“IF TRIALS ARE SUCCESSFUL, WE COULD HAVE A VACCINE BY EARLY 2021”
DR SOUMYA SWAMINATHAN, chief scientist at the Geneva-based World Health Organization (WHO), is at the forefront of the agency’s global battle against Covid-19. She spoke with Group Editorial Director RAJ CHENGAPPA on the importance of vaccines in halting the pandemic. Excerpts:
Q.What is your reaction to Indian researchers developing vaccines for Covid-19, with two being cleared for human clinical trials? A. It is very encouraging to see Indian R&D coming up with vaccine candidates, because India used to be considered a manufacturing hub of generic drugs. Secondly, the more candidates we have, the better. I think it is good that we have a large number of vaccine candidates across the globe going for testing, because we don’t know which one will be effective and safe. We are still learning about the immune system’s response to Covid-19, and it is possible that different vaccine candidates will stimulate the immune system differently. Only testing and studying immunology will tell us which vaccines provide lasting immunity. It is also good to see government agencies working with developers and manufacturers, because speed is definitely of the essence. The normal time-frame for vaccine development cannot be the norm right now. In order to achieve speed without sacrificing scientific rigour, we need collaboration between the government and the private sector and we need top scientific talent to work together.
Q. How do you see the controversy over the Indian Council of Medical Research (ICMR) putting a deadline for the early clinical trials to finish?
A. There must have been a misunderstanding. Rather than focusing on the letter [that described the deadline], the idea of swift trials needs to be taken in the spirit of ‘how can we do this, how can we bring in as much speed as possible?’ The WHO has set up an ACT-Accelerator (Access to Covid-19 Tools Accelerator), and we work along with CEPI (Coalition for Epidemic Preparedness and Innovations) and Gavi, the Vaccine Alliance. They focus more on R&D, to accelerate and support companies and governments in this field, and also work on policies, allocation, procurement and delivery to ensure access. Developing a vaccine is important, but it also has to be affordable and available. So, the ability to manufacture in large quantities is also important. In India, the ICMR and the DBT are two government agencies that have the capacity, the resources and the mandate to work on this.
Q. Is developing a vaccine for Covid-19 much more difficult than for other viruses?
A. It is actually simpler, because Covid-19 is a single-stranded RNA virus. It has a very simple structure, and because the genetic sequence data was available on January 11, it was possible for companies and other research centres to start working right away. A number of new vaccine platforms have been developed over the past few years, partly due to organisations like CEPI that have funded their development for other epidemic vaccines. These were quickly mobilised, especially the DNA and RNA platforms. Technological advancements have played a major role and are really speeding up the process. But what you still need are clinical studies, data and human trials.
Q. When do you expect the vaccines—if the trials are successful—would be available?
A. Early 2021. Their usage depends on how quickly you can manufacture them. You have to scale up production, and some vaccines will be easier to produce on that scale than others. Then, of course, you need logistics: your supply chain, cold chain, the ‘need policy’—who are you going to vaccinate
first—etc. I think this is an important topic, one that the WHO was discussing with member-states—who will you prioritise if you have a limited stock of the vaccine? You are not going to have enough to vaccinate everybody in the first year.
Q. Many people are sceptical and say that they see a conspiracy between Big Pharma and governments across the world to make money.
A. There certainly is a lot of misinformation about vaccines. Myths and rumours are circulating and creating fear and anxiety. I think it is very important to really put out the facts about the history of vaccines. People highlight only those vaccines which have had problems—of course, to say that you have a vaccine that is 100 per cent safe is not a claim anyone can make. It is a question of benefits versus risks, always. But that is why all vaccines need to be tested—so we have the ability to compare the benefits and the risks. I think a public education campaign on vaccines is important. It is all about doing proper testing and evaluation and looking at the data and making decisions in an open and transparent way, but based on data and based on science.
“AN IMPORTANT QUESTION IS WHO YOU PRIORITISE IF YOU HAVE A LIMITED STOCK OF THE VACCINE. THERE WILL NOT BE ENOUGH FOR EVERYONE IN THE FIRST YEAR ”
Q. Why is it important for a vaccine to succeed?
A. Based on what we have seen of the pandemic so far, the fact is that the virus transmits very easily from person to person and has significant consequences for both mortality and morbidity. We are also learning that the virus has long-lasting impacts on health— on the neurological system, on the lungs, on the cardiovascular system etc. So far, we don’t have a treatment to cure the infection. The most effective way of stopping it would be to have a vaccine. We have seen what the other possible solutions are—physical distancing, lockdowns and segregation are not viable long-term strategies.
Q. There are epidemiologists who believe that natural herd immunity is the answer?
A. The term ‘herd immunity’ is always used in the context of a vaccine—now people have started using it in the context of a natural infection. In most countries that have been affected so far, less than 10 percent of the population has been exposed. You can see from the antibody studies that are being published. Even in Indian data, in rural areas, 0.7 per cent of people had antibodies. This means a majority of people are susceptible, and so there is no question of herd immunity developing anytime soon through natural infections without a huge cost in terms of lives and the economy. It is now only possible through large-scale vaccination. ■