As part of the Imagine2030 campaign we want to show that innovation is not just something for the future. Biomedical advances being made right now will shape how we fight diseases of poverty in the future, and are delivering changes every day. We’re also not just focused on new medicines or tools, but also on innovative ideas about how to shape the global fight against infectious diseases. To get a an understanding of the latest international initiative set up to combat disease, we spoke with the interim CEO of the Coalition for Epidemic Preparedness Innovations (CEPI), John-Arne Røttingen.
Can you tell us a little bit about why CEPI was set up, and what makes it unique?
Repeated outbreaks, most recently Ebola and Zika, have forged a global consensus that current models for developing vaccines for sporadic epidemic are not working, and that a new system is urgently needed. Four expert reports on the Ebola outbreak response reached the same conclusion: a new system is needed to drive product innovation to prevent and contain future infectious disease epidemics.
CEPI will provide that new system. It will tackle the barriers to epidemic vaccine development, advancing safe, effective and affordable vaccines that can help to contain outbreaks at the earliest possible stage. It will give us the joint global insurance policy we need.
CEPI is very focused on not duplicating ongoing research or other global health efforts. We will stimulate, finance and coordinate vaccine development against priority threats through phase 2 trials, particularly when this development is unlikely to occur through market incentives alone.
CEPI will engage with a range of stakeholders that operate outside of CEPI’s financing scope, including the discovery phase and the manufacturing, procurement and stockpiling side. CEPI is thereby filling a gap between the normative functions of the WHO and the delivery mandate of GAVI. CEPI is founded on the idea of the partners bringing their capabilities to the table, in order to be able to build on existing capabilities to get the best possible preparedness against epidemic threats.
There are lots of organisations working in this field. Who is CEPI partnering with, and who would you like to bring into the coalition?
CEPI’s mission requires close partnerships with a wide range of stakeholders. We have signed a memorandum of understanding with the World Health Organization (WHO), and we have established a partners forum and a Joint Coordination Group, in order to engage with our partners. CEPI’s partners include governments, industry partners, upstream R&D funders, other vaccine development funders, academic institutions and civil society organisations among others. Coordination also has to be tight with agencies and organisations that may take responsibility for stockpiling and deploying eventual vaccines during an emergency response.
What role do you see for research and innovation in the efforts to achieve the SDGs?
Research and innovation have to be key elements in order to make the best possible informed decisions on how to achieve the SDGs. Policies must be founded on knowledge, not on beliefs. Research contributing to meeting the SDGs will span many fields from scientific contributions to developing new insights and technologies to social science contributes that help us understand socioeconomic barriers and facilitators for implementation.
CEPI has picked a number of diseases that it wishes to focus on from the beginning. How and why were these particular diseases selected?
CEPI has chosen to start developing vaccines against MERS, Nipah virus and Lassa fever. We took as starting point the WHO’s R&D Blueprint for Action to Prevent Epidemics. This contains a list of priority pathogens against which the development of medical countermeasures are urgently needed. CEPI’s Scientific Advisory Committee chose these three diseases based on a set of criteria including the risk of an outbreak occurring, transmissibility of the pathogen, burden of disease, feasibility of vaccine development and the current pipeline candidates.
Since there always will be an unknown or a not selected pathogen that we will not be able to predict, CEPI will also fund development of rapid and adaptable vaccine technology platforms, where antigens from a new pathogen can substitute or be added to an existing vaccine.
Do you expect that you will expand the focus of the organisation as it matures?
In the first years CEPI will focus on vaccine development according to our business plan. We are also exploring how we in partnership with other organisations can foster development of diagnostics of relevance to epidemics, and at a later stage we will consider moving on to also fund development of diagnostics and therapeutics.
Will CEPI be involved in advocating for global health research on the international agenda, given its relative lack of prominence in high-level political debates?
CEPI will advocate for global health research. We will of course focus on our mission to increase preparedness against epidemic threats, but also demonstrate that there are similar needs for development of other global health relevant technologies where market incentives are not sufficient.
What do you hope the achievements of CEPI will be when we look back in ten years?
In ten years, I hope we can look back at having advanced 5-10 vaccines to the stage where there is proof of principle (up to and including phase II trials), ready for large scale efficacy trials or emergency use in the event of an epidemic, and that we for some of these also have efficacy data sufficient for some level of regulatory approval. In addition, I hope CEPI will advance 2-3 new vaccine technology platforms that will enable quick vaccine development in case of the emergence of new viruses with epidemic potential.
If you had one hope or wish for 2030, what would it be?
That we as a connected world will be able to advance substantially on all the SDGs. Avoiding deaths and ill health from preventable infectious diseases is one important step.
Learn more about CEPI here.