EVIDENCE BRIEF

Solar direct-drive
vaccine refrigerators
and freezers
Solar direct-drive (SDD) refrigerators and freezers can be a good option for vaccine storage in
areas without reliable electricity, and many models are now WHO-prequalified. But with little
information on SDD field performance currently available, making a case for investing in this new
technology can be difficult.

This evidence brief provides

supply chain managers in low-
and middle-income countries
with a summary of how recent
SDD projects have performed,
highlighting problems
encountered and the steps
that were taken to resolve
them. An overview of how
SDD technology works, and
how to make sure that SDD
technology is the right choice,
is also provided. Solar panels on the roof of Pelewa dispensary, Kenya. Photo: Catherine Silali.

The need for off-grid cooling options

For many years, refrigerators powered by gas or kerosene ++ Keeping the temperature within the acceptable range
(known as absorption refrigerators) were considered the of +2°C to +8°C for vaccines is difficult in absorption
most appropriate option to store vaccine in areas without refrigerators.1 There is a high risk of exposing vaccine
reliable electricity. However, various drawbacks with to freezing temperatures.
these devices have made keeping temperatures within ++ Gas and kerosene refrigerators require frequent
the safe range for vaccines of +2°C to +8°C both difficult maintenance to keep them operating well.
and expensive. ++ Operating gas and kerosene refrigerators contributes
to local air pollution and an increase in global
++ Ensuring a regular supply of gas or kerosene is greenhouse gas emissions.
expensive for immunization programmes in the long
term. In the 1980s, battery-powered solar refrigerators were
++ Supplies of gas or kerosene are subject to introduced as a solution to these problems. But the
interruption, and once on site they are vulnerable to batteries they rely on required frequent maintenance,
diversion for other purposes. had a lifetime of just three to five years, and quality
++ Absorption refrigeration is less efficient than the replacements were expensive and often difficult to
compression-cycle technology that is used in electric obtain.
refrigerators.

See: UNICEF. Compression and absorption type refrigerators and freezers for vaccine storage (http://www.unicef.org/supply/files/Com-
1

pression_and_Absorption_Type_Refrigerators_and_Freezers_for_Vaccine_Storage.pdf).

Solar direct-drive vaccine refrigerators and freezers Page 1

 New solar technologies offer a solution
A new approach to solar refrigerator design has directly to the solar array. This new technology has the
emerged, eliminating the need for expensive (and potential to resolve many of the problems of off-grid
problematic) energy storage batteries used to power vaccine refrigeration, enabling national immunization
solar refrigerators. SDD technology uses solar energy to programmes to extend the cold chain into areas in the
directly freeze water or other cold storage material and “last mile” that might otherwise be underserved.
then uses the energy stored in the frozen bank to keep
the refrigerator cold during the night and on cloudy Figure 1 illustrates the differences between solar battery-
days. These appliances include refrigerators, water-pack powered (left) and SDD (right) refrigerators.
freezers and combined refrigerator water-pack freezers
and are called solar direct-drive because they are wired

FIGURE 1.
Differences between battery-powered and SDD refrigerators²

SDD refrigerator

Solar battery-powered refrigerator

Reducing costs with solar technology

Because batteries are usually the most vulnerable refrigerators may be compared, factoring for both capital
component, and the most expensive part that needs costs and operational costs.4 In this example, the mains-
regular replacement, removing them has the potential powered ice-lined refrigerator has the lowest annualized
to increase the long-term success of solar vaccine total cost of ownership, while the kerosene-fuelled
refrigeration. Also, depending on the future cost of absorption refrigerator has the highest annualized life-
electricity and other key inputs, SDD refrigerators can cost.
compete with other types of refrigerator in terms of total
cost of ownership.3 The SDD refrigerator would have the lowest total cost of
ownership in areas with unreliable electricity and suitable
This is illustrated in Figure 2, which provides an example solar irradiance, and where a solar service provider can
of how t­he annualized total cost of ownership of vaccine be funded to provide the necessary support.

² Source: FGL/IM-PAHO and Solar Electric Light Fund.

