Accelerating scientific research and development
The arrival of COVID-19 spurred unprecedented innovation worldwide to develop novel technologies, treatments, and vaccines. Nations rushed to share genome sequencing data and information to rapidly put in place countermeasures, including diagnostic tests and vaccines. Governments took steps to speed up the mass production of vaccines, making significant research and development (R&D) investments and absorbing some risks associated with the process.12
The crisis and the response to it have illustrated the importance of moving from the traditional step-by-step model for R&D to an agile approach that can both shorten time to market and expand the scale of production.Global initiatives are building upon the remarkable speed of innovation in response to COVID-19 by accelerating rapid response solutions for future health threats.
In March 2021, for instance, the global Coalition for Epidemic Preparedness Innovations (CEPI) laid out a five-year, US$3.5 billion plan for the entire life cycle of pandemic preparedness, including the “moonshot” objective of developing and authorizing vaccines in 100 days.13
A United Kingdom–led pandemic preparedness partnership, affirmed by the G7 Carbis Bay Declaration in June 2021, also has called for vaccine development within 100 days, as well as accelerated development and deployment of diagnostics and therapeutics.14
Clinical trials represent another area in which international partnerships can expedite critical and life-saving treatments. WHO’s Solidarity Clinical Trial is an international collaboration among 600 hospitals in more than 50 countries to rapidly identify treatments for COVID-19; its goal is to simplify and accelerate trial procedures and minimize paperwork for patient enrollment, while also encouraging local researchers to contribute their expertise.15 In a similar vein, regional collaboratives for clinical trials, such as the European Research and Preparedness Network for Pandemics and Emerging Infectious Diseases, are building adaptive platforms that allow researchers to study multiple therapies simultaneously—and quickly eliminate unsafe or unpromising interventions.16
Ensuring equitable outcomes
While the pandemic has facilitated novel and innovative international partnerships, it has also exposed inequities.17 The distribution of COVID-19 vaccines and therapeutics was starkly unequal. High-income and developed countries managed to procure a significant chunk of supplies early on, while low-income nations and regions continue to struggle with insufficient support from scientific and manufacturing companies. This highlights the need to close widening disparities in global health resources.18
With increasing recognition that “no country is safe unless all countries are safe,” governments and multinational organizations are starting to mobilize their resources to build pandemic response capacity in low-resource settings.19 For example, apart from the UN-backed Access to COVID-19 Tools Accelerator (see the sidebar, “The ACT Accelerator: A coalition for global vaccine equity”), the Quad Vaccine Partnership between the United States, Japan, Australia, and India aims to expand COVID-19 vaccine manufacturing capabilities in the Indo-Pacific region, drive community engagement, and counter vaccine misinformation.20
African nations’ relative lack of scientific and manufacturing infrastructure has hindered their efforts to supply and distribute COVID-19 vaccines. However, some countries have looked to ramp up capacity. One large, multipartner initiative aims to reduce Senegal’s dependence on vaccine imports by boosting local manufacturing capabilities. The European Commission and public entities from Germany, France, and the United States are working with Senegal’s biomedical research center, Institut Pasteur de Dakar, to create a new production facility.21 Also WHO has joined a South African consortium and other partners to establish a technology transfer hub for mRNA vaccines in South Africa. Such initiatives could help countries become self-reliant, but much will depend on the willingness of mRNA manufacturers to share their technology and expertise.22
In addition to strengthening infrastructure, global collaboratives are also working to bolster clinical trial capacity in lower and middle income countries. The nonprofit, International AIDS Vaccine Initiative, drawing on funding from a wide range of European and African countries and CEPI, is moving toward the next stage of clinical trials for a vaccine for Lassa fever, which is endemic in West Africa.23