Stories from the coronavirus frontline – CEPI on developing a vaccine

In a special post, Sally Williams hears from Joseph Simmonds-Issler, Chief of Staff at CEPI – an innovative global partnership launched in Davos in 2017 to develop vaccines to stop epidemics just like COVID-19. Here’s what he said on 28 April 2020.

CEPI was able to act relatively quickly when COVID-19 appeared.

As part of our mission to accelerate the development of vaccines against emerging infectious diseases, CEPI (which stands for Coalition for Epidemic Preparedness Innovations) has been funding work on ‘Disease X’. This is what the World Health Organisation (WHO) refers to as the unknown pathogen that could cause human disease.

Initially we viewed the emergence of COVID-19 as an important opportunity to test out vaccine platform technologies and track closely how the outbreak was going to evolve. As the outbreak has grown it has consumed the organisation more and more.

Progress with vaccine development

CEPI began funding vaccine development very early. At the World Economic Forum in Davos, on 23rd January 2020, we announced funding for three vaccine development programmes. We leveraged the funding we already had for work on Disease X. At that point, the world was still understanding how the outbreak would play out.

In February 2020, CEPI called for investment of US$2 billion to develop a vaccine ready for global use. We have currently secured over $900 million of that target. We’re delighted some of our major donors have really stepped up: the UK, Norway and Germany in particular. The UK Government’s pledge of £210 million is to date the largest single contribution by any country to the COVID response.

We received 50 funding applications to develop a vaccine against COVID-19 and have announced eight ‘partnerships’ that we’ve agreed to fund. We are also working to fund enabling sciences, which support the use of vaccines.

A key role for CEPI is to keep track of vaccine development. We recently published a paper that maps the global landscape. There are currently 115 vaccine candidates worldwide in varying stages of development, led by big pharmaceutical companies, small biotechs and academic groups. It’s wonderful that there are so many diverse groups employing a myriad of different technologies. We’re supporting the ones we believe are the most promising.

One aspect that distinguishes the current context from normal times is the level of coordination and collaboration. The global health community has come together in an unprecedented way. For example, GlaxoSmithKline (GSK) has agreed to make its vaccine adjuvant technology available for CEPI projects. This may reduce the amount of vaccine protein required per dose, allowing more vaccine doses to be produced to protect more people.

We are also working closely with the UK Government. The Oxford Vaccine Centre is one of the eight partnerships we have announced, and we’ve previously funded Imperial College London through our Disease X call.

Embarking on vaccine development is just the first step. Next, we need to ensure that the most promising candidates are supported as they need to be, and that successful vaccines are made accessible in a fair way across the world.

When will a vaccine be ready?

We are asked constantly when will a vaccine be ready. We’ve said our goal is to develop vaccines against COVID-19 within 12 to 18 months, so sometime in 2021. That target is completely unprecedented: it normally takes around 10 years to develop a new vaccine. Therefore, 12-18 months is exceedingly ambitious and reflects a pretty radical and compressed escalation of the development process.

Instead of a normal sequential process, we are doing everything in parallel – that means investing in manufacture and scale-up very early on, to make sure there isn’t the lag associated with the sequential process. All CEPI’s processes are working at massive speed.

Vaccine development is very risky and there is a high failure rate. The regulators and everyone involved is absolutely committed to upholding very stringent safety standards. The risk here is that we’re spending money on different stages in parallel on candidates that may not be successful.

We don’t yet know which candidate will win the race. However, the issue is not just when will we have a vaccine that works, but when will we have it available at a sufficiently large scale for the world.

Fair access to vaccines

It is vital that there is a commitment from global leaders to achieve a fair allocation system for vaccines.

There is no global allocation system in place, but many countries are talking about this actively and publicly. The reality is that leaders have a responsibility to their citizens, but there is also a collective global responsibility. This is a discussion that needs to happen urgently – and before we know which vaccine will be the one. The time to come together is now, where countries can make a collective commitment out of enlightened self-interest, as well as for collective global reasons.

Securing funding is critical

The vaccine is the exit strategy for the world, and it may cost a lot of money but compared to the impact on global economies it is absolutely nothing. We need to reach the $2 billion target as soon as we can. To be clear, this is just the initial ask, to provide funding for vaccine development only. There will be a whole host of funding needed for the manufacture and distribution of a vaccine.

COVID-Zero is a global coalition of partners, organised by Wellcome, to advocate for at least $8 billion of new funding – for research, development and supply of treatments for all, and support for public health measures in countries with the weakest health systems.

From a CEPI perspective, ensuring that other countries and business step up to support this unprecedented global effort is completely critical. The costs of this pandemic affect everyone. It is a responsibility of government to respond to the global crisis, but we think there is a strong role for business to play too. The European Commission has announced a pledging event on 4th May 2020, which seeks to raise funds for research and development, including for CEPI.

The need for global partnerships has never been greater. With a pandemic like this, the disease being anywhere is the disease being everywhere and to protect your population you also need to protect the rest of the world.

 

As told to Sally Williams

Image: Ulrike Leone from Pixabay

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