³ Total cost of ownership refers to all costs associated with owning and operating a unit of equipment over its useful life expectancy.
4
Total Cost of Ownership Tool for Cold Chain Equipment, PATH (www.path.org/publications/detail.php?i=2576).

Solar direct-drive vaccine refrigerators and freezers Page 2

 Example average estimated annualized cost of ownership of FIGURE 2.
PQS prequalified refrigerator types (30-60L capacity)

$1,000

$800

$32 $170
$600
$650
$571
$400
$568
$167
$200 $668
$230
$188
$132
$0
Ice-lined Solar Solar Liquid Kerosene
refrigerator direct-drive with battery petroleum
(ILR) (SDD) gas (LPG)

Annualized operating costs

Annual capital costs

Protection from freezing

Vaccines are at risk of accidental freezing in the cold WHO prequalifies a comprehensive range of cold chain
chain. Indeed, studies indicate that accidental freezing equipment, temperature monitoring devices, injection
is pervasive and occurs across all segments of the devices and other products needed for safe and effective
cold chain.5 To help address this problem, WHO now immunization delivery. A catalogue of prequalified
defines three grades of freeze-protection for vaccine devices is available on the WHO Performance, Quality
refrigerators: and Safety (PQS) website. For a full list of all WHO-
prequalified solar-powered vaccine refrigerators and
++ Grade A – User-independent freeze protection. freezers, including their freeze-protection grading, refer
The user does not need to perform any actions to to the PQS Catalogue.6
protect vaccines from freezing temperatures. For
example, such refrigerators do not require thermostat
adjustments or storage in supplemental baskets or
bins in order to protect vaccines from freezing. These
refrigerators offer the greatest intrinsic protection to
vaccines against the risk of freezing.
++ Grade B – User-dependent freeze protection.
The user must perform one action to protect vaccines
from freezing temperatures.
++ Grade C – User-dependent freeze protection.
The user must perform more than one action to
protect vaccines from freezing temperatures.

5
Matthias DM, Robertson J, Garrison MM, Newland S, Nelson C. Freezing temperatures in the vaccine cold chain: a systematic literature
review. Vaccine. 2007;25(20):3980–6. doi:10.1016/j.vaccine.2007.02.052.
6
http://apps.who.int/immunization_standards/vaccine_quality/pqs_catalogue

Solar direct-drive vaccine refrigerators and freezers Page 3

 Making sure that solar is the right choice
Before beginning the process of introducing solar Is a solar service provider available (or will one be
vaccine refrigerators or freezers, the country should be made available) to provide all necessary services?
sure that solar is the right choice. This can be done by A solar service provider is an essential component in the
asking the following questions. successful implementation of a solar vaccine refrigerator
or freezer system. The solar service provider is a public or
Is sufficient solar energy available? private sector organization whose staff are appropriately
Many countries receive enough sunlight to justify the trained, equipped and capable of supporting a solar
consideration of solar-powered vaccine refrigeration. refrigerator or freezer system by providing all necessary
However, many countries also have microclimates with services, including site assessments, equipment
limited sunlight at some times of the year. For example, installation, user training, maintenance, troubleshooting
most of Colombia receives sufficient solar irradiance for and repair. These services can be provided either by
solar vaccine refrigeration, yet some mountainous areas a public sector organization (for example, the health
and coastal regions have microclimates with prolonged ministry) or by private sector organizations (for example,
cloud cover. In cloudy areas of the country, the choice of a solar electricity company and consulting services
solar technology will be limited and its implementation provider), or by a combination of both.
will require careful design, like increased array size, to
ensure adequate performance. Is secure and ongoing funding in place for the
lifespan of the equipment?
Is solar energy the most suitable option for vaccine The successful implementation of a solar vaccine
cooling? refrigeration system requires both financial and technical
Continuous cooling is required for vaccine storage and, support for early-phase activities, as well as long-term
traditionally, this requires a reliable source of power for planning and funding. Although solar refrigeration
active refrigeration. When choosing a power source, systems, and in particular SDD systems, can alleviate
various factors need to be considered. It is worth bearing many of the performance problems encountered with
in mind that even in locations with adequate solar traditional absorption refrigerators, they still require
energy, solar-powered refrigeration may not be the best regular maintenance and timely repair of equipment.
choice for vaccine cooling. In addition to solar, other Therefore, supply chain managers and other stakeholders
technologies offer solutions to the problem of unreliable must ensure that these requirements can be met at
electricity. Ice-lined refrigerators, for example, have long installation sites throughout the lifetime of the system.
been used to provide adequate vaccine storage during
extended power cuts.

