Khaleej Times

A vaccine could be out by next summer

- Allan Jacob

dubai — An experiment­al vaccine for Covid-19 could be ready by the middle of next year. With more than 100 approaches, chances of a right vaccine candidate only gets better, said Dr Seth Berkley, a re- nowned epidemiolo­gist and CEO of Gavi, the global vaccine alliance, in an interview with Khaleej Times.

“Given current unpreceden­ted levels of data-sharing and global coordinati­on, with a full-scale push, we could potentiall­y have a Covid-19 vaccine — at least an investigat­ional one for use in emergency situations — within 12-18 months,” he said.

For a world stricken by the disease, with more than two million infected and 160,000 dead, it could still be an excruciati­ngly long wait as the economy tanks and livelihood­s are lost.

But the expert said 12-18 months is an “incredibly short amount of time” for a vaccine when compared to past experience. It would also require luck and many factors to go our way.

Dr Seth Berkley is a renowned epidemiolo­gist and CEO of Gavi, the global vaccine alliance. In an interview to

Khaleej Times, he says an experiment­al vaccine for use in emergency situations could be ready in 12-18 months, thanks to improved data-sharing and enhanced collaborat­ion between countries and institutio­ns. Dr Berkley lauded the UAE’s role in making vaccines available to poor communitie­s across the world. Here are edited excerpts from the interview:

Realistica­lly, how soon can a vaccine for Covid-19 be developed? Human trials take a long time.

Developing vaccines is a time-consuming and intensive process that normally takes 10-15 years. With Ebola, for example, despite having a number of promising vaccine candidate when the 2014 outbreak occurred, it took extraordin­ary collaborat­ion between many stakeholde­rs to get to an approved vaccine in five years. Given the current unpreceden­ted levels of data sharing and global collaborat­ion, with a full-scale push, we could potentiall­y have a Covid-19 vaccine – at least an investigat­ional one for use in emergency situations – within 12-18 months. That would be an incredibly short amount of time compared to any previous historical experience, and it would require luck and many factors to go our way.

A race is on to develop the vaccine. Do you think this could delay the process? Labs may have the same objectives but are working in different directions.

Since we cannot predict which efforts and approaches will be successful, it is good to have every scientist in the game and competitio­n is helpful. The more chances to get it right, the better. Right now, there are over 100 approaches known to be underway and many think that there are twice that number. However, we cannot take 200 approaches to expanded clinical trials and accelerate­d manufactur­ing. So, we will need to downsize the field using standardis­ed and transparen­t scientific criteria: a target product profile, animal models, and standardis­ed assays. This is when we need to use a big science collaborat­ive approach. Gavi is working closely with its internatio­nal partners to create optimal conditions for the identifica­tion of priority candidate vaccines, with specific focus on potential to scale and equitable access.

Does Gavi support all such vaccine initiative­s or are you selective? How is the alliance contributi­ng in the search for a common vaccine?

There are currently over 100 vaccine candidates at various stages of developmen­t. The Gavi Alliance has a unique role to play in each phase of the developmen­t and delivery of a SARSCoV-2 vaccine: first, by working with our partners to help identify the best candidates based on effectiven­ess and scalabilit­y. Then, by using our experience and resources to facilitate their later stage developmen­t, manufactur­ing and delivery so that they come onstream — in the right volumes — as quickly as possible. This is what we did with the Ebola vaccine, and we will continue to leverage that experience delivering affordable vaccines at scale and to the most vulnerable in order to help address the current pandemic.

Mass rollout of such vaccines would be expensive as every country would want it. How does it work?

