Are we globally prepared for the next pandemic?

Echoes of the global health challenges we faced during the COVID-19 pandemic still linger as new variants emerge and COVID continues to make headlines. A question that continues to sit in the back of many people’s minds is what happens if there is another outbreak or global pandemic? Are we preparing and how ready are we for the next one? Vaccitech’s Chief Business Officer, Graham Griffiths, discusses key learnings in drug and vaccine development, the challenges of preparing for the unknown, and how strategic collaboration is imperative to achieve faster and more equitable outcomes – if and when another pandemic strikes.

Pandemic preparedness is a huge field of work with infrastructure across academia, industry, and health organisations, and vaccines are an essential part of the arsenal of protection that will help ensure better outcomes – saving lives and saving money. But other larger picture factors must be considered when thinking about pandemic preparation, including virus surveillance, reducing transmission, and developing treatments that can be administered quickly and equitably. Before COVID-19, the experience in the Ebola outbreak in 2015 was that many people died because the vaccine was not available sooner.¹ In response, much effort has gone into organising and strategising vaccine development and distribution to ensure expedited availability and equitable distribution for the future. Vaccitech collaborates on the vaccine aspects of its product pipeline with organisations like Oxford University’s Pandemic Sciences Institute and the Coalition for Epidemic Preparedness Innovations (CEPI), both of which take an integrated approach to optimise all areas of pandemic preparation and response.   

The relationship between vaccine manufacturing process and pandemic protection

Much of pandemic preparedness relies also on the current infrastructure surrounding development of vaccine manufacturing processes. This was acutely highlighted by the COVID-19 pandemic.

The pandemic presented many challenges for the pharmaceutical industry. Amongst these, the timeline for the establishment of manufacturing processes, scale up, development of methods to ensure vaccine quality, manufacturing, and distribution. Alongside these, the stability and storage needed for ‘cold chain’ treatments were the most prevalent gaps identified.²

These gaps drove an unprecedented need for academic, government and private institutions to work together to fast track the development of vaccines to treat the virus. The pandemic brought the critical importance of research and innovation to the forefront to drive the changes needed to ensure the formulation and distribution of safe and viable vaccines to the right locations across the world.

There are research efforts already underway offering different approaches to the creation and acceleration of vaccine development. Viral vector facilities can offer a faster, more scalable approach to manufacturing vaccine therapies,³ while extensive research in disease-causing pathogens, antigens and novel T-cell immunotherapies is already proving extremely innovative for the fast and safe treatment of infectious diseases.⁴ The pandemic highlighted the need to significantly shorten the overall vaccine development process, where mRNA vaccine technology was utilised for the first time in commercially available immunisations. This alone has demonstrated the potential impact that research and innovation can have on the future of drug development to overcome the existing challenges associated with conventional vaccines.

Faster vaccine development without risk aversion

Because vaccines play an important role in preventing illness, producing and distributing vaccines quickly is critical – especially when considering pandemic risks. The need to increase speed must always be paired with minimising risk. Some pandemic threats are already on our radar, but the next outbreak could alternatively be a “Disease X”, which represents the knowledge that a serious international epidemic could be caused by a hypothetical, currently unknown pathogen.³ Thus, a strategy is needed that addresses all scenarios. For instance, with a Disease X strategy, the goal would be to have a range of validated platforms to choose from that can be rapidly applied to the disease that arises, based upon research into different types of pathogen. Alternatively, for the pathogens that are known priority threats, we can be one step ahead of a possible pandemic by manufacturing and developing specific vaccines that target, for example, either individual virus strains or whole families of viruses, regardless of what strain the virus is. Both approaches are being pursued by dedicated organisations, biopharmaceutical industry, and academia.

Before COVID-19, Vaccitech had been working with a platform known as ChAdOx in various indications. ChAdOx is a viral-vector platform invented by the University of Oxford and rights were in-licensed when Vaccitech spun out of Oxford University in 2016. When the pandemic hit, Oxford University and Vaccitech were able to rapidly design and initiate development of a vaccine using that technology quickly, which kicked off the development of a SARS-CoV2 vaccine between AstraZeneca and the University. That collaboration put more than three billion doses on the market,⁴ saving over six million lives by the end of 2021 and preventing up to 120 million hospitalisations.⁶

Back to business as usual?

The accelerated vaccine development process against COVID-19 set a precedent for speed to approval, driven by the global nature and economic implications of the virus.¹ However, since the “all in” mentality when COVID hit, there has been a regression to more typical drug development timelines and siloed approaches. Today, global organisations, as well as pharmaceutical, academic, and industry groups are running into resource challenges, slowing down the vaccine and drug development process.

