Looking for Exit C-19, Foundations Back Quest for Coronavirus Vaccine and Therapeutics

The coronavirus pandemic is deep into its third month, and experts say the number of cases globally—currently at more than 447,000—will continue to rise exponentially during the coming months. In time, the populations of some countries may develop herd immunity or the spread of the disease may slow, at least in the northern hemisphere, as we enter the warmer months. But experts say COVID-19 is too widespread and too contagious simply to fade out on its own. Science will have to deliver solutions in the form of vaccines, drugs, immunotherapies, and possibly other treatments.

Many funders responded to the pandemic with admirable swiftness to ensure the safety of vulnerable populations and communities. Eyes are also on Washington, D.C., as Congress debates a broad national economic response. But philanthropy has got to listen to the scientists and rethink its role and funding in vaccines and therapeutics.

Needed: An Exit Strategy

“One of the dangers at the moment is that nearly everyone in government and business is thinking about immediate needs, such as how to keep the country and its health systems running, or how to keep businesses running, as they must,” said Mark Henderson, director of communications for Wellcome Trust, the U.K.-based global health foundation. “But the risk is not thinking about an exit strategy right now. We don't have a treatment and we don't have a vaccine, and we are going to need those things. Vaccines are that exit strategy.”

One of the experts whose opinion should be taken seriously is David D. Ho, MD, founding scientific director and CEO of the Aaron Diamond AIDS Research Center. He has said in recent interviews that it may take 18 to 24 months for researchers to develop and test new vaccines and treatments. “I think we have the real possibility that COVID-19 may become a fact of life until science comes through, as it has done for past epidemics,” Ho has said.

One of the few examples of such needed long-term thinking about vaccines came three years ago from Wellcome and the Bill & Melinda Gates Foundation, along with the World Economic Forum and the governments of Norway and India. In January 2017, those partners co-founded an organization called the Coalition for Epidemic Preparedness Innovation (CEPI) to finance and coordinate the development of vaccines for epidemic threats.

The impetus for CEPI was the Ebola outbreak of 2013-2016, which revealed the global community’s lack of preparation for pandemics. CEPI started out funding work on vaccines for six diseases, including MERS—also a coronavirus. (See our past coverage of CEPI.)

CEPI estimates another $2 billion will be needed to develop a vaccine, with another $1.5 billion to find effective drugs to treat people with COVID-19. (Additional billions will be needed to address other health aspects related to the pandemic.) According to a CEPI spokesperson, to date, the governments of Denmark, Finland, Germany, Norway and the U.K. have committed over $185 million to its COVID-19 vaccine development efforts. It's calling upon other countries, private-sector partners and philanthropic givers around the world to invest in the global effort to develop a vaccine.

New Medicines Are Needed, Too

While a vaccine is the best chance to eliminate the COVID-19 threat, we’ll also need medicines to cure or treat the sick—currently, there are no approved antivirals or immunotherapies for the disease. This month, the Gates Foundation, Wellcome and Mastercard announced the commitment of up to $125 million between them to establish the COVID-19 Therapeutics Accelerator. Gates and Wellcome are each contributing up to $50 million, and Mastercard Impact Fund has committed up to $25 million to start the accelerator. They will work with the World Health Organization, government and private sector funders, and global regulatory and policy-setting institutions to move drug candidates as quickly as possible through the pipeline. The program will first focus on finding new and repurposed drugs and biologics to treat COVID-19 patients, but will eventually widen its focus to other viral pathogens.

We’re also seeing—and presumably will continue to see—efforts throughout the scientific and philanthropic community to develop vaccines and treatments. For example, the Infectious Disease Research Institute, a nonprofit, said it has received funding to begin clinical trials for immunotherapy to combat moderate to severe cases of COVID-19.

The common factor here is that these efforts will take time as well as money. That means more philanthropic organizations must consider shifting some of their focus and resources to the kind of longer-term thinking that will not only lead to medical solutions to the coronavirus pandemic, but will support partnerships and frameworks for responding to the inevitable future pandemics and other serious health threats. It can’t make sense to wait for an emergency before setting up systems for vaccine development and other global health security measures. As the current global situation demonstrates, any significant delay in the development of vaccines or therapies for an emergent epidemic can extract an intolerable economic and human cost.