With contributions of $100 million each, the Bill & Melinda Gates Foundation and Britain’s Wellcome Trust are the largest private donors in a new push to develop vaccines to stop the spread of diseases before they erupt into epidemics.
Called the Coalition for Epidemic Preparedness Innovations, the group of pharmaceutical companies, governments, and foundations said today it was nearly halfway toward its goal of raising $1 billion over the next five years.
In addition to the Gates and Wellcome contributions, Japan pledged $125 over the next five years and Norway $120 million over the same period. Germany said it will spend $10.6 million, and India and the European Commission will also contribute, according to a statement released by the coalition.
In addition, drug companies including GSK, Merck, Johnson & Johnson, Pfizer, Sanofi, and Takeda and the Biotechnology Innovation Organization have pledged to support the effort by evaluating drug-development proposals and offering manufacturing assistance.
In 2015, Gates directed nearly $1.2 billion toward global health, making it the world’s dominant private donor in the field. Gates’s interest in public health has led it to invest in private companies, such as Intarcia, which is developing an HIV prevention device. Other efforts include a six-year, $776 million commitment to improve nutrition in the developing world.
Following the appearance of Ebola in West Africa in 2014, the Gates Foundation committed $50 million to help suppress the epidemic. The effort was successful in containing the outbreak, but only after more than 11,000 lives were lost.
“Ebola and Zika showed that the world is tragically unprepared to detect local outbreaks and respond quickly enough to prevent them from becoming global pandemics,” Bill Gates said in a statement this week about the new fund. “Without investments in research and development, we will remain unequipped when we face the next threat.”
The fund hopes to neutralize three threats: the MERS-CoV, Lassa, and Nipah viruses. The three were chosen based on World Health Organization assessments of the risk of an outbreak, the danger to public health, and the feasibility of developing new vaccines. The coalition hopes to begin making grants later this year.
Lessons From Ebola
The idea for a global vaccine development fund stemmed from a discussion led by Mr. Gates at a 2015 meeting of the G7 in Berlin and an article that same year in The New England Journal of Medicine written by Wellcome Director Jeremy Farrar, among others.
Ebola was stopped relatively quickly, largely because health workers contained the disease through quarantines and encouraged good hygiene and proper burials of victims. Several promising drugs have now been tested for use in future outbreaks. But some experts said the United States had already made progress on those drugs in its fight against biological warfare.
There’s little profit motive for a pharmaceutical company to develop drugs for lesser-known diseases such as MERS-CoV, which was first reported in Saudi Arabia. Outbreaks have been isolated.
But an outbreak could erupt at any time, leaving global health providers flat-footed, according to Peter Piot, co-chair of the coalition.
Says Mr. Piot: “The aim is to stimulate the development of vaccines against microbes, mostly viruses, that have epidemic potential, where there is not a market incentive.”
Negotiating Prices
Members of the group said vaccines that result from the effort will be made available at an affordable price. But while board members agree that poor countries should not face price barriers to vaccines, there was significant disagreement over policies for middle-income countries.
Negotiating those and other details won’t be easy, according to Rohit Malpani, director of policy at the Doctors Without Borders access campaign. The aid organization has long been critical of Gates’s health work, believing that the foundation relies too heavily on technological fixes, like immunizations, at the expense of embedding health experts in communities to provide a broad range of care
Furthermore, he said, Doctors Without Borders, which has a seat on the coalition’s interim board, says that having representatives of pharmaceutical companies on the board is a conflict of interest. In addition, he said, there were disagreements on the board about whether the coalition should own any intellectual property it helps develop and about pricing of drugs that result from its work.
Although immunization has limitations, Mr. Malpani, said the experience of Ebola taught global health experts that developing new vaccines is crucial to stop the next epidemic.
“We’re trying to help shape [the coalition] in the right direction at the outset,” he said.