More recently, passive storage containers have been

developed that can keep vaccines cool without a power
source like combustible fuel or electricity. The newest
versions of these passive devices can provide a cold
storage life greater than 30 days with a single load of
frozen water-packs. Such devices offer a potential vaccine
cooling option at sites with low-capacity vaccine storage
needs and where no power is available.

The PQS Catalogue contains detailed guidance on

selecting the most suitable vaccine cooling option based
on a facility’s energy source availability.

Children posing beside solar panels, Colombia.

Photo: Alex Adams Photography

Solar direct-drive vaccine refrigerators and freezers Page 4

 SDD CASE STUDY 1.

United Republic of Tanzania

In the United Republic of Tanzania, only 28% of immunization health facilities have access
to grid electricity.7 Approximately 70% of health facilities rely on absorption refrigerators,
which often expose vaccines to freezing temperatures and are vulnerable to gas or
kerosene supply disruptions.
SDD technology offers a potential
solution to these problems. However,
until recently this technology had not
been used in Tanzania, and it was
unclear whether SDD refrigerators
and freezers would function reliably
across the country’s diverse climate
zones. To find out, in May 2014 the
Tanzanian Immunization and Vaccine
Department, the Clinton Health
Access Initiative and UNICEF initiated
a 12-month pilot project to evaluate
three different SDD refrigerators in
17 health facilities across five climate-
Installation of SDD vaccine refrigerator at Matamba health facility, Tanzania.
diverse regions of the country. Photo: Clinton Health Access Initiative.

In terms of temperature performance, all SDD refrigerators performed reliably without mechanical or electrical
problems. Surveys found high levels of user satisfaction, mostly regarding the ease of SDD operation compared with
absorption refrigerators. One facility even became a storage and distribution hub for nearby facilities when a gas
shortage disabled the other local absorption refrigerators.

Conducted with government involvement throughout, this pilot highlighted the benefits of scaling up use of SDD
refrigerators and factors to be taken into account when considering doing so, particularly as a replacement for
absorption refrigerators. Through this evidence base, the United Republic of Tanzania has been able to make more
informed procurement decisions for off-grid sites and address concerns about country-specific performance. Key
lessons learnt include the following:

Site assessment is critical for successful SDD installation

Ahead of a large-scale deployment of SDD refrigerators, facility-level site assessments are critical to plan for
key variables such as solar array mounting options, shading, facility space for the refrigerator, and other design
considerations. Without this, technicians may encounter issues on installation day which they are not equipped to
address, leading to delayed or interrupted deployment.

Technicians must be empowered through resource availability

Planning activities must take into account the time, tools and resources that technicians require to properly install an
SDD refrigerator. For example, during the pilot, technicians relied on district health offices to provide ladders and
source key resources locally (i.e. poles, cement, additional fixtures and fasteners, etc.). Minimizing the need for such
last-minute installation-related procurements – and planning for those that cannot be anticipated – will be critical for
ensuring smooth deployments in the future.

There is an appetite for power beyond the cold chain

Medical officers and users expressed their desire for electricity availability for purposes beyond vaccine refrigeration,
particularly lighting that could be used to extend service hours. Emerging “energy harvesting” technologies being
developed by manufacturers and global partners could serve this need well, by utilizing excess energy from the SDD
for other health purposes, such as lighting, cell-phone charging, etc.

Comprehensive cold chain assessment led by the Clinton Health Access Initiative (CHAI), 2013.
7

Solar direct-drive vaccine refrigerators and freezers Page 5

 SDD CASE STUDY 2.

