Immediately after a deadly disease begins to spread, governments can help by allocating many resources to containing and treating the illness but with the crucial exception of the one thing actually able to end the epidemic: a vaccine. Outbreaks are difficult to predict, and vaccines take time to produce. As a result, such calamities entail great fear and uncertainty.
A new organization formed this year on August 31 to tackle this very problem by promoting the development of vaccines before they are needed: the Coalition for Epidemic Preparedness Innovations (CEPI). Noteworthy supporters are already helping to fund the coalition, including the Bill and Melinda Gates Foundation, the World Economic Forum, and the governments of India and Norway. Its goal is ambitious and noble: to promote the preemptive development of life-saving vaccines.
The CEPI’s general approach is to cultivate a productive relationship between public and private entities. At the moment, private organizations do not, by themselves, invest adequate resources to diseases that are not present dangers. The reasons are straightforward enough. As Jon Cohen describes in Science, vaccine-development is a slow process that, outside of a crisis-situation, usually has little commercial potential and therefore is unattractive to investors. The CEPI therefore commits itself to promoting relationships between public and private entities that will encourage preemptive vaccine-related research. It aims not to develop vaccines directly but rather to promote three things: the allocation of from governments and private donors to institutions able to conduct the research, to communicate scientific and technological findings efficiently, an to ensure that any progress that is made toward potentially vital resources is accessible to all who might benefit from them. They proclaim on their website:
Equitable access will be a founding principle of CEPI, so that vaccines developed with its support are available to all who need them – price should not be a barrier – and they are available to populations with the most need.
The organization does not aim to establish a fully stocked repository of every conceivable disease; rather, it has developed a more strategic approach. There are many candidates for what the next major disease-outbreak will be, and predicting it is very tricky. As a result, the organization plans to focus initially on identifying two or three vaccines and then to work its way up to eventually tackling the world’s top 20 disease-threats.
But preparing the vaccines is only part of how the CEPI plans to curb response-times for viral outbreaks. It also seeks to cut down bureaucratic inefficiency in times of crisis. In preparing the vaccinations, the organization also plans to have more expensive human testing and complex bureaucratic processes in different countries planned, outlined, and ready to go in the event of an out break. With a concrete plan already delineated before the disease strikes, appropriate procedures and resources do not have to be negotiated once lives are already on the line.
Engaging with outbreaks as the CEPI proposes stands to be cost-effective too. John-Arne Rottingen, Harvard Professor of Global Health and Population and CEPI’s interim boss, describes the proposed measures as a form of health insurance that only needs to be paid for a few years. Jeremy Farrar, who is the director of the Wellcome Trust and is working to support the CEPI, estimates that the top 20 disease-threats could be tackled in about a decade for a total cost between one and two billion dollars – and that’s for the whole world. In contrast, disease epidemics currently cost the world about $60 billion per year, by one estimate. If CEPI’s approach is sound, then acting on it will yield tremendous savings in money and in suffering.