The Washington Post

‘Vaccine hubs’ program needs U.S. funding, backers say


For much of the coronaviru­s pandemic, poor and middle-income countries struggled to secure doses of the most successful vaccines, which use cutting-edge messenger-rna technology.

As wealthy countries hoarded doses, the World Health Organizati­on and its partners came up with a path forward: a network of MRNA “vaccine hubs” for poorer countries to share technology and eventually make MRNA vaccines of their own, rather than rely on donations by wealthy government­s.

But three years into the pandemic, the U.n.-backed program to build a network of self-reliant research and manufactur­ing sites is struggling. It is seeking a large increase in funds to ensure its sustainabi­lity, its backers say, raising concerns about the longterm future of the program.

The United States has yet to respond to a funding request for $100 million, sent late last year by the effort’s backers. The support would about double its funding overall.

“I’m really worried about the financial future of the MRNA vaccine hub,” said Lawrence Gostin, a professor of global health law at Georgetown University, noting that the United States is the “big wallet” behind such global health efforts, setting the agenda.

The United States has offered no funds so far for the program, which is being organized primarily by the Medicines Patent Pool, a U.n.-supported public health organizati­on. Canada, South Africa and several European government­s completed the initial round of funding, which was designed to cover five years of work.

Internatio­nal efforts to learn from the coronaviru­s pandemic are foundering in the face of mounting fatigue and outright opposition, with much of the world focused on the war in Ukraine and its effects, tensions between Washington and Beijing, and broader economic problems.

Plans for a binding internatio­nal accord on pandemic preparedne­ss, under discussion at the World Health Assembly, are facing conspiracy-theory-tinged backlash from the far right. The World Bank, meanwhile, told reporters this month that a fund it had set up to help lower-income nations prepare for the next pandemic had received only $300 million in pledges, despite calls for $5.5 billion.

In view of the ambitious scale of the MRNA vaccine hub program, its funding request of $100 million would be comparativ­ely modest — “one one-hundredth of one percent (0.01%) of annual U.S. military spending,” aid and advocacy groups including Oxfam America and Public Citizen wrote in a letter sent to President Biden on Friday, urging him to support the program.

U.S. officials have praised the initiative and provided technical support and training. Secretary of State Antony Blinken, speaking at the U.s.-africa Leaders Summit in December, applauded the program as an investment “in future tech know-how and production in Africa, by Africans, with all of the health, science, and economic benefits that this brings.”

It is not clear why the United States has not offered any funding to the program. A State Department spokespers­on confirmed last week that the request had been received but said there were “no funding announceme­nts at this time.”

Charles Gore, the executive director of Medicines Patent Pool, said the letter had been sent to the State Department via the Department of Health and Human Services late last year. He said he hoped the United States would offer the funding eventually, after overcoming bureaucrat­ic hang-ups.

The program has shown significan­t initial scientific success. The MRNA vaccine hub outside of Cape Town, South Africa — the only one up and running — last year was able to reverse-engineer Moderna’s MRNA vaccine by using publicly available informatio­n, despite the refusal of the U.S. drug company to share its formula.

Early testing data has shown the coronaviru­s vaccine developed by the hub to be successful, and the hope is to go into human trials soon, Gore said. But the effort has faced logistical holdups, along with concern from advocacy groups that Moderna could use South Africa’s loose patent laws to block the local manufactur­ing of MRNA vaccines in the country.

While the hub in South Africa is fully funded, more money is needed to help establish the 15 partner vaccine manufactur­ing sites in countries including Brazil, India and Nigeria, Gore said. The $100 million would allow these sites to invest in the infrastruc­ture they need to work on MRNA vaccines and begin doing their own research and developmen­t.

“Initially the idea was that they should come fully funded themselves,” Gore said of the partner sites. “But the reality is that that’s not the case.”

Petro Terblanche, the managing director of Afrigen Biologics, the South African company that worked with researcher­s from the University of the Witwatersr­and to reverse-engineer Moderna’s vaccine, said that the United States had provided “unparallel­ed” technical support but that money was needed to address “sustainabi­lity.”

The manufactur­ing partners need to order specialist equipment and supplies that are specific to MRNA research, which uses an enzymatic process rather than the live cells used in more traditiona­l vaccine research. There are long waits for orders to be delivered, as much as one year in the case of some key equipment, Gore said.

The program’s backers acknowledg­ed that new vaccines would arrive too late to alter the trajectory of the pandemic. Instead, the hope is to use the technology as a platform for other MRNA vaccines and in future outbreaks. Afrigen has started to research new possibilit­ies, including vaccines for tuberculos­is and HIV.

Only two vaccines that have come to market use MRNA technology, and both are made by U.S. companies — Moderna and Pfizer, working with the Germany company Biontech. Moderna has only offered limited cooperatio­n to the hub, allowing its vaccine to be used for comparativ­e testing purposes. Moderna and Biontech have both announced plans to bring MRNA manufactur­ing to Africa.

Gostin said he worried that the WHO and the Medicines Patent Pool did not have a “robust funding model” in place for the hub program and may have underestim­ated the hubs’ total costs.

It was unlikely that the United States would fund the program, despite the nonfinanci­al support it has given, Gostin said, because of the potential complicati­ons from intellectu­al property law for U.S. companies and the high levels of scrutiny seen on global health funding at the moment.

“The U.S. is under intense budget pressure to not send money outside of the United States,” he said. “There are a lot of political overtones.”

 ?? Jerome DELAY/AP ?? Scientists work at an Afrigen Biologics facility in Cape Town, South Africa, in 2021. The MRNA “vaccine hub” is the only one up and running, and more money is needed to establish the 15 partner manufactur­ing sites in countries such as Brazil, India and Nigeria.
Jerome DELAY/AP Scientists work at an Afrigen Biologics facility in Cape Town, South Africa, in 2021. The MRNA “vaccine hub” is the only one up and running, and more money is needed to establish the 15 partner manufactur­ing sites in countries such as Brazil, India and Nigeria.

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