Colombia
It is often too costly to continuously operate absorption refrigerators in remote health
centres. In Colombia’s northern mountains, this means that some health centres have no
refrigeration, and those that do can only afford to operate the refrigerator for one week a
month, meaning that immunization services are unavailable for three weeks out of four.
In early 2013, three WHO-prequalified
SDD refrigerators, three SDD
water-pack freezers, and one
WHO-prequalified combined SDD
refrigerator-freezer were deployed
at four remote health posts in
Colombia’s northern mountains by
the Wintukwa Institución de Salud del
Pueblo Indigenous, with the support
of the Solar Electric Light Fund.

Three years after installation, in

September 2016, all SDD devices
were reported as working well. In their
first six months of operation, only one
high temperature alarm was recorded
(after investigation, it is believed that Installation of solar panels at Sabana Crespo health facility, Colombia.
this was caused by a lid not being Photo: Alex Adams Photography
closed properly overnight). These SDD
appliances have provided a continuous cold chain that has satisfied health facility needs for vaccine and medicine
cooling, and have also provided the necessary ice-pack freezing to support outreach activities of up to three days.
The Wintukwa Institución is now planning to deploy more SDD refrigerators at off-grid sites that rely on absorption
appliances or lack refrigeration.

There are several reasons for the successes of the installations to date:

++ WHO-prequalified vaccine refrigerators were used in all installations and the solar power system complied with
WHO PQS specifications.
++ Quality technical information was provided by the manufacturers prior to installation.
++ Pre-installation site assessments were conducted at all health centres (see below).
++ The installation was conducted by professionals, who in turn trained Wintukwa technicians at the time of
installation.
++ Health workers received hands-on training with the installed equipment.
++ Maintenance supplies and tools were provided at all sites.
++ Adequate spare parts were provided and timely repairs were conducted.

Facilities that require solar refrigerators or freezers need to be individually assessed before the solar equipment can
be installed. For this reason, each health post was assessed prior to establishing the final equipment specifications.
The site assessor used a solar site assessment worksheet8 to prepare for the installation and gather the necessary
information. This ensured that all the required installation equipment had been ordered and that the technicians
conducting the installation were fully prepared with the proper tools and supplies. For example, two sites required a
pole mount, one site was roof-mounted and another used a ground mount. A shading analysis was also conducted
to ensure that the SDD refrigerators and freezers would receive enough solar insolation to provide the required
refrigeration. As a result of this thorough preparation, each installation was completed in one visit.

8
A solar site assessment worksheet template is provided in: WHO–UNICEF, Introducing solar-powered vaccine refrigerator and
freezer systems – A guide for managers in national immunization programmes (www.who.int/immunization/documents/9789241509862).

Solar direct-drive vaccine refrigerators and freezers Page 6

 SDD CASE STUDY 3.

Kenya
Kenya has been installing SDD refrigerators at health facilities without reliable electricity
since 2009. Several hundred have already been installed, and this number is expected to
rise to several thousand within the next few years.
In 2016, the National Ministry of Health brought together 46 technicians from 47 counties for a five-day cold chain
maintenance workshop in Nairobi. During the workshop, equipment manufacturers conducted model-specific
installation and maintenance training. Following the workshop, technicians demonstrated increased confidence and
knowledge in performing SDD refrigerator maintenance. However, 46 technicians cannot manage cold chain failures
in almost 6000 health facilities. Additional capacity building is required, and therefore a similar workshop is planned
for 2017.

To date, health facility nurses and technicians have expressed satisfaction

with the performance of the new SDD refrigerators, citing their minimal
repair and maintenance requirements after installation. No major
breakdowns have been reported, while the total cost of ownership for SDD
refrigerators installed in 2009 and 2013 has compared favourably to the
gas and electric refrigerators used previously.

The installation of solar panels on health facility roofs caused various

problems at multiple facilities.

++ Water was found to accumulate on some solar panels due to incorrect

installation.
++ Solar panels were sometimes blown off roofs by heavy winds. Poor
installation and not using the right tools and materials were identified as
An SDD vaccine refrigerator installed at Pelewa
the causes of these failures. dispensary in Kadiajo, Kenya.
++ Some solar panels were stolen from health facilities. Better training on Photo: Catherine Silali.
installation techniques, utilizing secure screws, is required to prevent
these losses.

