The partnership will be called the Coalition for Epidemic Preparedness Innovations, or CEPI. It grew out of the lessons from the world’s woeful lack of preparedness for the 2014 Ebola epidemic in West Africa, which killed more than 11,000 people and caused at least $2.2 billion in economic losses in the three hardest-hit countries.
As a result of that and the current Zika epidemic in the Americas, a global consensus has steadily grown among an array of governments, public health leaders, scientists and vaccine industry executives that a new system is needed to guard against future health threats.
Global health experts welcomed the initiative, saying it would complement efforts already underway by the World Health Organization and the U.S. Biomedical Advanced Research and Development Authority (BARDA), part of the Department of Health and Human Services, which are working on Ebola and Zika vaccines.
The United States is not providing funding for CEPI, but it is offering subject expertise. Officials took part in the planning discussions, and “while we are not a formal partner to CEPI, we foresee synergies between our approaches,” BARDA Director Rick Bright said in a statement. One such area is development of the most efficient technology for biodefense and infectious disease response, he said.
Rebecca Katz, director of Georgetown University’s Center for Global Health Science and Security, expects the new coalition “will just add much needed resources to a hard problem” and not detract from other efforts' funding and resources.
CEPI initially plans to target three viruses that have known potential to cause serious epidemics and can be transmitted from animals to humans: MERS, a deadly respiratory virus first identified in Saudi Arabia in 2012 that can be spread by camels and now is in 27 countries, including the United States; Lassa fever, an acute viral illness mainly found in West Africa and spread by rats; and Nipah, a newly emerging infection initially identified in 1999 in Malaysia and Singapore. During a Nipah outbreak there among pig farmers and people with close contact with pigs, nearly 300 people were infected and more than 100 died.
Each virus is among WHO's priority pathogens. Few or no medical countermeasures exist to combat them.
The current system for vaccine development is in crisis, health experts say, because it’s a costly, complicated and labor-intensive development process that prioritizes therapeutics with the biggest possible market.
CEPI hopes to develop two vaccine candidates against each of the target diseases. Officials said they did not choose Ebola and Zika vaccine work because considerable research is already underway.
“The last thing we would like to do is duplicate efforts,” Trevor Mundel, president of the Gates Foundation’s global health division, told reporters during a briefing.
Officials said they have raised $460 million, almost half of their $1 billion target for the first five years. They’re now seeking proposals from researchers and companies and expect to announce which will be funded by mid-year. They're also calling for other governments and organizations to help complete fundraising by the end of the year.
The Indian government, one of the coalition founders, is finalizing a financial commitment, according to CEPI.
Several major pharmaceutical companies are providing support in the form of vaccine technology, expertise and guidance. Industry representatives are on the coalition’s board and scientific advisory committee.
Bill Gates has said his biggest worry is a pathogen, more infectious than Ebola, for which the world is totally unprepared. In a statement Wednesday, Gates said, “The ability to rapidly develop and deliver vaccines when new ‘unknown’ diseases emerge offers our best hope to outpace outbreaks, save lives and avert disastrous economic consequences.”
Wellcome Director Jeremy Farrar was among those who first proposed a global vaccine development fund in mid-2015. CEPI’s initial $1 billion investment goal, he said, pales in comparison to the tens of billions of dollars in costs from epidemics, starting with the 2003 SARS outbreak.
“Vaccines can protect us, but we’ve done too little to develop them as an insurance policy,” Farrar said.
CEPI's financial contributions so far for its first five years include:
• Japan: $125 million
• Norway: about $120 million
• Germany: about $10.6 million in 2017 with more funding to come
• Wellcome Trust: $100 million
• Bill & Melinda Gates Foundation: $100 million