Jeremy Farrar is director of the Wellcome Trust
Canada knows firsthand the dangers epidemics pose to us all. While Zika is the most recent virus to dominate the headlines – and it is less than two years since Ebola in West Africa – the SARS outbreak of 2003 proved how little germs care for borders. From origins in China, SARS spread to Hong Kong and Vietnam, where I was working at the time, and where I lost dear friends to this new virus. And it hitched a plane ride to Toronto, causing 251 cases and 44 deaths.
Canada also knows how to play its part in outsmarting epidemics. Scientists at the Public Health Agency of Canada's National Microbiology Laboratory in Winnipeg led early development of the first effective Ebola vaccine, VSV-EBOV. Through a partnership with the government of Norway, the U.K.'s Wellcome Trust, the World Health Organization, Médecins sans frontières (Doctors Without Borders), Merck, Newlink, and others, the Canadian vaccine then made it through successful clinical trials in Guinea in 2015. Through the ingenuity of science, and the creativity of a coalition determined to pursue science in the face of an epidemic, the world is better prepared.
The development of the VSV vaccine happened unusually swiftly for the world of vaccine science; steps that usually take years were completed within months. But even unprecedented speed was too slow to help contain Ebola and prevent the deaths of more than 11,000 people. Moreover, the extraordinary partnership formed to advance the vaccine was thrown together with commendable urgency, but without stable foundations. It was built on goodwill and determination to address a public health crisis, not the kind of incentives that drive ongoing investment. The experience highlighted what is possible through collaborative approaches, but also the need for a sustainable system that ensures we go on developing vaccines against known and unknown epidemic threats.
The global community is now creating such a system. On Thursday, the Coalition for Epidemic Preparedness Innovations (CEPI) was launched at the World Economic Forum in Davos, Switzerland. With almost $500-million in contributions from the Wellcome Trust, the Bill & Melinda Gates Foundation and the governments of Norway, Japan and Germany, CEPI will identify viruses that pose pressing threats, and support researchers and companies in developing vaccines against them before epidemics begin.
In partnership with government research labs, multinational vaccine manufacturers and the biotechnology industry, CEPI will develop and demonstrate the efficacy of vaccine candidates ahead of outbreaks, so that they can immediately be rolled out for human trials if and when such occurrences take place. If successful, vaccines will be available in time to prevent future outbreaks from becoming public-health emergencies. And the coalition will also advance adaptable new vaccine technologies that can rapidly be deployed against unknown threats that we cannot predict today.
CEPI will initially target the development of vaccines for three viruses among those the global scientific community feels pose the greatest risk of pandemic spread – Middle East Respiratory Syndrome Coronavirus (MERS-CoV), Lassa and Nipah – while exploring how to support vaccines already under development for Zika, Ebola and its viral cousin, Marburg.
While $500-million is a significant budget, it is only a small fraction of the estimated $60-billion annual global cost of epidemics. It also still falls short of the $1-billion that CEPI will need to fulfill its initial five-year work program.
We cannot predict every epidemic, but we can prepare. And we know that if Canada and other developed nations join CEPI's first wave of investors in supporting this initiative, CEPI will be able to deliver vaccine candidates that make us better prepared. Canadian scientists are world leaders in vaccine development and are certain to be at the forefront of the research CEPI will support. Canada's political leaders have also worked hard to promote collaborative approaches to health security during recent meetings of the G7 and the G20.
Few nations have Canada's dual experience of the impact of epidemics such as SARS and of innovating to protect against others. As Canada prepares to take on the presidency of the G7 next year, this is an opportunity to build on the nation's acknowledged leadership in epidemic public health, to the benefit of its own citizens and the wider world.