographies
                                                                                                    Refer to appendix for IPSOS
                                                                                                    survey results (Dec 2020)
                                                                                                                                   • This is however still low,
                                 The UJ-HSRC survey noted that among other factors, leadership and transparency have a               supporting that
                                 significant bearing on vaccine acceptance                                                           interventions are
                                 This highlights the importance of an effective and well managed employee engagement                 required to increase
                                 platform to ensure leadership visibility and promote employee willingness to get vaccinated         public perception and
                                 at the workplace                                                                                    increase vaccine acceptance

©2021 Right to Care NPC                                                                                                                                           14
Comms: In response to the reluctance around vaccinations a social
                               behaviour change campaign (SBCC) is required
                               We believe that RTC is best placed to deliver on a SBCC campaign of this nature due to our knowledge and
                               experience within this space – we have already developed a high level comms approach

      E2E vaccination
      programme tailored                                      Our high-level SBCC approach                                                    Why RTC
      to community needs
                                                                                                                                    • 21 years of experience in
      Our experience            Our experience in COVID-19, VMMC, and HIV SBCC campaigns will inform our three-pronged SBCC           public healthcare and deep
      supports the smooth        approach; aimed to encourage vaccine uptake once the quantitative and qualitative work has           networks within the private
      and efficient roll-out                                            been finalised                                                sector
      of programs at scale
                                                                                                                                    • PEPFAR South Africa's
                                   Education and “myth-
      We have all elements                                             Real life stories                  Practical information       top-performing partner in
                                         busting”                                                                                     HIV/TB care and treatment
      of a large scale
      vaccination program                                                                                                             as well as voluntary medical
      in place                 •    Provided by medical           • Stories of medical                •    Clear referral             male circumcision (VMMC)
                                    professionals                   professionals who have                 pathways and calls to
                                                                                                                                    • Our footprint (SA) covers
      We have also                                                  lost their lives to                    action
                                                                                                                                      seven provinces cutting
      designed a solution      •    High level                      COVID-19 to emphasize                                             across national; provincial,
      for the private sector        understanding about             the need for the vaccine          •    Easy set-up of             and local government
                                    vaccines                                                               appointments               spheres of the Department of
      A vaccination                                               • Develop a network of                                              Health
      program of this          •    To speak to key                 respected medical                 •    Appointment
      design can be scaled                                                                                                          • We have deep relationships
                                    fears/myths                     professionals in local                 reminders
      across multiple                                                                                                                 with health care workers
      geographies
                                                                    clinics who support the                (WhatsApp/SMS)
                                                                    vaccine
                                                                                                                                    • Ability to implement
                                                                                                      •    Information required
                                                                                                                                      research through
                                                                  • Include open webinars                  in order to receive
                                                                                                                                      quantitative surveys and
                                                                    with leading medical                   vaccine                    qualitative focus groups
                                                                    scientists in the country
                                                                                                                                    • Leading partner of both
                                  In keeping with the ethos of RTC and the call of the WHO, PEPFAR and various country partners,      NDOH and the private
                               RTC's golden thread of community, ubuntu, solidarity, and patriotism will be highlighted with          sector
                                 tangible reference to people's lived experiences rather than jargon-heavy pharmaceutical content

©2021 Right to Care NPC                                                                                                                                             15
We have already designed an E2E program for rapid roll-out in the
                               private sector                                                 Proposed –
                                                                                            to be confirmed

                               We have thought through the complete end-to-end solution for private sector and are well positioned to
                               finalise design and costing as vaccinations are made available

      E2E vaccination
      programme tailored
      to community needs          Operational
                                  management
      Our experience
      supports the smooth
      and efficient roll-out
      of programs at scale

      We have all elements
      of a large scale
      vaccination program
      in place
                                  E2E Process           1                        2                          3                        4                         5                      6
      We have also
                                                 Manufacturer to    Orion to distribute vaccines   RTC to set-up/manage    Mezzanine to coordinate     Deloitte to provide   Approved nurses to
      designed a solution                                                    to clinics
                                                 produce vaccine                                    clinics at workplace     employees at clinics    employee comms platform administer vaccine
      for the private sector

      A vaccination
      program of this
      design can be scaled
      across multiple
      geographies

                                  Key Employer
                                    Benefits     Reduced staff     Reduced staff movement                Limited             Early vaccination           Minimal                 Ease of
                                                  downtime          (limiting infection risk)      infrastructure costs         for all staff        management effort       implementation

©2021 Right to Care NPC                                                                                                                                                                     16
Our program would be tested in South Africa, with rapid response in
                               other geographies upon receipt of key information
                               Our approach is simple enough to be scaled across multiple geographies, however key unknowns across
                               national vaccine position, supply chain and regulatory aspects needs to be understood for each geography

      E2E vaccination
      programme tailored             Key elements to be understood before scaling across multiple geographies                                    Why
      to community needs

