COVID-19, Vaccine Development, and Global Health Lessons from Ebola

leading a startup team whether you're delivering a sugar rush stocking coffee or getting a regular delivery of snacks Office Depot has solutions that fit every startup culture from getting those first business cards in stationary to ordering fleece pullovers with your new logo to learn how Office Depot and the California Technology Council have partnered to bring you savings on all of these startup Essentials and more go to californ technology.org member benefits [Music] I'm Daniel leine and this is the bio report [Music] the covid-19 pandemic is threatening to stress Health Care Systems throughout the world and it's making the development of a vaccine an important part of a strategy to arrest the virus though clinical trials for a vaccine are underway creating one alone will not be enough if those efforts are successful there'll be challenges ahead with manufacturing Distributing and providing Equitable access throughout the world we spoke to Aurelia gron managing director for vaccines and sustainability for the Global Alliance for vaccines and immunizations about the covid-19 outbreak how it may be playing out in different parts of the world and what was learned from gab's involvement in previous efforts to develop an Ebola vaccine [Music] aelia thanks for joining us thank you for having me join you today we're gon to talk about Gabby efforts to develop a a covid-19 vaccine and how the pandemic is impacting different parts of the world as someone who's involved in global health and has been involved in responding to past outbreaks perhaps you can begin with some perspective on the current pandemic how does it compare to what we've seen in the past so indeed the current uh covid-19 pandemic is something that is quite unprecedented um from a a global Health uh and an economic uh perspective we um from a gabby perspective uh have been working for the last 20 years in developing countries making sure that we are able to provide routine immunization but also helping to respond to outbreaks of other diseases like yellow fever measles uh menitis uh most recently Ebola but uh the current covid uh pandemic is of quite of different scale what has it told us so far about our preparedness to contend with such an outbreak our preparedness to contend with this outbreak um has been shown to fall quite short um of uh what would be required uh to make sure that the disease is effectively contained um and therefore uh uh having the least amount of mortality um as well as um the the KnockOn impacts uh to to the economy um in the past there have been realizations during various outbreaks that we need to focus more on global Health security um but it's not in the middle of an outbreak that one starts to prepare it needs to be done um constantly and particularly outside of an outbreak to have health systems being strengthened have countries have good plans in place and test those times in places so we're certainly in catch-up mode here if listeners think of Gaby I suspect they think of it as this public private Health Organization that focuses on getting immunizations to poor Nations what does Gabby do what's it its role in a pandemic like this so indeed um gavi has been in existence for about uh 20 years and um we have focused uh our work by pooling donor resources to help countries that have um the the weakest Health Systems be able to introduce life saving vaccines and we've done this very much in collaboration with the countries um in terms of identifying what their vaccine needs are and then being able to support um their introduction um o of the different vaccines as we like the rest of the world and Gabi have been looking at um the incredible progression of the pandemic we've taken um a look at to see how can we leverage the track record that we have in rolling out vaccines in supporting vaccine development and apply it to this situation um for co9 so first and foremost we've looked at um the countries that we support um covid-19 cases are starting to emerge um more and more in the developing countries we likely know that um the disease is there it's maybe just not being identified uh quite as quickly as it has been in in other countries and so we've helped countries look at how they can prioritize um some of the the support and funding they get from Gabby to help uh address some of their um preparedness but we're also going to be very active in the vaccine uh development so looking at using some of our Innovative financing tools for example to see how we can rapidly um have funding available to the development of vaccine candidates it's important that as many vaccines as possible can be uh developed at the moment so that we have the best selection towards a successful vaccine that will be uh safe and efficacious and we're also um very heavily involved in terms of how do we think about making sure that when a vaccine does come to light that's going to help uh prevent uh covid-19 how do we think about making sure that the vaccine is available to the who need it and not necessarily to those who can pay the highest price for it um and how do we make sure that there's enough vaccines made for all of those who need it um and not just um a small a small subset of um people who who who um have uh taken specific rights um towards uh the vaccines and then further down the line from a gabby perspective um we um are supporting the vaccination of about 0% of the world's Birth Cohort so we're thinking how we can