In addition, solar panels quickly became dusty, and without adequate cleaning their efficiency was reduced. Key
lessons learnt include the following:

Good communication between countries and manufacturers is important

A streamlined post-procurement communication mechanism should be established to enable countries to
communicate directly with manufacturers, without necessarily going through procurement agencies in the country.
This should include a feedback loop on the performance of SDD refrigerators in the field for a minimum of one year.
In-country cold chain technicians should provide manufacturers with quarterly or biannual reports on equipment
performance, including temperature monitoring data, causes of failure, and requirements for spare parts and tools.
This assessment should become a core part of the satisfaction period in the procurement process.

SDD refrigerator manufacturers need to be involved in the post-procurement training of country technicians
Proper installation of SDD refrigerators is crucial to ensure good performance. Therefore, manufactures need to
allocate time and resources to send representatives who can provide technicians with thorough installation and
maintenance training.

Preventive care improves performance

In Kenya, most technicians have received SDD training. However, given the limited resources available, technicians
cannot make quarterly visits to all facilities. Therefore, health facility staff also need to be trained on basic SDD
refrigerator preventive maintenance, in particular cleaning the solar panels. Countries need to allocate sufficient
funding for training both technicians and health facility staff on caring for and maintaining these new devices. The
training should be implemented as part of mandatory operational-level training.

Solar direct-drive vaccine refrigerators and freezers Page 7

 Finding more information
The following resources can help supply chain managers to take the next step in introducing SDD projects.

RESOURCE 1

Introducing solar-powered vaccine refrigerator and

freezer systems – A guide for managers in national
immunization programmes, WHO–UNICEF
This document, available in English and French, provides managers
in national immunization programmes with guidance on how to
implement successful solar-powered vaccine refrigerator and
introducing
freezer systems. The guidance takes into account important new solAr-powered
vAccine refrigerAtor

developments in refrigerator technology, and is based on lessons

ISBN 978 92 4 150986 2 And freezer systems

learnt during the 30 years since solar refrigerator systems were first
A guide for mAnAgers in nAtionAl
immunizAtion progrAmmes

used in immunization programmes.

++ www.who.int/immunization/documents/9789241509862

RESOURCE 2

Selecting and Planning for Solar-Powered Cold

Chain Equipment
This eLearning module on the UNICEF Agora website
(registration required) accompanies the WHO–UNICEF
publication Introducing solar-powered vaccine refrigerator and
freezer systems introduced above.

++ https://agora.unicef.org/mod/scorm/view.
php?id=40344pqs_catalogue

RESOURCE 3

Cold Chain Country Support Package,

Cold Chain Support Package | Supplies and Logistics | UNICEF

UNICEF Supply Division Supplies and Logistics

Cold Chain Support Package

In the context of their respective programmes, UNICEF Country Offices manage a

broad spectrum of supplies with different levels of complexity.

A website to support UNICEF country offices and procurement

The Cold Chain Support Package (CCSP) provides commercial and technical
information to enable an efficient and effective procurement process for Cold Chain
products and services - thus contributing to the success of immunization
programmes.

service partners in strengthening immunization supply chains

This series of Procurement Guidelines consists of the following modules:

© UNICEF/NYHQ2011-0746/Asselin

Residents lift a solar panel onto the roof of the

Gbandiwlo Health Centre in the village of

through the procurement of cold chain equipment and services.

Gbandiwlo, in Kailahun District. The solar panel
will power a UNICEF-provided refrigerator.

1 2

The website provides information on important technical and 3

4

commercial considerations in the planning and procurement

5

6 7

phases of cold chain implementation projects. 8 9

Note! Changes and updates to the documents will be made regularly. UNICEF Supply Division (SD) invites comments and
suggestions from users, so that these guidelines will continue to reflect the needs and expectations of countries.