      Our experience                National position                  Supply Chain                 Regulatory & compliance
                                                                                                                                     • These questions need to be
      supports the smooth
                                                                                                                                       understood in order to
      and efficient roll-out
                               1.   Is national vaccine access   1.   What is the desired roll-     1.   Who are the key               identify if there is a need:
      of programs at scale
                                    secured – if so – which           out timing?                        regulatory bodies in-
      We have all elements          vaccines?                                                            country?
      of a large scale                                           2.   Who are the key                                                  − To expand supplier
      vaccination program      2.   Who can procure vaccines?         distribution/logistics        2.   Has emergency                   base
      in place                      (i.e. government, medical         companies in-country?              regulatory
                                    aids e.t.c.)                                                         approval/clearance
      We have also                                               3.   Are their cold-chain               already been done?
      designed a solution      3.   What is the current in-           facilities/networks in-                                          − To change program
      for the private sector        country sentiment towards         country?                      3.   What is the extent of           structure to respond to
                                    vaccines                                                             medical aid coverage in-        specific geographical
      A vaccination                                              4.   Do any standardised                country?                        needs
      program of this          4.   Have any programs already         stock tracking systems
      design can be scaled          been established?                 exist?                        4.   Are vaccines a prescribed
      across multiple                                                                                    minimum benefit for all
      geographies                                                                                                                    • An early understanding of
                               5.   Has government identified    5.   Do any standardised                medical aids?                 these elements will ensure a
                                    existing mass vaccination         tracking systems exist?                                          swift roll-out across
                                    sites?                            i.e. patient data, hospital                                      multiple geographies
                                                                      data/clinics data
                               6.   What is the willingness of
                                    private sector to pay
                                    towards a program?

                               7.   What is the national
                                    nursing capacity?

©2021 Right to Care NPC                                                                                                                                            17
Our current understanding of the Malawi vaccination status and
                               roll-out will allow for rapid intervention
                               With vaccinations anticipated to arrive at the end of January for approximately 20% of the population
                               (~3.6mn), assistance and preparation for a March roll-out is urgently required

      E2E vaccination
      programme tailored                                                         Our understanding of Malawi
      to community needs
                                                                                                                                         Regulatory/
      Our experience                      Vaccination status                                  Supply Chain
                                                                                                                                         Compliance
      supports the smooth
      and efficient roll-out
      of programs at scale     • Astra Zeneca supply confirmed                 • Existing medical stores trust and        • Key regulatory bodies include:
                                                                                 immunisations run a parallel system of
      We have all elements     • Procurement through government                  cold chain with:                                • Medical council of Malawi
      of a large scale
      vaccination program      • Expected vaccine arrival end Jan ’21                • MOH                                       • Nurses and midwives council of
      in place                                                                                                                     Malawi
                               • Roll-out expected Mar ‘21                           • GAVi
                                                                                                                                 • Medicine and poisons board of
      We have also
                               • No identified mass vaccination sites                • UNICEF                                      Malawi
      designed a solution
      for the private sector
                               • Target 20% population (3.6mn)
                                                                               • Current country system has cold-chain    • No emergency clearance has been
      A vaccination            • Priority rollout –                              facilities for existing vaccination        issued for vaccinations as yet
      program of this                  • HCW,                                    treatments and drugs
      design can be scaled             • Elderly                                                                          • In-country medical aid coverage is low
      across multiple                  • Population with co-morbidities        • Paper based stock tracking systems         as healthcare is free at point of care
      geographies
                               • Current national vaccine coverage             • Standardised patient tracking systems    • Vaccinations are given for free
                                 ~90%, most vaccines free at point of            exist for patients in EMR HIV positive     (including private clinics)
                                 service                                         clients

                               • Mixed sentiment towards vaccine myths

                               • Large national nursing capacity
                                 covering all levels of health care services
                                 (community, secondary, tertiary)

©2021 Right to Care NPC                                                                                                                                              18
Our current understanding of the Zambia vaccination status and
                               roll-out will allow for rapid intervention
                               ~11 million doses have been secured through the African union and Covax facility, government parastatal
                               Medical Stores Ltd is expected to be the key distributor, with existing cold-chain infrastructure in place

      E2E vaccination
      programme tailored                                                       Our understanding of Malawi
      to community needs
                                                                                                                                         Regulatory/
      Our experience                      Vaccination status                               Supply Chain
                                                                                                                                         Compliance
      supports the smooth
      and efficient roll-out
      of programs at scale     • Astra Zeneca – 8.7 million doses through   • Desired vaccination roll-out in February    • Key regulatory bodies include:
                                 the African union                            2021
      We have all elements                                                                                                       • Zambia medicines regulatory
      of a large scale         • Covax facilty – 2.7 million doses          • Vaccine distribution to be done through              authority
      vaccination program                                                     government parastatal:
      in place                 • Procurement through government                                                                  • Health professionals council
                                                                                   •
                               • Government (MOH) have prepared a
      We have also
                                 vaccination strategy
      designed a solution
                                                                                                                          • Vaccination pre-clearance per WHO,
      for the private sector
                               • Priority rollout –                         • MSL is the key medical logistics              however additional in-country clearance
                                       • HCW (COVID-19 centres and other)     provider in Zambia, and has available         would be required
      A vaccination                    • High risk populations (>55 and       cold-chain facilities and standardised
      program of this                    those with co-morbidities)           stock tracking systems                      • Medical aid/insurance coverage limited to
      design can be scaled                                                                                                  employed sector
      across multiple          • No mass vaccination sites planned at       • Additional tracking details are available
      geographies                present                                      through MSL, systems are currently
                                                                              used for ordering drugs and supplies
                               • Private sector has been paying for staff
                                 to be tested for COVID-19, assumption
                                 this would be further expanded to
                                 vaccinations

©2021 Right to Care NPC                                                                                                                                                 19
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