Africa is no stranger to the devastation unleashed by outbreaks of infectious disease. The Ebola outbreak that began in 2014 killed over 11,000 people in West Africa and caused an estimated economic loss of $2.2 billion in the three worst-affected countries in 2015 alone. If we are to protect against future tragedy, we need to be better prepared.
One positive development to emerge from the tragedy of the Ebola outbreak was the global cooperation to fast-track a vaccine that has proved effective at protecting against the disease. This scientific success story — achieved in the most challenging of circumstances — proved that when we work together, we can overcome the many hurdles of producing safe, effective vaccines.
But the collaborative effort that resulted in a successful Ebola vaccine, though admirable, did not begin until after the epidemic had spiralled out of control and so came far too late. Had there been a proven vaccine ready at the beginning of the outbreak, many thousands of lives would have been saved.
It is only a matter of time before the next deadly epidemic strikes. In order to prevent another catastrophe on the scale of Ebola, Africa should capitalize on the current momentum to nurture innovation and build its capacity to detect, respond to and contain infectious disease outbreaks.
There are many other infectious diseases that we know have the potential to cause a major epidemic across the African continent, and around the world. Like Ebola, many of the infectious diseases that pose the biggest threat to society could be prevented with vaccines. But those vaccines don’t exist, often because of the limited market potential for such products. As a result, the global R&D community has not consistently translated promising scientific research into proven medical products, ready for use.
It was for this reason that the Coalition for Epidemic Preparedness Innovations (CEPI) was set up. Founded by the governments of India and Norway, plus the Bill & Melinda Gates Foundation, Wellcome and the World Economic Forum, CEPI provides a new way of financing and coordinating the development, manufacture and testing of vaccines against epidemic threats — vaccines that otherwise would not get made.
CEPI seeks to build much closer collaboration between governments, business and civil society. To achieve its goals, it will require sustainable long-term funding. When it launched in Davos earlier this year, it had already raised over $540 million of initial investment from international governments and philanthropy. But it needs more — at least $1 billion — to deliver what it has promised in its first five years.
CEPI’s initial focus is to move new vaccines through development and early human testing, so that we have a range of candidates, tested and ready to be used early when an outbreak strikes. It will also develop new technologies to enable rapid vaccine development against, as yet unknown, deadly pathogens. Crucially, the vaccines that emerge from the CEPI process will be accessible and affordable to those populations in greatest need.
African nations stand to be among the biggest beneficiaries of these vaccines. Tropical climates are home to far denser and more varied populations of pathogens, and with increasing ecological pressure and denser urbanization, these infections have the potential to spread and travel like never before. Three of the four viruses CEPI will target initially for vaccine development — Ebola, Nipah virus, Lassa virus and MERS-CoV — are found in Africa. And of the 25 countries considered most vulnerable to an infectious disease epidemic, 22 are on the African continent.
Partnership from African governments is therefore crucial to CEPI’s success. Clinical trials of CEPI-funded vaccines will need to be conducted in-country, during an outbreak, and CEPI must work to ensure that the necessary capacity to do so is in place in countries that are vulnerable.
In the longer-term, we hope partnership with CEPI will help countries to strengthen their own capacity for vaccine development and outbreak prevention by creating new partnerships and providing access to previously unavailable expertise. In short, engaging with CEPI will give African countries an insurance policy against future epidemics.
As with any insurance policy, all partner countries are being asked to help raise the funding that CEPI needs to fulfil its mission. However, we believe that these should be fair and proportionate to a nation’s financial means.
Epidemic preparedness requires more than just vaccines. They must also be accompanied by new treatments, diagnostic capabilities, better surveillance, greater regulatory capacity and improved public health infrastructure. After all, it was basic public health measures — quarantine, protective clothing and handwashing — that eventually brought the Ebola epidemic under control. CEPI will work towards just such a holistic approach, establishing partnerships and financing where needed.
But vaccines have a powerful role to play, and by getting involved at this stage, African partners can be an integral part of building the resilience to epidemics and pandemics that will protect the populations of the future.