Who believed a speedy vaccine doable? He did
Moncef Slaoui has done what most thought impossible
PHILADELPHIA – In 2009, a flu pandemic was racing across the world when a venture capital firm that backs health care companies held its annual retreat. The meeting was a who’s who of pharmaceutical and biotechnology executives – the top leaders of the top companies in the world.
One man pulled together a group of his peers and issued a directive: “We are going to work together to make something happen here.”
That scene came to mind when the Trump administration asked Jeremy Levin, head of the industry’s Biotechnology Innovation Organization, who should run America’s COVID-19 vaccine development effort.
“Moncef Slaoui,” he answered without hesitation.
Slaoui, 61, a Moroccan-born retired vaccine developer and drug company executive, brought his colleagues together before, so it seemed logical to tap him again.
Slaoui’s name came up repeatedly in the spring, when Health and Human Services Secretary Alex Azar was looking for someone from the private sector to help lead Operation Warp Speed – an unprecedented and audacious effort to deliver a COVID-19 vaccine by year’s end.
The scientific community was skeptical. The fastest vaccine development on record was for the mumps, and it took four years. There was no way to make a safe, effective vaccine in seven months, many said. Something would have to be compromised. Slaoui thought he could pull it off. In many ways, he’d been preparing for the challenge his entire life.
A political activist in his youth, he spent nearly 30 years at pharmaceutical giant GlaxoSmithKline, 27 of them working on a vaccine for malaria. He brought 14 vaccines to market and rose to head research and development for the entire company.
“Both my father and mother had as their No. 1 objective education, which comes with fairness, with values, with helping other people.” Moncef Slaoui co-leader of Operation Warp Speed
“Vaccines have always been my first love. That’s what I like the most,” he said in an interview with USA TODAY.
He liked the idea of taking on a nearly impossible mission with the prospect of helping humanity – maybe even more so because people thought it couldn’t be done.
Slaoui said he signed on to co-lead Operation Warp Speed as chief science adviser under two conditions: There would be no political interference in his work and no bureaucracy to slow him down. Both conditions were met, he said, and science, not politics led the way.
The Friday before Thanksgiving, Slaoui visited Temple University Hospital to see what the clinical trial process there was like, how researchers managed to quickly recruit more than 200 volunteers and what he could do to help them sign up many more.
That morning, six months and four days after he accepted the job, happened to be the one Pfizer and its German collaborator, BioNTech, declared their vaccine development process complete and applied for the U.S. Food and Drug Administration’s permission to release it to the public.
Slaoui expected vaccines against COVID-19 would be very effective – 80% to 90%, he predicted in early summer. The coronavirus that causes COVID-19 is actually very weak, he said. That’s why 8 of 10 people can shake it off with limited or no symptoms at all.
But the 94% effectiveness seen in the Pfizer/BioNTech vaccine and another by Moderna is “a dream,” he said. “It means we’ll be able to control this pandemic.”
If people can be convinced to take it, he added: “We are very, very concerned about people not taking a vaccine.”
Slaoui came to Temple in part to encourage more people to participate in the trial of Johnson & Johnson’s COVID-19 candidate vaccine. A trial with a diverse group of participants, he knew, would lead to greater acceptance of the vaccine once it became available.
Such site visits characterize the hands-on approach he has taken in leading the vaccine development effort. He’s personally toured at least five other clinical trial locations and a handful of manufacturing facilities.
Slaoui and the Operation Warp Speed team gather every weekday at 8 a.m. – virtually or in person – and talk about each of the leading vaccine candidates. At 10 a.m., they do the same for drugs being developed to treat COVID-19.
They’re called “battle rhythm” meetings, an idea that originated with his Operation Warp Speed co-leader, Army Gen. Gus Perna, who runs the military’s 190,000-person logistics and supply chain division.
Now that his part of the job is largely
complete, Slaoui is thinking of stepping down by the end of the year. The emphasis is on Perna to get the vaccines he helped develop into the shoulders of millions of Americans.
Everything has gone amazingly well, Slaoui said.
Then he superstitiously knocked with both hands on a wooden conference room table.
The right one for the job
Slaoui didn’t seek out the co-leader post. He is “not aligned with this administration,” he said, and detests politics.
“I am disappointed with how nasty and unprincipled it has become,” he said.
But when the Trump administration went looking for someone who could run an unparalleled vaccine development effort, Slaoui’s name came up again and again.
“When we brought him in for the interview, it was clear that he bought into our vision and believed that our ambitious goal of a vaccine by the end of the year was achievable,” Azar said. “Our confidence in him has been rewarded as he has proved invaluable as scientific adviser to Operation Warp Speed.”
Slaoui was the obvious choice, said Elias Zerhouni, who served as director of the National Institutes of Health during President George W. Bush’s administration.
“We couldn’t have found anyone better than Moncef,” he said. “If there is one person in my view who has been there, done that, it’s Moncef Slaoui.”
