Live at World Vaccine Congress Asia 2014, the day was opened with a panel discussion on accelerating vaccine deelopment in Asia through Public-Private Partnerships(PPP). Andrew Potter, CEO of PREVENT Canada moderated the discussion with Lanling Zou of NIAID USA, Duane Gubler of SUKW-NUS Graduate Medical School Singapore and Stephen Cook of GSK Belgium. It was a great start to a fantastic event with the audience actively participating and interacting with the panelists.
Dengue was one of the big topics brought up. Due to population growth and eco development, the geographical spread of dengue is increasing rapidly. It is endemic in 124 countries, with an increase in endemic activity and epidemic transmission. Despite the seriousness, nothing can be done to reverse the trend due to lack of tools. Research in dengue, however, has increased a lot over the last 10 years, allowing us to better understand the factors involved and new tools in the pipelines. 6 vaccines are in clinical trails as well. Even though we have new insecticides, biologic controls to block dengue replication and other new tools, none of these cures can be truly effective due to a lack of manufacturing capabilities. Vaccine manufacturers need to work isolation, dengue has to be controlled in the whole region and programmes have to be tailored to each country. PPP is defined as a gloal alliance of dengue and public healthcare scetor. All of the stakeholders have to contribute to the funding. The ultimate goal woul of course be to eliminate dengue as a public health problem, if the focus is on urban areas.
“You have to prevent dengue, not cure it!”
An interesting point mentioned is that NGOs and other companies are needed to fund PPP in dengue endemic countries. Responding to a question on underdiagnosis of dengue in India, Duane mentioned that the Indian government does not have the tools to control it and thus requires government commitment to prevent dengue, not cure it. This applies to other mosquito-borne diseases such as Chikugunya as well. The mosquito population has to be decreased to reduce transmission. Emphasis should be on such prevention methods and not on the diagnosis.
GSK’s goal, as mentioned by Stephen Cook, is to improve existing vaccines that they have and to develop new vaccines. 19,000 children under the age of 5 died every single day, due to vaccines not available to them. However, a new vaccine manufacturing facility can take 400-700 million dollars for validation etc. Thus, partnerships are important to reduce these costs. Examples of possible partnerships are partnering in scientific and technical expertise, financial and management programmes, partnering in communication, regulatory expertise, IP and strategic relationships to make vaccines readily available. Clinical trials partnerships committees facilitate networking ad communication. One factor that needs to be taken into account however include managing demand and cashflow. For GSK, successful partnerships have led to a collaboration for the malaria vaccine.
NIAID, as covered by Lanling, helps to contribute to accelerate vaccine development. They have helped more than 20 vaccine licenses, provide major funding to small business, Product Development Partnership and performing feasibility gap analysis. The major roles of NIAID engaging in PPP is to share the costs and risks for development of novel and public vaccine and develop vaccine in the absence of private investment. To fund clinical trials in other countries outside US and for small biotechs, companies can write the proposal and will go through a peer review process. However, this depends largely on the type of vaccine developed.
In summary, the limitations of PPP to accelerate vaccine development include scientific priorities, public needs and multiple serotypes of disease such as dengue, Current manufacturers such as Sanofi only target one serotype and thus the individual who received the vaccine may not be protected against other serotypes.