A new public-private coalition that aims to derail epidemics by speeding development of vaccines has now hung its shingle with the backing of the Wellcome Trust and the Bill & Melinda Gates Foundation.
The Coalition for Epidemic Preparedness Innovations (CEPI), which launched its website today, grew out of the widespread conviction that vaccines languishing in R&D could have prevented the recent Ebola epidemic in West Africa that killed more than 11,000 people. “CEPI is something the world desperately needs, and we’ve been struggling to create it for several years,” says John-Arne Røttingen, who headed the steering committee of an Ebola vaccine trial in Guinea that yielded astonishingly positive results.
Røttingen is interim CEO of CEPI, which for now will be headquartered at the Norwegian Institute of Public Health in Oslo, where he headed the infectious disease division until taking the new job. Norway and India are also partners in CEPI, which has yet to raise money but has a preliminary agenda. “CEPI can’t fill all the gaps—that would be too ambitious,” Røttingen says. But he says the coalition aims to fund early stage human trials of vaccines that have little commercial market but could have a major impact on global health. CEPI plans to work closely with the World Health Organization (WHO) and help vaccine developers navigate the complicated regulatory pathways that lead to marketed products. CEPI also wants to purchase small stockpiles of these vaccines so they’re on hand to attack emerging diseases.
The seed of the CEPI idea was planted in a perspective that ran in the 23 July 2015 issue of The New England Journal of Medicine, “Establishing a Global Vaccine-Development Fund.” Co-authored by Wellcome Trust Director Jeremy Farrar, the article called for $2 billion in startup money to launch the fund. Last January the idea was discussed during the World Economic Forum in Davos, Switzerland. “Once you get from the vision to the details, difficult conversations come up,” says Farrar, who plans to present a CEPI funding proposal to the Wellcome board in November.
CEPI hopes to raise enough money in its early years to spend “a couple of hundred million dollars” annually, Røttingen says. In addition to considering proposals from independent investigators, CEPI will issue requests for proposals that target specific opportunities.
Its initial focus on two or three vaccines not yet identified is meant “to demonstrate this model can work,” Røttingen says. They will be chosen from a list of 11 that WHO put together in May as part of a report called An R&D Blueprint for Action to Prevent Epidemics. Diseases on the list include Middle East respiratory syndrome and the related severe acute respiratory syndrome, Crimean-Congo hemorrhagic fever, Nipah virus, and chikungunya. Farrar notes that the Ebola vaccine, which still has not come to market, remains a priority. “We are tantalizing close to an Ebola vaccine, and that’s part of the ongoing frustration: Can the world finish the job?” he asks.
CEPI’s interim board includes leading public health officials, scientists, and vaccine industry executives. Farrar and Røttingen both stress that they’re extremely pleased that the coalition includes India—a government that has not been a major contributor to global health efforts but has significant vaccine resources—and note that CEPI is seeking additional partners. It plans to issue its first requests for proposals in November.