You are what you...drink?
YorkTest Laboratories has been delivering FoodScan, one of Europe’s leading food intolerance programmes for over 25 years. Boasting a variety of at-home finger-prick blood tests, YorkTest can check for environmental allergies, food intolerances, can investigate blood sugar levels as well as the health of people’s liver and gut.
“We believe passionately in the value of testing for food intolerance, which has a wide variety of symptoms,” explains York Test’s Managing Director, Tom Hardman. “And we are the leaders because we have been investing in this area.”
Despite an already impressive portfolio of products and services, YorkTest is expanding its reach into previously unchartered territory; drink intolerances. The company has just launched DrinkScan, the world’s first test designed to indentify intolerances to ingredients in beverages.
“It brings a new dimension to intolerance testing, as people don’t really think about being intolerant to drinks” notes Hardman. DrinkScan tests for intolerances to 95 different drink ingredients found in both soft and alcoholic beverages. The test is thorough - not only does it look for intolerances to wine; it can specifically identify the type of wine that reactions stem from by testing for intolerances to 12 different varieties of grapes.
Dr Hilary Jones, a practicing doctor and UK television personality has backed DrinkScan during its launch. Discussing intolerances, he said: “Intolerance has a much more subtle reaction than an allergy and symptoms can sometimes take several days to develop.” Symptoms are typified by irritable bowel syndrome, bloating, eczema, migraines, skin problems, tiredness, joint pains and fatigue and the delayed reaction means people find it very difficult to identify what in their diet is causing these symptoms.
“It’s such an easy to do finger prick test, unlike a lot of other blood tests where you have to go and have a full blood draw,” asserts Hardman. “It’s totally painless. Doing a blood test and popping it in the post is quite an unusual experience, but you’re getting the benefit of a laboratory analysed service and comprehensive results.”
Also included in the DrinkScan service is aftercare, which consists of a consultation with a BANT (British Association for Applied Nutrition and Nutritional Therapy) registered therapist, who offers guidance about necessary dietary changes based on patients’ DrinkScan results. “We believe in counselling people to help them implement dietary changes in the best way to get the best results,” says Hardmand. “That’s our promise.”
DrinkScan has been designed to run alongside FoodScan and the company believes it has the potential to be very popular. Although the initial launch of DrinkScan is only in the UK, there are plans to extend it out into Europe.
Hardman believes DrinkScan will evolve to be a big part of YorkTest’s product offering. He concludes by saying: “We expect it to be a major part of what we do and from the reaction we’ve had we are hoping it will be very popular. We’re very confident because this is an extension of what we’ve been doing for the last 30 years and we can extend our area of expertise from the FoodScan into Drink Scan.”
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The challenges to vaccine distribution affecting everyone
While it is comforting to know that vaccines against COVID-19 are showing remarkable efficacy, the world still faces intractable challenges with vaccine distribution. Specifically, the sheer number of vaccines required and the complexity of global supply chains are sure to present problems we have neither experienced nor even imagined.
Current projections estimate that we could need 12-15 billion doses of vaccine, but the largest vaccine manufacturers produce less than half this volume in a year. To understand the scale of the problem, imagine stacking one billion pennies – you would have a stack that is 950 miles high. Now, think of that times ten. This is a massive problem that one nation can’t solve alone.
Even if we have a vaccine – can we make enough? Based on current projections, Pfizer expects to produce up to 1.3 billion doses this year. Moderna is working to expand its capacity to one billion units this year. Serum Institute of India, the world’s largest vaccine producer, is likely to produce 60% of the 3 billion doses committed by AstraZeneca, Johnson & Johnson and Sanofi. This leaves us about 7 billion doses short.
Expanding vaccine production for most regions in the world is complicated and time-consuming. Unlike many traditional manufacturing operations that can expand relatively quickly and with limited regulation, pharmaceutical production must meet current good manufacturing practice (CGMP) guidelines. So, not only does it take time to transition from R&D to commercial manufacturing, but it could also take an additional six months to achieve CGMP certification.
