Putting Vaccines Within Reach

On a hot day in 2017, in a remote village in the Democratic Republic of the Congo’s Kwilu Province, dozens of parents gathered with their babies and young children in the shade of a large tree. One by one, the children received something potentially life-changing—their first-ever vaccines.

At the centre of the gathering was Blandine Mbwey, a community vaccinator who had left at dawn, walking 10 kilometres from the nearest health centre in a town called Pay Kongila. Time is rarely on her side. Typically, after carrying fragile vaccines in a cooler lined with ice packs, she needs to begin vaccinations immediately before the doses spoil in the tropical heat. And once finished, she must hurry back to the health centre’s refrigerator before the remaining vaccines lose their potency.

That day, however, was different. Accompanying Mbwey was John Beale, who was helping to test a new portable, self-powered vaccine transport system called Indigo. Unlike conventional coolers, Indigo doesn’t rely on ice. Instead, it uses advanced insulation and battery-free evaporative cooling to maintain a safe temperature range for more than five days.

“The issue with ice is that you need a fridge to make it,” Beale explains. “In rural Congo, there is no grid providing reliable electricity. Vaccinators may be on foot for days at a time, so Indigo allows them to carry enough doses to cover multiple villages before returning home.”

Beale leads Partner Engagement at Global Health Labs (GH Labs), a Seattle-based non-profit funded by Gates Ventures and working closely with the Gates Foundation. GH Labs designs tools that can be deployed in the world’s most resource-constrained settings—places like the Democratic Republic of the Congo, where millions live without regular access to health care. “What keeps me going is the fortitude of the people in the field,” he reflects.

More than a physical distance

Vaccines may travel thousands of kilometres from international manufacturing facilities to reach a nation’s capital, then hundreds more to regional health centres. Yet, as Beale explains, the greatest challenge often lies in the final stretch of that journey. “The challenge of the last mile is more than physical distance,” he says. “It’s the infrastructural, economic and logistical barriers that prevent people in remote areas from accessing health care.”

Most vaccines must be stored between 2° C and 8° C. Too warm, and they spoil. Too cold, and they freeze, losing their potency. Conventional coolers stay within that narrow range for only about 24 hours—limiting vaccinators to one-day journeys and leaving millions of children beyond their reach.

Because the Indigo vaccine carrier has extended their range dramatically, the impact is profound: children in communities once deemed unreachable can now be immunized. 

A journey begins at UVic

Beale’s journey toward global health began decades earlier, as an undergraduate at the University of Victoria. In the early 1980s, he enrolled in anthropology, driven by curiosity about how people live and connect across cultures. Midway through his studies, he took a break and spent a year backpacking across India. “I was pretty much off-grid,” he recalls. “When I came back to UVic, I was fascinated by economic forces at every level—community, regional and global.”

That curiosity led him to switch majors to economics, a decision that shaped the questions guiding his career: why some societies thrive while others struggle and how policies and systems can either open doors or close them.

It was also at UVic that he met his wife, Megan Bonner, in a course on Southeast Asian Economies. The day after their final exams, the two married at the Interfaith Chapel (now the Multifaith Centre), financing their next adventure by tree planting before moving abroad.

“Three months after graduation, we went to Japan,” he says. “We haven’t been Canadian residents since, but we look forward to coming home to Victoria one day.” Over the decades, Beale’s career has spanned more than 20 countries and multiple industries—from semiconductors to mobile telecommunications to global health. While Beale has not yet returned to live in Canada for more than 30 years, his positive experiences with UVic have come full circle as all of his children are now UVic alumni.

In the tech sector, that meant identifying how new chips and software could expand what a phone could do for its user. In global health, it means collaborating with engineers to design devices that bridge gaps in health care delivery for underserved populations.

At GH Labs, Beale’s role is to connect innovation with impact—helping new ideas survive the realities of the field. “My job is to take the designs in prototype form and evaluate them in the field in order to identify what gaps there might be in that capability and performance so that we can improve on it further, while also cultivating interest for those designs deemed successful.”

A mission of health equity

For Beale, focusing on immunization is both pragmatic and moral. Vaccines are among the most effective public-health interventions in history, yet every year, 1.5 million children under five still die from diseases that vaccines could prevent.

“If you can get a child past the age of five, they have a much better chance of surviving into adulthood,” he notes. “Immunization is a very cost-effective way of saving lives.”

In some countries, fewer than half of all children receive a full course of vaccines, and many receive only partial protection. The gap is significant in rural areas, where poor roads, unreliable power and long distances make delivery extraordinarily difficult.

Beale acknowledges that global health work can also be affected by shifting government priorities and funding cycles. “You have to approach this work with a glass-half-full perspective. Being a hopeless optimist is part of the gig,” he says.

Tracking the impact

Nearly 10 years after Beale’s first visit to Pay Kongila, the Indigo system is now in use throughout DRC, and many other countries. Vaccinators across sub-Saharan Africa have been able to extend immunization coverage to previously unreachable communities. Based on lessons learned from the field, GH Labs’ engineers have continued refining the technology.

“It can take years to prove a technology works in remote locations where there are limited resources,” he says. “And then you need to engage not just governments, but also global health organizations like UNICEF, which often finance national health programs.”

While studies measuring the Indigo vaccine carrier’s long-term impact are still underway, early signs are promising. In Borno, Nigeria, the device has been fully adopted by the state health ministry after successful trials showed increased vaccine availability, higher vaccination rates and reduced transport time and cost. The results, Beale says, speak to a broader vision that extends well beyond any single technology. “Stronger health for communities globally is better for everybody.”

—Damon van der Linde

This article appears in the UVic Torch alumni magazine.

For more Torch stories, go to the UVic Torch alumni magazine page.