The Covid-19 pandemic has emphasized the need to strengthen existing health architectures and be better prepared for responding to recurring outbreaks in the future.
The global response to the COVID-19 pandemic was beset with several challenges, but one bright spot stood out: the whole vaccine research and development pipeline, from the first SARS-CoV-2 viral sequenced to vaccine efficacy trials, was accomplished in just under 300 days, an unprecedented timeline.
The pandemic has emphasized the need to strengthen existing health architectures and be better prepared for responding to recurring outbreaks in the future. Countries worldwide have been seeking to build manufacturing capacities for drugs and vaccines, but just as necessary and important is the need to deepen global research and development collaboration in providing novel solutions to emerging health challenges. In this regard, India’s National Biopharma Mission, an industry-academia collaborative mission aimed at accelerating early development for biopharmaceuticals, and the Indian SARS-Cov 2 Genomics Consortium, are promising national initiatives.
But while the COVID-19 pandemic created a sense of urgency, it is important to remember that health emergencies are a pernicious, recurring challenge. The world needs a more representative, global, end-to-end platform that can facilitate rapid and equitable access to vaccines, drugs and diagnostics. An effective Pandemic Preparedness and Medical Countermeasures strategy requires the world to envision vaccine research and development as a global public good and work together to accelerate access to life-saving vaccines and drugs.
One approach towards this end could be to form a Global Vaccine Research Collaborative (GVRC) to strengthen global resilience against future pandemics through rapid development, manufacture, and deployment of safe, affordable, and quality vaccines.
The need for nurturing an ecosystem of vaccine manufacturing and research and development, with a strong collaboration between academia, government, research institutions, civil society, philanthropic foundations, international organizations, and private entities was not only recommended by the 2021 G7’s 100 Days Mission report under the United Kingdom’s Presidency but also reiterated in 2022 by the G20 Member States’ Health Ministers during Indonesia's presidency.
It is very timely that India – a champion of vaccine equity and a powerhouse of affordable and high-quality vaccines – has assumed G20 presidency this year, followed by Brazil and South Africa in the coming years, to conceive, build and drive this initiative forward. India's presidency of the G20 has focused on fostering international collaboration to address pressing global issues, under the leadership of Prime Minister Narendra Modi, recognizing the interconnectedness and shared responsibilities of nations in finding solutions to these challenges.
During the Covid-19 crisis, India’s remarkable achievement in not only developing a cost-effective indigenous vaccine but delivering essential medical supplies and vaccines to over 96 countries through its ‘Vaccine Maitri’ initiative showcased its commitment to global solidarity.
The GVRC could build on the learnings and good practices from other similar frameworks such as the ACT-A/COVAX, Pandemic Influenza Preparedness (PIP) Framework, International Coordinating Group (ICG) on Vaccine Provision. Investments into preparatory research, increasing our knowledge base and exploring innovative coordination and funding mechanisms must underpin this new collaborative. To this end, it is important to identify the most pressing priorities ahead of it.
The first and most urgent priority for GVRC would be to build and compile a shared research knowledge base. An open-access digital database identifying pathogens that can one day cause a pandemic is the first step. This includes identifying pathogen families that are endemic to selected regions and countries. The Coalition for Epidemic Preparedness Innovations (CEPI) One-World Vaccine Library is an ongoing effort that could be integrated into the broader GVRC. The vaccine library will consist of research-grade vaccine constructs or reagents and clinical candidate vaccines arising from vaccine R&D efforts against high-risk virus family targets.
Building an international network of networks for vaccine R&D is the second key component. This network should bring together epidemiology, clinical, preclinical, central laboratory and regulatory capabilities to accelerate development of vaccine candidates, with a focus on enhancing capacities in the Global South. Finally, the GVRC could identify major bottlenecks to international collaboration for vaccine R&D and foster trust. This will require addressing critical issues of clinical trial networks, regulatory harmonization, intellectual property, and availability of inputs, while simultaneously fostering equity, access and engagement with affected communities from the outset.
There is growing recognition of the imperative to develop and ensure equitable access to vaccines. CEPI’s ambitious and aspirational $3.5 billion roadmap to compress vaccine development timelines to 100 days is one such initiative. GAVI has made commendable efforts to enhance vaccine access. Organizations such as PATH are working to make lifesaving vaccines available to affected communities around the world. The G20 itself has reiterated its commitment to vaccine research and delivery, as well as rapid pandemic response.
A Global Vaccine Research Collaborative, supported by the G20, has the potential to converge these efforts. The G20 represents around 85% of the global GDP, over 75% of the global trade, and about two-thirds of the world population. The grouping also encompasses the G7, BRICS and other developing countries, making it the ideal platform to not only drive cooperation between the Global North and South but also to ensure that vaccine research is responsive to regional needs.
COVID-19 is not the last pandemic the world will face together. Cross-country and cross-regional collaboration have to be an important part of our larger game plan to respond quickly to future threats and challenges. The Global Vaccine Research Collaborative can be a key contributor to the proposed Medical Countermeasures platform, building a coordinated and effective strategy for preventing future health emergencies.
(Nikolaj Gilbert is president and chief executive officer of PATH.)