Since the covid vaccines became available at the end of 2020 countries across the world have been trying to get their populations vaccinated.

In Europe, despite some vaccine hesitancy the uptake of the covid vaccine has been strong. The average rate of people who are fully vaccinated in European countries is 73%. However, vaccination rates are not the same across the world, in Africa the average number of doses administered is 41 per 100 people.

One of the causes for lower vaccination rates in Africa is countries like Kenya have a very large rural population with poor energy access. In Kenya only 29% of the population live in urban areas, and as recently as 2015 less than a third of rural Kenyans had access to energy. Major efforts have been made to improve the situation and today 75% of Kenyans have energy access but that still leaves millions without power.

The lack of energy in rural Kenyan communities makes transporting and storing vaccines very difficult. Norah Magero the founder of Vaccibox explains how rural health clinics are currently trying to store vaccines, “You find them using an insulated cooled box with ice packs to carry vaccines from the main facility to the level three facility. What happens to the cool box is within four hours, you have to return the vaccines, because of the ice packs. It’s not a fridge. It’s just a storage container. And the other facilities have even tried to adapt their home use and the soda use fridges. And they’re not really the temperature regulation is impossible in these fridges, it is not accurate.”

Not having reliable cold storage in rural health clinics means they can’t store blood, insulin and various types of vaccines.

Building the Vaccibox

In 2018 Magero set up Drop Access, a foundation that aims to provide renewable energy solutions to rural Kenyan communities. At first, she designed a solar pump for farmers which helped improve their productivity, but then the farmers came to her with a different problem.

“Some farmers just asked me so now we have the pumps. We have so much water, and we have so much milk, but we’re throwing away the milk. It’s boiling, how do we store this milk? And that is the first time I like when we sat down with my team to try and find cold storage solutions for farmers.”

But the Covid hit and one of Drop Access’ donors suggested they try to pivot their milk fridge and make it a vaccine storage fridge. So Magero and her team set about making a solar powered, transportable, vaccine fridge. The design also included some digital capabilities like an alarm or text that would go off if the fridge as left open too long.

When it came to making a prototype of the box Magero knew that she wanted the Vaccibox to be built in Kenya.  “We realised substandard technologies are coming into the country. And they’re being passed on for years within the healthcare industry, which is not really right. Because when they break down, even getting someone to repair is such a problem, so it means it’s such a waste of money to the end user. And also, it’s risky for us because then there is no guarantee that vaccines are going to be kept cold throughout the year.”

During Magero’s previous career as an energy auditor for the Kenyan Energy Regulatory Commission she had seen the problems that cheap, old, foreign tech being exported to Kenya was creating.

“Low-cost technologies are always dumped here, it’s less efficient, and there’s nothing I can do about it. And I really struggle telling schools and managers like, hey, you need to [get rid of] your oven. Because it’s costing you so much electricity bills, it’s not really serving you, and you’re wasting so much money every year. And it was so hard for me to convince them why they need to throw it away.”

Building the Vaccibox in Kenya would not only bring jobs to Kenya but also mean that users could easily have maintenance or repairs done on the Vaccibox from the original manufacturer.

However, the decision to build the Vaccibox in Kenya added a few extra difficulties during the manufacturing process.

“We had to learn where we would go to cut the metal, how we [would] transport it to our workshop, which workshop is going to take us in? How do we do this well, how to do a clean job […] Kenya does not have developed infrastructure and industries to do these technologies locally. So we’re basically developing each and every single thing from scratch within a very limited and tight budget.”

After months of trying and failing to get a working vaccine cold storage box and going three times over budget, Magero and her team had finally produced a working prototype.

The Vaccibox is a 40-litre box that can be put on a bike, boat, car or can be wheeled making transporting vaccine easier. The Vaccibox is also IoT enable which allows for the tracking the location of vaccines and the temperatures they are in. It also has temperature controls so different vaccines can be stored at the right temperatures.

Testing the Vaccibox

Now having a working prototype Magero wanted to take the Vaccibox to rural Kenyan communities to see what impact it could have on vaccination rates. But when they tried to offer the Vaccibox to rural health clinics they faced a lot of scepticism

“They were very sceptical, [saying things] like ‘oh my god, you guys claim that you built this here. We don’t build this thing in Kenya. So is it really going to work?’ So we had to spend the whole day trying to convince them.”

