CEPI: A New Approach to Epidemic Preparedness
When Ebola virus disease swept through Guinea, Liberia and Sierra Leone in 2014, the world saw firsthand the shortcomings of the global response. Ebola, a severe and often fatal illness causing hemorrhagic fever, killed more than half of those who contracted the disease as response teams worked around the clock trying to contain its spread. But these healthcare workers were forced to work without one of medicine’s best preventative tools: a vaccine. By the time an Ebola vaccine candidate was ready, the epidemic was waning and more than 10,000 people had died.
Nearly three years to the day after the first Ebola cases were reported out of West Africa, a new initiative was launched to drive vaccine innovation for priority public health threats. The Coalition for Epidemic Preparedness Innovations (CEPI) was launched in January 2017 at the World Economic Forum with the ambitious goal of accelerating the development of vaccines for emerging infectious diseases, particularly for diseases that lack market incentives. CEPI aims to serve as an “insurance policy” against these diseases, outsmarting epidemics by accelerating the development of safe and affordable vaccines.
The 2014 Ebola outbreak was a stark reminder that the current vaccine development system rarely invests in research and development for diseases with limited market incentive, such as Ebola. When it comes to diseases of epidemic potential, vaccine developers are often faced with a limited potential return on investment, since outbreaks are unpredictable and the price of a vaccine for an infectious disease rarely will recoup the high research and development costs. When the Ebola outbreak began, vaccine candidates were unavailable because they had stalled in the pipeline. CEPI aims to overcome these barriers through its partnerships of public, private, philanthropic and civil organizations to accelerate vaccine development for priority diseases.
Founded by the Governments of Norway and India; the Bill and Melinda Gates Foundation; the Wellcome Trust and the World Economic Forum, CEPI has spent the last six months in its “start-up phase,” securing additional funding and identifying its first target diseases. Initial investments by its founders totaling $540 million and planned co-funding from the European Coalition of €250 million have put the Coalition well on its way toward mobilizing the full $1 billion budget it has allocated for its first five years of activities. After evaluating diseases from the World Health Oroganizations’s list of priority pathogens for public health impact, risk of outbreak and feasibility of vaccine development, CEPI’s Scientific Advisory Committee chose to target MERS, Lassa and Nipah for its first call for proposals.
CEPI has since caught the eye of leaders around the world. As dignitaries gathered at key meetings throughout May, infectious disease control – and epidemic preparedness in particular – was a consistent topic of discussion. At the first-ever G20 Health Ministers Meeting, German Chancellor Angela Merkel underscored the importance of epidemic preparedness during her address, with a strong call for additional countries to pledge support for CEPI.
“Good cooperation between industrialized and developing countries is also vital for the research and development of new means and methods of prevention, diagnosis and treatment of diseases,” said Chancellor Merkel. “The industrialized countries have a special responsibility for medical advancement…I encourage all those considering whether to participate [in CEPI] to get involved. Every contribution helps.”
Later in the month, leaders at both the 70th World Health Assembly and the G7 Heads of State Summit also discussed epidemic preparedness, culminating in assurances that leaders will remain committed to reducing outbreak response delays and to strengthening coordinated responses to public health emergencies.
It is only a matter of time until the next infectious disease epidemic strikes. If we are to avoid the devastating loss of life by the next Ebola or the next Zika, we must invest in the technical platforms necessary to ensure there are vaccine candidates and small stockpiles ready when the next outbreak begins. But such lofty goals, as with global health emergencies, demand collaboration. While CEPI has already made initial progress towards its mission to “stop future epidemics by developing new vaccines for a safer world” in just the few months since its launch, new partners will need to be brought into the fold – and new funding committed – for its full promise to be realized.