Addressing the complex challenges of global vaccine development for a pandemic

During the pandemic, numerous countries regretted that they did not have sovereign vaccine manufacturing capability that would have given them direct ability to produce product to vaccinate their citizens. Even though many states had the ability to pay whatever was asked, supply simply could not meet the demand. This resulted in some inequitable distribution and delayed vaccine deployment in some areas, which had tragic outcomes. Having sovereign vaccine capability requires a large investment in building and maintaining infrastructure that will be able to manufacture whatever the needed vaccine products prove to be. Such an investment needs to be sustainable regardless of whether there is a pandemic, but is easily justified when weighed against the potential economic impact of a future pandemic, with the International Monetary Fund having estimated that COVID will have cost the global economy $12.5 trillion by the end of 2024.⁷ In the future, international collaborations and alliances are critical to develop and make vaccines using validated platforms and reproduce the needed vaccine at designated manufacturing sites around the world.² This should ultimately prove to provide faster, more equitable vaccine distribution and deploy a truly global fight against a pandemic from the beginning.

In the race against a pandemic, collaboration is paramount

COVID-19 reminded the world that emerging pathogens, including viruses, are an ever-present global health risk. The strategy at Vaccitech has been to continue building on the early development of the COVID vaccine and use that knowledge to build a broad pipeline. Vaccitech is leveraging multiple platforms to address an array of infectious diseases, including Middle East Respiratory Syndrome Coronavirus (MERS-CoV), a member of the SARS/CoV-2 family of betacoronaviruses that has previously demonstrated its potential to cause an epidemic with the 2015 South Korea outbreak.

There is no one size fits all approach to future diseases that threaten humanity. Disease-specific approaches where a specific virus or viral strain is predicted, targeted, and identified is still important today. Beyond this, the continued pharmaceutical technology innovation into mRNA, live attenuated vaccines, and viral vectors as well as the advent of different platform approaches that can fast-track vaccine trials is critical to both the discovery, formulation and distribution of effective treatments and the overall success of pandemic preparedness.

To ensure lessons are learned from the past and present, we must come together as an industry to explore different approaches to the safe and effective development of pandemic protection. Pandemics cannot be fought alone. That is why Vaccitech frequently works with partners and collaborators who are invested in driving vaccine candidates forward for MERS and shingles, as well as drugs for Hepatitis B and Human Papillomavirus infections, as well as Prostate and non-small cell lung cancer (NSCLC). To bring solutions forward faster, focusing on collaboration and partnerships is key to global success and human health. 

References

1. A world in which epidemics and pandemics are no longer a threat to humanity. Heading titled ‘The Challenge’. [Internet] CEPI. [cited 2023Sept]. Available from: https://cepi.net/about/whyweexist/
2. D’Amico C, Fontana F, Cheng R, Santos H. Development of Vaccine Formulations; Past, Present and Future. Drug Deliv. Transl. Res. 2021; 11(2):353–72
3. Felicity Thomas. Overcoming Vaccine Development Challenges. [Internet] PharmTech. 2021. [cited 2023Oct].Available from: https://www.pharmtech.com/view/overcoming-vaccine-development-challenges.
4. Vaccitech Technology. [Internet] Available from: https://www.vaccitech.co.uk/technology/
5. Prioritizing Diseases for Research and Development in Emergency Contexts. [Internet] WHO. [cited 2023Sept]. Available from: https://www.who.int/activities/prioritizing-diseases-for-research-and-development-in-emergency-contexts
6. Vaccitech Corporate Presentation. Slide 27. [Internet] Vaccitech. 2023 [cited 2023Sept]. Available from: https://investors.vaccitech.co.uk/static-files/1e45de8d-c9e4-4555-8296-1c7c7e031e86
7. Vaxzevria receives full marketing authorisation in the EU for the prevention of COVID-19 [Internet] AstraZeneca. 2022. [cited 2023Sept]. Available from: https://www.astrazeneca.se/content/astraz/media-centre/press-releases/2022/vaxzevria-receives-full-marketing-authorisation-in-the-eu-for-the-prevention-of-covid-19.htm
8. IMF sees cost of Covid pandemic rising beyond $12.5 trillion estimate [Internet] Thomson Reuters. 2022. [cited 2023Sept]. Available from: https://www.reuters.com/business/imf-sees-cost-covid-pandemic-rising-beyond-125-trillion-estimate-2022-01-20/