use all of the the the systems that we have in place for de delivering other vaccines today to help deliver covid vaccines and make sure that we have very rapid deployment to to the vaccine when it's made available the focus today has been to slow the spread of the virus us we've seen the use of a number of practices intended to do that how critical will the development of a vaccine be to ultimately combating it it's very difficult right now for us to assess the trajectory of um uh of the outbreak um from the gab's perspective um essentially we are doing a Race Against Time um the sooner that um we are uh able collectively to identify a good uh vaccine produce it um scale it up uh to produce large amounts of Doses and start to deploy it with better chance we will have to be able to potentially have um a role in containing um the the outbreak and then certainly being able to have a vaccine to prevent future outbreaks um uh as is likely to to to be the case the current pandemic as you mentioned is hitting developed countries hardest right now but it is in Africa too how well prepared is Africa to respond to the virus so as you as I was mentioning before indeed we're starting to see cases um uh uh in in Africa at the moment I think a worry is that um perhaps we're only picking up a small number of cases is because countries may have weaker capacity to um to detect um and so the numbers of cases that we're seeing are actually far below what is actually um happening in reality um the the the countries that we're um that Gabby is supporting are the weakest countries from the perspective their Health Systems um and so um they the risk that their health systems become overwhelmed um is quite high and here I think this is where the urgency is in trying to get those Health Systems as prepared as they can be um and then making sure that we can provide support to the countries um as they deal with increased cases is there any modeling to suggest how the pandemic May progress there or how the response might vary I think there have been a little bit of modeling um uh done through uh uh various groups um and I modeling a little bit the trajectory that's happened um in China or um in Italy um as in many cases um it really relies heavily on how effective measures like social distancing are done and uh whether there's an ability to have testing uh done so it's hard to predict that case at this stage um but I think we need to be able to uh be prepared to react to um a high amount of cases is there any particular challenge to developing a vaccine for covid-19 or Corona virus more broadly from the perspective of the development of the covid-19 vaccine um we have um some helpful uh experience uh that we've learned through uh previous pandemics um SARS uh uh H1N1 um and the like we also um I think need to take an approach in terms of utilizing a broad variety of uh different Technologies and different approaches and I think what will be important at this stage is using some of the more traditional Technologies um that uh are proven uh alongside some of more Innovative ones uh to be able to see where we're going to have um the the the highest results and of course each comes with their pros and cons in terms of having well understood technology but perhaps with limitations in how quickly they can scale up and Innovative Technologies that are less well understood and characterized but uh potentially an ability to uh be scaled up much more much more rapidly so all of these factors uh need to be weighed in well well given that what thought should be given to what it would take to manufacture a specific vaccine approach so a couple of factors for thinking about manufacturing one is uh first and foremost we're going to need um a large volume of vaccines I think that's a fairly uh safe assumption and so we need to think about um what are uh the the the numbers of Manufacturers the types of technologies that will enable us uh to do so secondly um an important factor that I uh alluded to before is this question of access how do we make sure that the vaccines that are produced which initially will likely be in short supply versus the very high demand uh that will be required are allocated in a manner that is um in in line with the need from a public health perspective and not with other factors like whoever can pay um the highest price for them or whichever country it's in who has the ability to lock its borders and not allow for vaccines to be um exported uh so the manufacturing perspective needs to include scale a consideration of geography and a consideration of um having the the the right allocation system to have the vaccine go where it is most needed vaccine is already in clinical studies in the United States in China what's a realistic time frame for getting one to the public very difficult to say these are still very early days with um the first vaccines entering uh phase one clinical trials um I I think an estimate um that's uh been widely quoted has been 18 months or so uh I think we'll know a lot more in in a month or two one issue you touched on earlier which is a concern for gab is Equitable access once a vaccine is developed how would you expect it to be distributed and made available so th this is where I think there's a great need for uh political leadership um across uh countries and an agreement between countries to abide by a principle of um Equitable access and this is where the leadership of the the G7 and the G20 and and other um uh countries that are um uh very heavily