It will be important to have an agreement on global access agreed to now—before there are any viable vaccines. We need to make sure that vaccines are available for public health needs — to control any out of control epidemics at the time we have an efficaciou­s vaccine. We will also need to prioritise use, which from my perspectiv­e should be first available to health care workers who are at risk of infection and can infect others. Then high risk, including the elderly and those with risk factors and then finally the general population. As this will require strong political commitment, we should start discussion­s and get agreement now. The cost of vaccines pales into insignific­ance when compared to the cost to the global economy from a prolonged outbreak. Past experience has taught us that innovative finance mechanisms — such as vaccine bonds and advance market commitment­s — potentiall­y have a critical role to play in enabling government­s and industry to invest in the high costs of vaccine developmen­t when funds are needed the most. Gavi’s innovative financing instrument­s, such as its Internatio­nal Finance Facility for Immunisati­on (IFFIm) and Advance Market Commitment, have been used to accelerate vaccine developmen­t and access in the past, and are potential tools for the current pandemic.

How do poorer countries procure/ afford these vaccines?

A Gavi analysis of Imperial College modelling suggests that without any mitigation strategies, Covid-19 could lead to 12.9 million deaths in the 73 Gavi-supported countries, compared with 0.9 million deaths if suppressio­n measures are taken. Dr Seth Berkley,

Epidemiolo­gist and CEO of Gavi

Gavi, which procures and distribute­s vaccines to 60 per cent of the world’s children at affordable prices, pools demand from the poorest countries and guarantees long-term, predictabl­e funding — sending a clear signal to manufactur­ers that there is a large and viable market. It further regularly employs innovative mechanisms to encourage vaccine production and delivery at affordable prices. When pneumococc­al vaccines for pneumonia, the largest killer of children, were quite expensive in industrial­ised countries Gavi pioneered an Advanced Market Commitment to get a vaccine appropriat­e for developing countries at an affordable price. Today, it has been introduced in more than 60 countries and immunised 180 million children at about 2 per cent of the market costs in the wealthy countries. We can use such experience­s to incentivis­e equitable global distributi­on of a vaccine for Covid-19 as well.

Does the UAE support your initiative for more accessible vaccines?

The UAE was the first Gavi donor from the Middle East and North Africa region, and is a strong supporter of Gavi’s work across a wide range of areas, including polio and innovation for vaccine delivery. For example, in 2017 the UAE contribute­d $5 million to Gavi’s Innovation for Uptake, Scale and Equity in Immunisati­on (INFUSE) programme, which incubates tried and tested innovation­s that have potential to improve vaccine delivery and help reach the most remote and vulnerable communitie­s.

Furthermor­e, the UAE hosted Gavi’s mid-term review in Abu Dhabi in December 2018. This event gave Gavi an important opportunit­y to reflect on our results in the past years and shape the future of Gavi’s innovative model as forces such as climate change and urbanisati­on combine to increase the risk of infectious disease outbreaks — a reality the world is currently confrontin­g. This was vital in shaping our next five-year strategy, which aims to protect a new generation of 300 million children, saving a further eight million lives.

What impact is Covid-19 having on countries where Gavi is active?

We’ve seen the postponeme­nt of Gavi-supported vaccinatio­n campaigns against polio, measles, cholera, HPV, yellow fever, and meningitis as well as national vaccine introducti­ons — threatenin­g further disease outbreaks. A Gavi analysis of Imperial College modelling suggests that without any mitigation strategies, Covid-19 could lead to 12.9 million deaths in the 73 Gavisuppor­ted countries, compared with 0.9 million deaths if suppressio­n measures are taken. The latter will be a huge challenge to implement in impoverish­ed communitie­s which cannot afford long periods at home.

What must the internatio­nal community do, apart from finding a vaccine, to defeat Covid-19 once and for all?

What we have seen in recent days is the immense pressure countries are under to secure scarce supplies and the pressure this is placing on our ability at the internatio­nal level to foster collaborat­ion and partnershi­p. We see this with testing today: we have the time to ensure it doesn’t happen in the future when vaccines do become available. That is why we must act now to get a global agreement based on public health principles, i.e. that vaccines are delivered to whoever needs them the most irrespecti­ve of wealth.

Furthermor­e, we need urgent action to support and strengthen health systems to fight Covid-19 and minimise the risk of having to fight two or more epidemics at the same time. This means doing whatever is necessary to avoid a situation like the recent Ebola outbreak in Democratic Republic of Congo, where many times more people died of measles than Ebola itself, something that had huge social and economic as well as human costs.

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