Magero finally convinced a clinic just to use the box as a fridge, not storing vaccines. So, they left the Vaccibox with the health clinic. Each day the clinic would call Magero and tell her the fridge was still running and it was still cold. After a month the health clinic were continuing to report that Vaccibox was working and even a nurse who had been the most sceptical was then onboard.

“To me I feel that was the biggest success that I saw. We built it. It’s working. And we’ve gained the confidence of a very, very sceptical nurse who thought that the [box was] going to electrocute him, or it was going to explode.”

The Vaccibox team wanted to see the impact the Vaccibox could have in rural communities, so they set up pilot programmes. The first was at the Usungu Dispensary, a health clinic that is 22km away from connection to the electrical grid.

Before the Vaccibox, the Usungu Dispensary would get vaccines twice weekly from the nearest county hospital and return them once the ice packs melted. Now with the Vaccibox in place, the Usungu Dispensary has the capacity to vaccinate more than 1,500 children a month and the Vaccibox being in just that one facility resulted in the immunisation rate in that one region rise by 45%.

The second pilot programme was set up in a healthcare centre in the Maasai Simba conservancy, which is an extremely sparsely populated area. The previous vaccination programme involved vaccines being available once a week, with women having to walk huge distances with their children to get vaccinated.

Now, with the Vaccibox, vaccines can be taken around the Maasai Conservancy and conduct door to door vaccinations.

“And we’ve seen how Vaccibox can actually increase their vaccination by over 200% but by just ensuring that this person is able to move from the healthcare facility to the homes instead of the mothers walking, they actually wait at the Manyata’s in the homestead and get vaccinated from there. And we’re just learning how Vaccibox is so relevant like in these rural and off grid communities. A facility that did not have power, cannot do vaccines, is now storing vaccines, a facility where women walk long distances, is now getting vaccines to the homesteads.”

Royal Academy of Engineering’s Africa Prize

At the end of 2021 Magero and the Vaccibox were nominated for the 2022 Royal Academy of Engineering’s Africa Prize.

The Africa Prize, which was set up in 2015, aims to support the commercialisation of technology and innovations that improve quality of life and economic development, coming out of Africa.

“When we started doing this production of Vaccibox people threw around that word ‘joke’. And we looked like a joke for a very long time. Then we got onto the Africa Prize. And the Africa Prize literally gives us the guarantee: ‘we trust in the technology’. And [so we received] experts and mentors to build [and] to be better.”

Through the Africa Prize process Magero was able to have consultations with leading global health companies like Pfizer and Glaxo Smith Kline.

Then in June 2022 Magero and the Vaccibox actually won the Africa Prize, becoming the first Kenyan and second woman to ever to be recognised.

Alessandra Buonfino, an Africa Prize judge said, “We’re delighted to award Vaccibox the Africa Prize. The potential impact of improving the cold chain delivery of medicine – especially vaccines – to rural areas is immense, Magero truly represents the idea that one innovator can change an entire community. We look forward to watching her and her team scale this innovation to reach even more people.”

The future of Vaccibox

The Vaccibox was created to deal with a problem that Magero had seen for herself in her local Kenyan community, but there is the potential for the Vaccibox to have a much wider reach.

Magero said, “I’ve come to understand that these problems that we saw here in my community are not isolated. There is still so much need for healthcare and vaccination across the whole of Africa, and even Southeast Asia and just the global south.”

Part of Magero’s plan for the expansion of Vaccibox is that the manufacturing will be based in Africa to boost employment and help the local economies. For Magero the experience of being a young unemployed engineer is something she doesn’t want to be the experience for future Kenyan generations.

“We have created so many jobs, and we’re creating so many jobs for young people, which to me is very, very important. Because there’s a time I was a jobless engineer in this country, which is so unfair. But yeah, it happened. But now we are creating jobs. And that means more young people will have a chance to be employed, more women will have a chance to be to be fairly employed, you know. We get to revolutionise production and manufacturing within the African continent.”