implicated um needs to needs to come through so that among all of the different um countries among the vaccine developers and the manufacturers there can be an agreement and a sign on to a principle of um allocation based on on need and so I think it's going to take an effort of tremendous political will um and of trust and of transparency uh perhaps one unlike any seen before so that we can make sure that we address this um uh as a global Community um and not as uh National or or or or private entities because ultimately given the scale of the pandemic um no no one single country is going to be able to protect um itself and it will need a global level cooperation and is the challenge Beyond a financial one are there issues in poor countries of Distributing vaccines because of supply chain because of because of Health Systems because of language barriers or trust absolutely and I I think as um we can anticipate the the the already very weak Health Care Systems are going to be um tested uh to their limits and perhaps um Beyond um so first and foremost um the availability of healthcare workers is going to to be uh very very uh strongly put at test and and in certain areas there is already a sheer lack of um uh health care workers and then even if we do have the vaccine um you alluded to the the question of you know whether um populations will respond uh effectively to to the provision of the vaccine is there enough Trust of the government and of the government systems are they going to be to to have good acceptability of uh a vaccine by uh local populations um is there going to be the right sort of commu community engagement be it through uh language through the provision of materials um that uh are easy to engage with with for example in populations with low levels of literacy so the the community engagement perspective is very critical um to uh uh to consider because even with the tool um if it's not well accepted then it won't it won't have any Effectiveness I know you were involved somewhat in the development of an Ebola vaccine that was a a very different scale of pan a very different scale of outbreak but was anything learned from that experience that might be applicable here the the experience that that we had uh for Ebola has very interesting analogies and in a way has taught us uh quite a lot um firstly I think the ability for the global Community to react and be coordinated very quickly is absolutely critical um secondly um having a good dialogue between all of the different parts of um the value chain if you like of a of a vaccine development and roll out is critical from the the research and development uh perspective to um those who will engage in in manufacturing to those who are doing the clinical trials um to The Regulators um and then onwards to uh funders and those who who roll out the vaccine and what we learned is really having that dialogue and those um actors together around the table um being able to work out issues and and and give their considerations um was very helpful it was also I think um an important um learning to be able to understand some of these questions around um uh uh access how do we think about what volumes are being produced who are they going to be rolled out if we are in a situation where we have supply shortages so indeed The Bu sitation although um was on on a smaller scale given the numbers of of uh countries affected um uh has I think charted a course for a level of um coordination uh that is proving very very critical uh right now within the covid-19 outbreak one problem to our approach to developing a vaccine is that even if successful it would provide us for protection against that pandemic not the next pandemic I I think here flu and the threat a new strain could pose what's the potential for developing a universal Corona virus vaccine and a universal flu vaccine is that ultimately where we need to put efforts once we're through the current crisis I think we're still in the phases where we're learning about the virus and um uh It's ability uh to mutate so um I think these are questions that are on the scientist's minds and and rightly so um the the the experience with the flu as you point out is that um every year um we need to think about what circulating strains are likely to happen and try to Target a vaccine um uh against that um the the um uh the experience with developing a universal flu vaccine has been very difficult it's been uh a long and drawn out effort over over many many years um there are promising leads um uh at the moment but still um not within sort of IM immediate uh reach uh so as in when we are able to develop a first generation uh uh vaccine against covid-19 uh for this strain I think immediately the question will pose itself um but uh first we need to understand a little bit more uh on about the virus Orelia grun managing director for vaccines and sustainability for the Global Alliance for vaccines and immunizations arelia thanks so much for your time today thank you Daniel thanks for listening the bio report is a production of the LaVine Media Group to automatically download of this podcast each week subscribe to our RSS feed or through iTunes or other Podcast manager to join our mailing list go to LaVine mediagroup tocom we'd love to hear from you if you want to drop us a line or are interested in sponsoring this podcast send email to Danny laven mediagroup tocom special thanks to Jonah LaVine who composed our theme music and the Jon LaVine Collective which performs it e [Music]