Devex CheckUp: The 100 Days Mission has a loooong way to go

It's now been four full years since COVID-19 entered the public consciousness, but multiple initiatives that were born out of the pandemic are still finding their feet.

That includes negotiations for a pandemic treaty — which began in 2022 and is set to be submitted at the World Health Assembly in May, more on that further down — as well as the 100 Days Mission that the G7 endorsed in 2021, whose aim is for the world to have available diagnostics, treatments, and vaccines within 100 days of the World Health Organization declaring a public health emergency. They hope that this will save lives and prevent an outbreak from spiraling into a pandemic. But a new report published this week reveals that’s easier said than done.

With the exception of COVID-19, there is an extremely bare clinical pipeline for viruses with pandemic potential — be it on vaccines, treatments, or diagnostics. Marburg and Nipah viruses, which can have high fatality rates, don’t have any approved treatments, and only one candidate in early-stage clinical trials. Zika and SARS, which history has shown can spread widely, have zero diagnostic candidates in late-stage clinical trials.

But the challenges aren’t limited to the dearth of medical products in clinical development. There’s also very little funding for their research and development. To illustrate: R&D funding for COVID-19 from 2020 to 2022 was over $14 billion, while the combined R&D funding for the nine priority pathogens listed by WHO totaled just $1.7 billion from 2019 to 2022.

Despite that, the 100 Days Mission and its proponents are setting ambitious objectives, such as having at least two midstage-ready treatment candidates for each of WHO’s priority pathogens, while ensuring there is equitable access to these medical products if and when they become available.

Read: The pipeline for pandemic products is bare. Here's why it matters

All or nothing

Tedros told member states this week that he is “gravely concerned” that they may not conclude negotiations on the pandemic treaty and amendments to the International Health Regulations at WHA by May. There’s very little time for the negotiations, and yet several outstanding issues remain unresolved.

Roland Driece, co-chair of the Intergovernmental Negotiating Body on the pandemic treaty, said there are two main challenges they are facing: the time crunch and “slipping urgency.”

“When we started this work two years back, the whole world spoke about COVID, about the pandemic and [that] we should do a better job in cooperating. But we are two years down the line, and COVID is in some countries a memory from the past almost,” he said.

Background reading: What is the pandemic treaty and what would it do?

Funding their way

Back in 2022, we wrote a piece looking at a new financial intermediary fund hosted by the World Bank — which later on was renamed the Pandemic Fund — and how it could work. Since then, the fund has made its first grant allocations and raised $2 billion. However, there remain concerns about its governance and operations. In its second year of operations, I asked Priya Basu, who leads its secretariat, how they’re planning to address those.

Read: Where does the Pandemic Fund stand in its second year? (Pro)

+ A Devex Pro membership gives you access to all our expert analysis, insider insights, career resources, exclusive events, and more. Not a Pro member yet? Start your 15-day free trial period.

Early to (inocu)late

The global health community celebrated a historic moment Monday that was decades in the making. Cameroon became the first country to launch the world’s first approved malaria vaccine into its routine immunization program. This means children visiting health facilities in the central African nation are the first to receive this ground-breaking vaccine outside of pilot programs and clinical trials.

“We are not just witnessing, but actively participating, in a transformative chapter in Africa public health history,” said Dr. Mohammed Abdulaziz, head of disease control and prevention at the Africa Centres for Disease Control and Prevention.

There are now two approved malaria vaccines and they have been shown to reduce clinical malaria cases by more than half in the year after vaccination. Overall, 20 African countries plan to introduce these vaccines into their routine immunization programs this year.

But experts also warn that these vaccines are not a silver bullet and can’t replace other interventions, primarily bed nets.

“We won't see progress that we're hoping to get through the vaccine if we're actually trading off the vaccine for other interventions,” says Kate O’Brien, director of the Department of Immunization, Vaccines and Biologicals at WHO.

Read: Cameroon launches historic malaria vaccine rollout

Filmed in Davos

If you were in Davos last week, you may have caught my colleague Vince Chadwick pressing aid officials and politicians on artificial intelligence and multilateral bank reforms. Or just trying to stay warm.

But here’s my favorite moment from his time in Davos this year — getting Gates Foundation’s Trevor Mundel to demonstrate some of the exciting global health innovations they’re supporting, including next-generation diagnostics and a tongue swab to diagnose tuberculosis. How cool is that?

Watch here.

What we’re reading

The U.K. is in the middle of a measles emergency, with the majority of cases being in children younger than 10. [Reuters]

A promising cancer vaccine is struggling to enter late-stage trials due to funding constraints. [ABC News]

British American Tobacco lobbied the Kenyan government to reduce the size of health warnings on its nicotine pouch. [The Guardian]

Sara Jerving contributed to this edition of Devex CheckUp.