Almost no one else had developed both vaccines and drugs from lab to commercialization, understood how to assess unproven technologies, was a natural, public-service-driven leader and knew how to get things done, Zerhouni said.
Levin said he’s always felt a kindred connection with Slaoui. Levin grew up in South Africa and was disgusted by apartheid; Slaoui in Morocco, opposed to policies that trapped the majority of the populace in poverty.
“This is a man who stood up for the human condition,” Levin said.
From activist to executive
Slaoui was born in 1959 in Morocco into a family that believed strongly in education.
“Both my father and mother had as their No. 1 objective education,” Slaoui said, “which comes with fairness, with values, with helping other people.”
His father opposed the country’s French occupation and spent two years in jail for his politics. After Morocco won its independence in 1956, his father became a successful entrepreneur.
Slaoui had four siblings, one of whom
died at 6 months old from whooping cough, which could have been prevented with a vaccine. Slaoui hadn’t been born, but the loss meant he grew up in a home that understood the value of vaccines.
All three boys ended up in medicine or scientific research; his sister is a professor of French literature.
Slaoui went to university in Belgium and became a political activist, “maybe today, (considered) a terrorist,” he said, chuckling. His objective was to overthrow the monarchy.
He never damaged any property or hurt anyone, he said, but organized other Moroccan students studying in Belgium and went on two hunger strikes there in opposition to the wealth disparities he saw back home.
Returning to Morocco to visit his ailing mother, he knew he might be targeted by the secret police.
“Because my family was influential, I didn’t end up in jail forever or disappear,” Slaoui said. But it was a “big wake-up call. I told myself that is not the way you can help, because it can end quite quickly. It’s not very effective.”
He decided to make his social impact through health care instead – including the malaria vaccine he spent decades shepherding and one against rotavirus. Both illnesses kill hundreds of thousands a year, mainly children.
“That’s much more effective than disappearing somewhere in a jail,” he said.
Slaoui has never needed more than 4 to 4.5 hours of sleep a night. He wakes every day at 3 a.m. (4 a.m. on weekends), does a little work, then exercises for an hour or two – solo activities such as biking, running or walking that he could do anywhere in the world his work took him.
“I have many calls with Europe during those hours,” he said. “If I have a call, I’ll be walking fast, and when I’m done, I’ll run.”
He’s never watched “Star Trek,” so his American-born wife had to explain to him what Warp Speed meant. Though some have criticized the name as emphasizing speed over safety, he sees the two as connected, not contradictory.
Operation Warp Speed changed his life dramatically almost overnight.
He moved from his suburban Philadelphia home to Washington, seeing his wife and 8-year-old son only on weekends. “I miss him and vice versa,” he said, proudly pulling up a picture of the boy on his ever-present cellphone. “And my wife, of course.”
Slaoui, who has two grown sons from his first marriage, admits he’s really enjoying the job.
“I have a blast,” he said.
He loves the “alignment” of the team he works with. They’re united by a common mission: making safe, effective vaccines as quickly as possible. The
team members bonded very quickly.
“Nobody has a different agenda,” Slaoui said.
The group’s Department of Defense affiliation means that companies involved in the Operation Warp Speed work can get the supplies they need before everyone else.
When a train carrying a crucial pump needed to make vaccine for Moderna’s latest trial became stalled on its tracks, the military put the pump on an airplane. It arrived in time. Such prioritization allows companies to move faster and scale up further, Slaoui said.
“We held Moderna by the hand on a daily basis,” he said.
Moderna’s trial was recruiting well, but not many participants were people of color, who have been hit particularly hard by the pandemic. Slaoui understood that if the trials were not diverse enough, people of color wouldn’t trust that the results were relevant and wouldn’t feel safe getting vaccinated.
He convinced the company to slow down its recruitment of white participants and bring more Blacks and Hispanics into the trial.
Getting Americans to buy in
One thing Slaoui can’t control is public opinion.
That’s largely why he toured the Temple University Hospital clinical trial site Nov. 20 and Emory University Hospital the week before that: to get a sense of the challenges of recruiting for the trials and to encourage people to participate.
“Thank you so much for (offering) your body for science,” Slaoui said to Carlaann Henry, who received the Johnson & Johnson shot at Temple and was waiting 15 minutes to be sure she didn’t have an adverse reaction.
“It’s my pleasure and probably my duty,” she told him.
Outside the hospital after touring the site, Slaoui called on more Philadelphians to join the trial.
“It’s your civic responsibility to participate, to help society, to help your country, to help your world assess the efficacy of vaccines,” he said. “That, we are all convinced, will be the only way through which we will be able to get someday back to our normal lives.”
Earlier the same day that Pfizer asked the FDA to authorize its vaccine, he noted how remarkable it was that COVID-19 vaccine development had come so far, so fast.
“It’s one of the great things about the USA,” Slaoui said. “If you believe and you try, then you can. It’s just amazing.” Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.