Home Today's Paper Most Popular Video Gallery Photo Gallery
Subscription Blog Signin Register
Tuesday, August 20, 2019 11:03:36 PM
Follow Us On: Facebook Twitter Twitter Twitter Twitter

Vaccine supplies for future global epidemics

Share your thought
Post a comment »
Read all () »

Gloria Pallares :
There are dozens of deadly diseases with the potential to become international health threats, including Ebola, avian influenza, and Zika. Yet there is uncertainty about when and where deadly epidemics will emerge, meaning there is little financial incentive for pharmaceutical companies to bring vaccines to the market.
Enter public-private partnerships. The 2014-2016 Ebola outbreak in West Africa, which claimed more than 11,000 lives and took several billion dollars to contain, rallied international organizations and countries around the need to align efforts - among themselves and with the private sector - to prepare for future health emergencies.
The deployment of an Ebola vaccine to control an outbreak in the Democratic Republic of the Congo in May, for example, was the result of a deal between Gavi, the Vaccine Alliance and U.S. pharmaceutical company MSD. It was the first time a vaccine could be used as an integral part of the response to an outbreak of the virus.
The Coalition for Epidemic Preparedness Innovations, launched in 2017 with initial funding of nearly $500 million, is also engaging the industry to accelerate the development of vaccines for Lassa fever, Nipah virus disease, and Middle-East Respiratory Syndrome.
CEPI's targets stem from a World Health Organization research and development blueprint list of priority pathogens that may cause epidemics, but have no vaccines to slow their spread. This list, which aims to cut the time needed to develop candidate products from years to months, is another outcome of the first Ebola wake-up call.
Following the Ebola outbreak in DRC's Equateur province, Devex spoke to Gavi, CEPI, WHO, and Médecins Sans Frontières to discuss how lessons learned from this emergency can inform preparedness against other lethal infectious diseases, and what role PPPs are playing in getting the world ready for the next big epidemic. The Ebola vaccine illustrates the role of PPPs in helping tackle global epidemics. Between its discovery in 1976 and the beginning of the epidemic in West Africa, the virus infected about 2,400 people and killed less than 1,600. By 2014, there were 10 vaccines and drugs in the pipeline, but none of them was ready for rollout.
"Before 2013, Ebola outbreaks had been sporadic, and only affected a small number of people in isolated communities in poor African countries," Deputy Chief Executive Director of Gavi Anuradha Gupta told Devex. "Despite the severity of the disease, there was little incentive for pharmaceutical companies to bring [a vaccine] to market."
In 2016, Gavi responded by committing an initial $5 million toward the procurement of MSD's Ebola vaccine once it is commercially available. This will require licensing by international regulatory authorities such as the European Medicines Agency and the U.S. Food and Drug Administration, and prequalified and recommended by WHO. As part of the deal, MSD agreed to ensure that a stockpile of 300,000 doses of the investigational vaccine was continuously available in case there was an outbreak before the product was licensed. This includes 100,000 doses that can be shipped within five calendar days.
Efforts to contain the latest Ebola outbreak in DRC have been given a vital boost with the availability of five experimental medicines, WHO experts told Devex, though none have yet been officially licensed.
"We created a guaranteed market and a clear incentive for the company to take the vaccine through licensure," said Gupta. "The deal also meant that, when Ebola broke out in the DRC earlier this year, there was a supply of thousands of doses to meet the demand."
Around 3,300 people received the vaccine from May-July through a "ring vaccination" approach targeting front-line responders, contacts of infected individuals, and contacts of contacts. The same method had been used to control smallpox.
The DRC government had to approve the deployment of the investigational vaccine under compassionate-use regulations and as part of a clinical protocol. Then, the United Nations Children Fund, WHO, and MSF supported the implementation, while WHO, Gavi, the United Kingdom Department for International Development and others funded operational costs.
"Merck donated the doses and worked with WHO to ship them when needed. Until licensure, there is no commercial value and no money changes hands between Gavi and Merck when it comes to using doses from the stockpile," clarified Gupta.
