An Iterative Cyclic Algorithm for Designing Vaccine Distribution Networks in Low and Middle-Income Countries

The World Health Organization's Expanded Programme on Immunization (WHO-EPI) was developed to ensure that all children have access to common childhood vaccinations. Unfortunately, because of inefficient distribution networks and cost constraints, millions of children in many low and middle-income countries still go without being vaccinated. In this paper, we formulate a mathematical programming model for the design of a typical WHO-EPI network with the goal of minimizing costs while providing the opportunity for universal coverage. Since it is only possible to solve small versions of the model optimally, we describe an iterative heuristic that cycles between solving restrictions of the original problem and show that it can find very good solutions in reasonable time for larger problems that are not directly solvable.