A new global coalition is laying the groundwork to achieve an ambitious goal of speeding up the development of vaccines to combat the spread of deadly emerging infectious diseases that pose great risk to public health.
Launched in January, the Coalition for Epidemic Preparedness Innovations (CEPI) is an alliance of governments, private companies and philanthropic organizations that share the same mission: to finance and guide vaccine research and development in order to prevent the next infectious disease outbreak from becoming a global public health emergency.
“There will with certainty be another major epidemic breakout somewhere in the world. The question is when – not if – and where,” Frederik Kristensen, Norway-based deputy CEO of CEPI, said in an interview with Homeland Preparedness News.
Some infectious diseases are endemic to certain regions, such as Lassa virus in West Africa, but unexpected flare-ups also occur, as with the spread of Zika virus in South America and the United States. There is currently no vaccine against either virus.
“With the increased mobility, with people living more densely in cities and with climate change going on, the risk for a spread from these flare-ups or an epidemic from a new pathogen is much bigger than we have been used to,” Kristensen said.
CEPI will initially target three diseases: MERS-CoV, Lassa and Nipah viruses, which can cause serious epidemics.
It aims to develop four to six vaccine candidates against two to three priority pathogens to proof-of-concept in five years, so that medical countermeasures could be available if and when an outbreak begins.
MERS-CoV is the virus that causes Middle East respiratory syndrome and is a disease passed from animals to humans, often by camels. The Saudi Arabian Ministry of Health has reported 1,589 MERS-CoV cases, 659 of them fatal, since the virus was first detected in humans in 2012.
Lassa virus causes Lassa fever and is transmitted from rodents to humans. Various outbreaks of Lassa fever were reported in West Africa in 2016 and 2017, according to health officials. Nipah virus can be spread to people from infected bats and pigs, and outbreaks happen nearly every year in Bangladesh.
Each of those three zoonotic diseases can also be transmitted through person-to-person contact.
When selecting which diseases to tackle first, CEPI sought guidance from the World Health Organization’s list of priority pathogens that are seen as likely to cause severe outbreaks in the near future.
CEPI also plans to support research and development work being conducted on an Ebola vaccine.
CEPI’s other main objective is to build stockpiles of vaccines that can be rapidly deployed during public health emergencies. “If there is an outbreak of a hitherto unknown pathogen, a key challenge is to have built the technical and institutional platforms to be able to respond quicker to that unknown threat,” Kristensen said.
Infectious disease epidemics not only kill large numbers of people, they also wreak havoc on global economies. Infectious disease epidemics cost the world an estimated $60 billion each year in potential economic loss, according to a 2016 report from the international Commission on a Global Health Risk Framework for the Future.
The Ebola crisis in West Africa, where more than 11,000 people died, revealed weaknesses in global preparedness for combating infectious diseases. Experts called for a new system to drive the creation of vaccines to prevent and contain future epidemics.
“One of the lessons that clearly came out of this was that we, as a global community, are not sufficiently prepared with respect to coordinating research and development for diseases with high epidemic potential,” he said.
Manufacturing vaccines that are safe and effective can take years, even more than a decade, and vaccines aimed at epidemic diseases may face poor commercial prospects. The risks and costs of development combined with complicated regulations that vary by country also can serve as obstacles to creating vaccines.
“I think the core obstacle that CEPI is trying to address is that for most of these diseases there really is no commercial market,” Kristensen said. “Due to this lack of market incentive, CEPI is pooling public and private and philanthropic investments so that the research community and companies have strong and clear financial support for developing vaccines against these threats.”
CEPI recently issued a Request for Information on technologies related to the production of vaccines and antibody therapeutics, drawing more than 60 submissions by this week’s deadline. Those responses will provide information for CEPI to issue a Call for Proposals in the coming months on rapid response platform technologies specifically for vaccine development.
“We want to do a thorough review of what has come in and then make the final decision as to what that call will look like and the final timing of it,” Kristensen said.
So far CEPI has secured an initial investment of $540 million, with a goal of raising $1 billion for the first 5 years. The coalition’s investors include the Bill and Melinda Gates Foundation and the London-based Wellcome Trust, each contributing $100 million over 5 years, as well as the governments of Norway, Japan and Germany, among others.
Several corporations, including GlaxoSmithKline, Merck, Sanofi, Johnson & Johnson, Pfizer and Takeda are actively partnering with CEPI, deciding which technologies, staff and manufacturing facilities they can contribute. And more than 50 organizations have endorsed CEPI’s mission, including Emergent BioSolutions Inc., Inovio Pharmaceuticals and Moderna.
Helping to guide CEPI as members of its Scientific Advisory Committee are the Biomedical Advanced Research and Development Authority (BARDA), the National Institutes of Health and the U.S. Army Medical Research Institute of Infectious Diseases.
In addition, Richard Hatchett began work this month as CEO of CEPI. Hatchett previously served as deputy director and chief medical officer of BARDA, part of the U.S. Department of Health and Human Services.