"The vaccine is an important additional tool in managing Ebola outbreaks and a major milestone for global public health that has brought hope to the affected community," WHO spokesperson Tarik Jarasevic told Devex. "However, it does not replace the vital role of good community mobilization, surveillance, contact tracing, and infection prevention and control."
Asked about PPPs' role in the fight against epidemics, WHO referred to a 2017 report that notes they are "the most visible manifestation of the power of collaboration to promote R&D for diseases that predominantly affect the poor."
In that spirit, the governments of Norway and India, the U.K. Wellcome Trust, the Bill & Melinda Gates Foundation, and the World Economic Forum launched CEPI in 2017, following a series of expert consultations convened by WHO.
Speaking to Devex, CEPI CEO Richard Hatchett noted vaccine development takes a long time and is costly and complicated, while epidemics are unpredictable and demand for vaccines is episodic. On top of that, vaccines such as the one for Ebola expire after a couple of years.
"As a result, you have a situation which is often referred to as a 'market failure,' but in reality, the market is doing precisely what markets do in terms of supply and demand. What that means, though, is there is no provision for the collective need when there is an outbreak."
CEPI's coalition of public and private partners was created to bridge that gap: "Our funding and support change the return on investment calculus for private sector partners, so they do not need to rely exclusively on commercial sales to repay the full cost of [vaccine] development," explained Hatchett.
The organization's strategies include working with companies as it builds a portfolio of vaccine candidates, and supporting cross-cutting R&D preparedness against pathogens that may cause future epidemics, but are still unknown to cause human disease. The alliance is also working with industry partners on issues of access, research, and manufacturing. The coalition hopes this model can share the risks, costs, and benefits of the process across partners.
"Ebola proved that we can develop vaccines quickly, even in extremely challenging conditions, but we cannot continue to rely on ad-hoc partnerships and the goodwill of a handful of companies," reads a statement on CEPI's website. "We need a sustainable model for epidemic vaccine development."
Miriam Alía, MSF vaccination and outbreak response adviser, recognized the role of PPPs in helping bring critical vaccines to the market, but called on manufacturers to keep prices as close as possible to production costs. Particularly, given prior public and philanthropic investments in R&D.
Following the attacks of Sept. 11, 2001, for example, the U.S. funded biodefense research related to Ebola, as did Canada's Department of National Defense, which invested $7 million in developing a vaccine. In Aug. 2014, Canada donated the vaccine for use in Africa and allowed MSD to manufacture it.
"Prices should not be so high so as to limit access to vaccines during an outbreak," said Alía, who is a delegate to the International Coordinating Group on Vaccine Provision powered by MSF, WHO, UNICEF, and the International Federation of the Red Cross and ICG is expected to manage the global stockpile of the Ebola vaccine once it is licensed, so that emergency supplies are adequately allocated to countries during outbreaks.
Gavi finances ICG's stockpiles of meningitis, yellow fever, and cholera vaccines for its eligible countries, and Gupta told Devex they will also "fund 100 percent of the Ebola vaccine for Gavi-supported countries."
For MSF's Alía, an important next step would be to make the vaccine easier to use in the field. The product must be currently kept at -60 to -80 degree Celsius, so implementers have to rely on specialized fridges to transport supplies to remote areas of DRC.
Another possibility could be having stockpiles in some high-risk countries. "The DRC is at risk of periodical Ebola outbreaks, so having protocols and in-country supplies could accelerate the response and greatly increase its effectiveness," Alía said.
Taking a broader look at epidemic preparedness, CEPI's Hatchett noted that preparing for clinical trials during outbreaks would take a "tremendous" amount of planning. "Many of the countries at risk do not have strong clinical trial infrastructures, so much of the capacity we will need still needs to be built," Hatchett said.
This June, there were outbreaks of six of the pathogens on WHO's priority list, he pointed out, including Ebola, Rift Valley fever, and Zika.
"Familiarity can invite complacency, but vaccine development requires sustained commitment of people and resources, so once we decide to develop one, we are in for the long haul," he added.
Hatchett believes one of the main challenges is maintaining public attention to the threat of global epidemics: "Now we need to keep this issue at the top of people's agenda, so we can prepare for, and not just react, during future outbreaks," he said.  

