Another pandemic need never happen

The writer is chief executive of the Coalition for Epidemic Preparedness Innovations

The world has entered a new and much less predictable phase of the pandemic. While there is much we don’t yet know about them, the new viral variants that have emerged in the UK, South Africa, Brazil and elsewhere present a grave threat that should not be underestimated. If we are to maintain the gains made over the past year, the spread of these variants needs to be aggressively controlled.

The good news is that pharmaceutical companies are already working on revising their vaccines and the technologies that produced the first wave of them. This should enable even faster production of new ones. It took 314 days from the release of the Sars-Cov-2 genetic sequence in January 2020 to BioNTech/Pfizer ’s submission of phase 3 clinical trial data for vaccine regulatory review. That was a record-breaking sprint for an industry in which product development often takes decades. Even so, it was too long given the threats posed by Covid-19, as the new variants make clear.

For the future, we should set a “moonshot” goal to compress that timeline to 100 days. That may sound like an outlandishly ambitious target. But, with the right level of investment, it is achievable. Moreover, this increased speed will be needed if we are to break the cycle of epidemics stalking humanity.

Had we achieved a 100-day timeline in the current crisis, that first regulatory review would have begun in April 2020, seven months faster than the 10 and a half months achieved by BioNTech/Pfizer, with their mRNA vaccine. The first injections might then have been given on May 8 2020, when fewer than 3.8m cases of Covid-19 had been confirmed globally, rather than on December 8, when there were more than 67m.

Those extra 200 days could have saved most of the 2.3m lives so far lost to Covid-19, and prevented trillions of dollars of economic damage. Faster vaccine deployment would also have limited the opportunities for, and perhaps altogether prevented, the emergence of the dangerous viral variants.

A silver lining of the crisis is that scientists will emerge from it with new tools that will allow them to design and develop vaccines far more rapidly than ever before. By leveraging mRNA technology — alongside other advances in vaccinology — it is possible to envisage a substantial reduction, or even elimination, of the risks posed by future outbreaks. It is the first time in history that we can credibly make such a claim.

If political leaders can muster the will to make the right investments, emerging infectious diseases could be struck off the list of existential threats to our way of life. By improving global surveillance and sequencing capabilities, investing in global vaccine manufacturing capacity and compressing vaccine development timelines, the world could be positioned to stamp out emergent diseases before they wreak havoc like Covid-19.

Such an aspiration may seem almost utopian. But it is well within our grasp. Achieving it, however, will require extensive planning and investment.

We will need to apply the latest science to develop and test vaccine candidates against a set of “prototype pathogens”. When new threats do emerge, we will need rapid publication and analysis of their genetic sequences, tight co-ordination of viral specimen collection and dissemination, well-prepared clinical trial systems and precise execution of each step of the development process, including speedy regulatory review.

Today, around 260 viruses from 25 viral families are known to infect humans. Within these viral families, another 1.6m yet-to-be-discovered viral species may exist in mammal and bird hosts. In theory, any of these might be the next Covid-19 — or worse.

We cannot develop vaccines against all these potential threats, but we can produce a library of vaccines against pathogens that are representative of their viral families. Previous work on vaccines for the Middle East Respiratory Syndrome, or Mers, enabled us to jump-start Covid-19 vaccine development. In the same way, such a library would accelerate work on those for most newly emerging threats.

Certain classes of virus such as coronaviruses are such a recurrent pandemic threat that efforts to develop a universal vaccine, effective against all strains, are warranted. We are initiating such work imminently.

Humankind cannot prevent viruses from jumping the species barrier and on to humans. But with the right research and development investments, and a deliberate focus on eliminating barriers to rapid vaccine development, I believe we can eliminate the risk of a pandemic with the impact of Covid-19 from occurring again. It might cost tens of billions of dollars. But as a global insurance policy, that has got to be a bargain.