The contrast between this summer and that of 2020 couldn’t be more stark. Three years ago, the world was reeling from the first six months of the COVID-19 pandemic, and while most of us were in lockdown we were beginning to get the first promising clinical trial results for both vaccines and treatments. As these results emerged, so did optimism that science could help forge a path out of the pandemic.
One would think that the recent memory of the huge costs of COVID-19 — millions of lives lost, and the global economy hit with a $15 trillion loss — and the somber reckoning of the risks of a pandemic from which no one was safe would still be top of the political agenda. Yet, with COVID-19 no longer a public health emergency of international concern, there is a risk that we turn from panic to neglect. It is crucial that discussions continue on how we can do everything possible to prevent and respond to future pandemics and address the inequity we saw as vaccines were rolled out across the world. This is the central goal of the “100 Days Mission” established by the Group of Seven leading industrial nations in 2021, which seeks to sustain the political and industry leadership necessary so that in the event of a future pandemic, we can develop and deploy high-quality diagnostics, therapeutics, and vaccines in just 100 days.
The fact that the development of a COVID-19 vaccine was the fastest on record — approved just 326 days after Chinese scientists published the SARS-CoV-2 viral genome in January 2020, gives a sense of just how ambitious this 100-day target is. According to a simulation by the independent predictive health intelligence and data analytics company Airfinity, if effective vaccines are rolled out 100 days after the discovery of a new pathogen, the likelihood of a pandemic as deadly as COVID-19 in the next decade drops from over 27% to around 8%. So, we need to get this right now.
The speed of the COVID-19 response was a triumph of science. The innovation ecosystem we have in place has delivered new medicines and vaccines that have helped drive global health progress over the past 60 years. This system, nurtured over decades, supports continuous research and development and is what gave us the strong foundation to respond to COVID-19. Tests and potential vaccines and treatments were in development within days of the sequence of the novel coronavirus was published online, enabled by the immediate, unhindered access to pathogens and their genetic sequences.
Perhaps one of the most powerful examples of this is the development of mRNA vaccines. Decades of risky investments in mRNA research to treat cancer meant that although never tried before for vaccines, the technology was ready to be put to the test for tackling COVID-19. It is because of this innovation ecosystem that companies such as Moderna and BioNTech were able to make the case for primarily private investments to push forward the science of mRNA technology, burning money for almost two decades, hoping for a breakthrough. It turned out to be a game changer, enabling the vaccination of people against COVID-19 even before its application in treating cancer. This underscores how important continuous innovation is to global health.
While the focus today is on the successes of mRNA vaccines, we know that of the 23 mRNA vaccine candidates, only two made it to the finish line. Furthermore, 60% of COVID-19 treatments were repurposed, meaning companies explored their library of compounds to see which could work against COVID-19. But all these treatments would have taken more time to develop without the decades of investment in how to tackle other infectious diseases.
As we look at how best to prevent and respond to future pandemics, the challenge is to address the inequity we saw in access to vaccines and treatments, while preserving the innovation ecosystem that delivered.
In responding to COVID-19, we collectively witnessed the global health care community falling short of its promise to leave no one behind. We must take this lesson and turn it into a commitment to do better next time.
The innovative pharmaceutical industry has published a practical proposal for a type of social contract that would put equity at the front of our collective response — a proposal that has since been endorsed by the Developing Countries Vaccines Manufacturing Network and the Biotechnology Industry Organization. This includes a commitment to allocate part of the real-time production of vaccines, treatments, and diagnostics to low-income countries. But for this to work, there are foundational prerequisites that support pandemic preparedness, which COVID-19 highlighted.
First, governments in countries where manufacturing facilities are located need to commit to facilitating the export or import of raw materials and finished products. Trade restrictions and tariffs hamper efforts for equitable rollout.
At WHA, experts join Devex to discuss the future of global health
Devex CheckUp @ WHA 76 highlighted lessons from the COVID-19 response, explored what preparations are underway for the next global health threat, and featured innovations in medical oxygen, assistive technology, mental health, and more.
Second, COVID-19 also highlighted that resilient production capacity, geo-diversified manufacturing, sustainable supply chains, and a network of established trusted partners are a key part of preparations for future pandemics. We also need to support voluntary partnerships between companies, including those that involve the transfer of technology and know-how to expand capacity. Successful collaborations are based on a proven track record of quality and safety, as well as experience, expertise, and established relationships.
But this won’t happen overnight. We need to understand future demand, create the right environment that attracts sustainable investments, ensure we have a highly skilled workforce, and strengthen regulatory capacities and supply chains.
The pandemic also demonstrated just how important strong health systems are in a successful pandemic response. The goal of achieving universal health coverage by 2030 is critical in improving global health, but it is also part of our future pandemic preparedness. The right infrastructure, resources, and health care professionals are also essential in order to turn vaccines into vaccinations and rapidly deliver treatments to populations.
Alongside this infrastructure, procurement agencies will be needed to act on behalf of priority populations in low- and middle-income countries, equipped with the necessary resources and ability to forecast demand. Securing advanced purchase agreements at the same time as high-income countries will be key. Procurers need to ensure their allocation mechanisms consider priority populations and countries’ ability to deploy medical countermeasures in response to a pandemic.
Taking the time — in this middle hour between crises — to get the policies and incentives right for responding to future pandemics couldn’t be more important. It is crucial to ensure that we learn the right lessons as we seek to improve equitable access to vaccines and treatments, while preserving the innovation ecosystem that delivered these health care solutions. This must be the guiding principle of our plans.