(Gloria Pallares is a journalist reporting on sustainable development, global health and humanitarian aid from Africa and Europe).

Add Rate

News Archive

Inside The New Nation

Football »

In 1 game, Bale shows he can still contribute at Real Madrid

AP, Madrid :Just like that, Gareth Bale is part of the solution for Real Madrid again.After only one game back as a starter, the player who wasn't wanted by coach Zinedine Zidane a few weeks ago showed he can still contribute to the team.Zidane started Bale in the team's Spanish ...

International »

Sudanese army and civilians seal interim power-sharing deal

Reuters, Khartoum :Sudan's main opposition coalition and the ruling military council on Saturday signed a final power-sharing deal that paves the way for a transitional government, and eventually elections, following the overthrow of long-time leader Omar al-Bashir.Tens of thousands of people of all ages took to the streets of the ...

Entertainment »

Bindu Kona’s Eid celebration

Sheikh Arif Bulbon :Bindu Kona is a popular singer of present time. Eid celebration of the singers is really exceptional to them specially for whom who has to be engaged with stage shows round the year. Bindu Kona has to engage with stage shows round the year in and outside ...

Football »

Bayern Munich target Coutinho arrives for medical ahead of loan move

Philippe Coutinho has arrived at Bayern Munich to complete his medical as he edges closer to sealing his loan move from Barcelona.The Brazilian midfielder has agreed to join the Bundesliga champions on a season-long loan deal - with Bayern having the option to make the deal permanent at the end ...

Editorial »

Find out a sustainable solution to protect leather market

ALTHOUGH tanners were supposed to start buying rawhide at the government-fixed rates, merchants refused to sell, demanding the payment of a "considerable" portion of their arrears. It comes after seasonal traders, farmers and madrasas across the country threw away thousands of pieces of rawhide of sacrificial animals, approximately Tk 100 ...

International »

British MPs press Johnson to recall parliament over Brexit

British Prime Minister Boris Johnson came under pressure Sunday to immediately recall lawmakers from their summer holiday so parliament can debate Brexit.More than 100 MPs have written to Johnson to urge him to reconvene and let them sit permanently until October 31 - the date Britain is due to leave ...

City »

Aporajeyo Bangladesh, a social organisation, formed a human chain in front of the Jatiya Press Club yesterday demanding punishment to the persons responsible for low-price of hide and skins.

Editorial »

Jugglery of growth figures failed to create jobs

BANGLADESH'S economic growth though mesmerising, it has been proved over the past decade that jobs could not be created proportionately for the youths keeping adjustment with the growth. Besides, female participation in the labour force shrank in the last nine years, especially in rural areas. As a result employment elasticity, ...

Cricket »

Mashrafe seeks two months to ponder about his retirement

The Bangladesh Cricket Board (BCB) has shelved the idea of arranging a one-off ODI against Zimbabwe to give Mashrafe Bin Mortaza a grand farewell after the ODI captain asked the board to give him two months to think about his future.The decision to cancel the plan came after BCB president ...

Football »

Guardiola backs Sterling to reach 30-goal mark

AFP, Manchester :Pep Guardiola wants to see the on-form Raheem Sterling break the 30-goal barrier for the first time in his career this season, but will only judge the England forward on his overall contribution to the Manchester City team.Sterling has started the new campaign in prolific form, scoring in ...

City »

Bangabandu Sangskritik Jote paid tributes to Poet Shamsur Rahman by placing floral wreaths at his grave in the city's Banani on Saturday marking the 13th death anniversary of the poet.

International »

Hundreds defy restrictions, join protests in Kashmir

AP, New Delhi :Hundreds of people protested an unprecedented security crackdown and clashed with police Friday in Indian-controlled Kashmir, as India's government said it was constantly reviewing the situation in the disputed region and the restrictions there will be removed over the next few days.The U.N. Security Council met on ...

International »

Discussions on Afghan peace deal go ‘very well’, says Trump's spokesman

The White House says President Donald Trump's talks with his national security advisers to discuss Afghan peace talks went "very well" and that negotiations with the Taliban "are proceeding."Officials on August 16 said Trump was meeting with his top advisers to review negotiations with the extremist group about a possible ...

Entertainment »

Kona finally admits her secret marriage

Entertainment Desk :Popular singer Dilshad Nahar Kona revealed  on Thursday  that she had tied the knot with the person she loved, on April 21 of this year. Her husband, Golam Md Iftekhar, is a businessman, and has been in a relationship with Kona for seven years.Kona was heard saying to ...

Editorial »

Clashes among groups of govt followers on national mourning day

NEWSPAPERS reported that at least 22 people, including former Awami League lawmaker of Nilphamari-3 and upazila unit AL vice-president Golam Mustafa, were injured in a clash between two rival groups of the party in Jaldhaka of Nilphamari on Thursday. The clash took place when the groups hosted separate programmes to ...

Items that you save may be read at any time on your computer, iPad, iPhone or Android devices.
Are you new to our website? Do you have already an account at our website?
Create An Account Log in here
Email this news to a friend or like someone
Write a comment to this news