Cold Chain Tools & Resources

Cold Chain equipment discussion forum10

++ www.unicef.org/supply/index_68367.html
UNICEF Supply Catalogue11

WHO PQS Catalogue12

Cold Chain Weight & Volume Calculator13

https://www.unicef.org/supply/index_68367.html?p=printme[12/2/2016 12:24:59 PM]

Solar direct-drive vaccine refrigerators and freezers Page 8

 RESOURCE 4

PQS Catalogue, WHO

A list of WHO-prequalified equipment, including solar-powered
vaccine refrigerators and freezers, is available in the PQS Devices
Catalogue, available on the WHO website.

++ http://apps.who.int/immunization_standards/vaccine_quality/
pqs_catalogue

RESOURCE 5
Cold Chain Equipment Optimisation Platform
Technology Guide, Gavi
To support countries in improving their cold chains, Gavi, the Cold Chain Equipment
Optimisation Platform
Vaccine Alliance has established the Cold Chain Equipment
Optimisation Platform. Through the Platform, Gavi has committed
an initial US$50 million to jointly invest with countries to purchase
and install new cold chain equipment, including SDD vaccine
refrigerators. With so many new developments underway, it is
critical to use a structured approach to select the right equipment.
This guide aims to provide clear advice on new technologies,
identify which devices comply with Platform requirements, and
help make purchasing decisions. It is intended for use in health
facilities and lower levels of the cold chain.
TECHNOLOGY GUIDE
Current as of 2/2016

++ www.gavi.org/support/hss/cold-chain-equipment-
optimisation-platform

RESOURCE 6

TechNet-21
TechNet-21 is a global network of immunization professionals
committed to strengthening immunization services by sharing
experiences, coordinating activities, and helping to formulate
optimal policies. The TechNet-21 website contains a forum for
discussions on cold chain equipment, a database of reviews
of PQS-prequalified products, as well as a library of technical
resources related to cold chain equipment management.

++ www.technet-21.org

Solar direct-drive vaccine refrigerators and freezers Page 9

 RESOURCE 7 Acknowledgements
The authors would like to express their thanks to
the following individuals and organizations who
E5-03.1 Installing and looking after contributed to this document.
vaccine refrigerators and freezers
WHO
This Effective Vaccine Management (EVM)
++ Dan Brigden
Standard Operating Procedure (SOP) tells you
++ Isaac Gobina
how to install new vaccine refrigerators and
++ Souleymane Kone
freezers and covers routine non-mechanical
++ Patrick Lydon
maintenance and responses to emergency
maintenance. UNICEF

++ www.who.int/immunization/programmes_ ++ Ousmane Dia

systems/supply_chain/evm/en/index2.html ++ Dereje Haile
++ Shaikh Humayun Kabir
++ Adama Sawadogo
++ Benjamin Schreiber

RESOURCE 8 PATH
++ Matt Morio
++ Pat Lennon
++ Joanie Robertson
Total Cost of Ownership Tool for
Cold Chain Equipment, PATH Independent consultants
++ Olivia Bessat
The total cost of ownership tool for cold chain ++ James Cheyne
equipment is designed to help users understand
the costs of purchasing and maintaining cold Design and layout
chain equipment over time. The tool allows ++ Rebecca Diop, RRD Design LLC
country-specific customization for modelling
capital and operating expenses of WHO-
prequalified equipment via interactive worksheets. We are also grateful to the following people for their
permission to share details of SDD refrigeration
++ www.path.org/publications/detail.php?i=2576 projects.

SDD Case Study 1. United Republic of Tanzania

++ Mike Brison, CHAI
++ Steve DeSandis, CHAI
++ Gopal Nadadur, CHAI

SDD Case Study 2. Colombia

++ Steve McCarney, Solar Electric Light Fund
++ Laudelino Pacheco Torres, Wintukwa Institución
de Salud del Pueblo Indigenous, Colombia

SDD Case Study 3. Kenya

++ Joyce Charo, Kenyan Ministry of Health
++ Catherine Silali, Kenyan Ministry of Health
++ Shahrzad Yavari, Nexleaf Analytics

WHO/IVB/17.01
© World Health Organization 2017. Some rights reserved.
This work is available under the CC BY-NC-SA 3.0 IGO licence.

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