Dr. Alan Bernstein is president and CEO of global research organization CIFAR and was the founding president of the Canadian Institutes of Health Research. He is a member of Canada’s COVID-19 Vaccine Task Force.
There’s a global race on, far more important than any in Olympic competition: the race between humanity and the SARS-CoV-2 virus, responsible for the COVID-19 pandemic.
The race for a vaccine has raised many questions, including the speed at which things are moving. How is it possible to develop a safe and effective vaccine in less than one year when development typically takes four to five years?
Speed and safety are both possible in creating effective vaccines and three factors make that so.
First, profound advances in the underlying science have transformed vaccine development over the past 20 years. For example, RNA vaccines, currently undergoing clinical trials, are based on new science that made human trials possible in a record two months after the sequence of the virus was first shared online.
Second, we’ve seen unprecedented global collaboration within the scientific community, between university-based scientists and the biopharmaceutical industry, between vaccine developers and national regulators. This includes the 500,000 vaccine trial volunteers – essential players in accelerating the development chain – who are rolling up their sleeves so the rest of us receive a vaccine that is proven safe and effective.
Third, although vaccine development typically proceeds in a linear fashion, this pandemic has profoundly changed the way vaccines move down the pipeline, including how they are funded and regulated by governments. The normally sequential progress from idea to preclinical testing to clinical testing to approval to manufacture is now proceeding in tandem with upfront investments – even before results of Phase 3 trials are known. These “at-risk” investments, as well as continuing dialogue with regulators, have considerably shortened the time required to develop safe and effective vaccines. Governments rightly see these as sound investments, because shaving even a week or two off the process will save many lives and billions of dollars in economic loss.
Recently, the Phase 3 AstraZeneca trial was paused and then restarted in Britain because a volunteer had developed symptoms of a nervous system disorder. After close examination of this single event, the British regulator allowed the trial to proceed. Some may find this alarming. But while a pause in a trial is always concerning, it is not uncommon and the action itself demonstrates that the safety regime is so rigorous that even a single adverse event among the tens of thousands of people in the trial is taken seriously. We should find reassurance in this.
Wealthier countries such as Canada have a clear obligation to ensure that individuals in their own countries – especially front-line health care workers, individuals with pre-existing health conditions, people living in three-generation households, racialized communities and Indigenous people – have early access to an approved vaccine. To date, based on recommendations of the COVID-19 Vaccine Task Force, Canada has signed advance purchase agreements to buy vaccines from five different manufacturers.
But there is another vitally important factor in the global race against the virus: equitable access to the vaccine for all countries. COVID-19 does not respect borders, and so the true race is not between countries or companies, but between all of humanity and the virus. And so it is in every country’s self-interest to support multilateral efforts to ensure global equity of access to safe and effective vaccines. For if the virus is anywhere, it’s everywhere.
The COVAX facility, an initiative of governments and manufacturers, has been constructed to ensure global access. It funds development to incentivize manufacturers to produce sufficient quantities of their vaccines. This week Canada and a growing list of 63 other higher income countries signalled their intention to support COVAX. The United States, China and Russia have not yet joined.
Our commitment to the multilateral COVAX facility does not preclude the bilateral arrangements the Canadian government has already announced to purchase vaccines or donate excess vaccines beyond our own needs to individual countries or regions.
When vaccines are added to our armamentarium of public health measures and we win the race against this virus, we should remember the ingredients that led to our success as we build a better future for Canadians and people everywhere: science, global collaboration and strong international organizations.
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