The problem becomes even more complex when considering the co-products required. Glass vials and syringes are just two of the most essential co-products needed to produce a vaccine. Last year, before COVID-19, global demand for glass vials was 12 billion. Even if it is safe to dispense ten doses per vial, there is certain to be significant pressure on world supply of the materials needed to package and distribute a vaccine.
It is imperative drug manufacturers and their raw material suppliers have clear visibility of production plans and raw material availability if there is any hope of optimizing scarce resources and maximising production yield.
It is widely known by now that temperature is a critical factor for the COVID-19 vaccine. Even the regions with the most developed logistics infrastructures and resources needed to support a cold-chain network are sure to struggle with distribution.
For the United States alone, State and local health agencies have determined distribution costs will exceed $8.4 billion, including $3 billion for workforce recruitment and training; $1.2 billion for cold-chain, $1 billion vaccination sites and $0.5 billion IT upgrades.
The complexity of the problem increases further when considering countries such as India that do not have cold-chain logistics networks that meet vaccine requirements. Despite India’s network of 28,000 cold-chain units, none are capable of transporting vaccines below -25°Celsius. While India’s Serum Institute has licensed to manufacture AstraZeneca’s vaccine, which can reportedly be stored in standard refrigerated environments, even a regular vaccine cold chain poses major challenges.
Furthermore, security will undoubtedly become a significant concern that global authorities must address with a coordinated solution. According to the Pharmaceutical Security Institute, theft and counterfeiting of pharmaceutical products rose nearly 70% over the past five years. As with any valuable and scarce product, counterfeits will emerge. Suppliers and producers are actively working on innovative approaches to limit black-market interference. Corning, for example, is equipping vials with black-light verification to curb counterfeiting.
Clearly, this is a global problem that will require an unprecedented level of collaboration and coordination.
Disconnected information systems
While it is unreasonable to expect every country around the world will suddenly adopt a standard technology that would provide immediate, accurate and available information for everyone, it is not unreasonable to think that we can align on a standard taxonomy that can serve as a Rosetta Stone for collaboration.
A shared view of the situation (inventory, raw materials, delivery, defects) will provide every nation with the necessary information to make life-saving decisions, such as resource pooling, stock allocations and population coverage.
By allowing one central authority, such as the World Health Organization, to organize and align global leaders to a single collaboration standard, such as GS1, and a standard sharing protocol, such as DSCSA, then every supply chain participant will have the ability to predict, plan and execute in a way that maximises global health.
Political influence and social equality
As if we don’t have enough stress and churn in today’s geopolitical environment, we must now include the challenge of “vaccine nationalism.” While this might not appear to be a supply chain problem, per se, it is a critical challenge that will hinge on supply chain capabilities.
In response to the critical supply issues the world experienced with SARS-CoV-2, the World Health Organization, Gavi, the Vaccine Alliance and the Coalition for Epidemic Preparedness Innovations (CEPI) formed Covax: a coalition dedicated to equitable distribution of 2 billion doses of approved vaccines to its 172 member countries. Covax is currently facilitating a purchasing pool and has made commitments to buy massive quantities of approved vaccines when they become available.
However, several political powerhouse countries, such as the United States and Russia, are not participating. Instead, they are striking bilateral deals with drug manufacturers – essentially, competing with the rest of the world to secure a national supply. Allocating scarce resources is never easy, but when availability could mean the difference between life and death, it becomes almost impossible.
Global production, distribution and social equality present dependent yet conflicting realities that will demand global supply chains provide complete transparency and an immutable chain of custody imperative to vaccine distribution.
The technology is available today – we just need to use it. We have the ability to track every batch, pallet, box, vile and dose along the supply chain. We have the ability to know with absolute certainty that the vaccine is approved, where and when it was manufactured, how it was handled and whether it was compromised at any point in the supply chain. Modern blockchain technologies should be applied so that every nation, institution, regulator, doctor and patient can have confidence in knowing that they are making an impact in eradicating COVID-19.