I had the pleasure of indulging my inner vaccine geek for three days last week at the World Vaccine Congress, where I was a guest blogger. Everyone who works in health care has a particular “disease passion” (I know, we are strange) and I have always loved working in infectious diseases. To me, the progress we have made against disease through vaccination is nothing short of extraordinary. Some of the highlights from my days are below:
How Do We Make Sure Developing World Vaccines Are Available?
The answer to this question came out of contrasting presentations by the World Bank and MSF (Doctors Without Borders, as it is known in the US). The World Bank presented a pilot case study showing how, by using advanced market commitments (AMC) made by public and private partners, they had been able to get vaccines against pneumococcal disease rapidly and cheaply into developing markets. Unfortunately, they have no other such programs underway. The current economic environment has meant that none of the governments previously involved could commit to the level they had previously. AMCs have always seemed like a remarkable way to make going into developing countries attractive to large vaccine manufacturers, and this pilot proved it. The next presentation by MSF said we should be looking outside AMCs since they have only benefitted large multinationals rather than encourage local industry. MSF also believes that AMCs stifle incentives to develop vaccines directly for developing world needs. Instead, these countries get second-generation vaccines that were created for industrialized countries and don’t take local needs into account (like lack of reliable refrigerated transport, or cold chain). The MSF speaker then managed to get everyone in the room angry by comparing vaccine manufacturing to iPod manufacturing. A very lively discussion ensued. On my final day, the esteemed Dr. Francis, one of the early AIDS pioneers, gave an encouraging talk about the rapidly growing vaccine industry that is taking place in countries like India, Brazil and China. It is hoped that these new entrants will spur innovation in vaccines against developing world illnesses and keep prices low locally.
Partner, Partner, Partner
There were multiple presentations throughout the week on partnering: partnering to reduce risk, partnering to get new technology, partnering for local access, partnering for access to antigens, partnering to get product to market more quickly. You name it, there is a reason to partner on vaccine development today. One Sanofi Pasteur presentation looked at its Phase I, II and III pipeline vaccines and pointed out that all of its Phase I vaccines are results of partnering. The attendance at the conference reflected this new mindset — most of the attendees were either business development people from large pharma, researchers from big and small companies and vendors selling services to all.
The Scary Viruses Are Still Out There
A really frightening presentation by a modern day virus hunting organization showed that there is genetic proof that HIV originally appeared in Africa sometime in the 1920s but didn’t have any way to migrate. Of course all that changed in the 1980s. The viruses we should be most scared of manage to cross species barriers. This is a perfect storm for creating new viruses is a region where people live in close, routine proximity to animals, where there is not much agriculture, a lot of hunting for bush meat and an encroaching industry, like logging. This environment creates opportunities for human and animal blood and fluids to mingle easily and then transport disease rapidly to dense populations. One of the interesting things these types of virus-hunting organizations are doing to spot pandemics early is to equip Masai warriors in Africa with cell phones and text instructions so they can spot any new diseases among their herds. I love when technology and health care come together so beautifully.
Technology Will Save the Day
New technologies will impact the speed with which we create new vaccines and make vaccine development more efficient. Imagine one universal vaccine for the entire world that will impact every strain of Hepatitis B, or influenza. That is the ultimate goal.
Boomer Vaccines Ahead
Several speakers mentioned that new vaccines need to be developed not only against developing world diseases (malaria, HIV, TB, etc.) but for our currently aging populations. Imagine a whole new series of vaccines that impact common infections found in the elderly — from gum disease to skin infections to bacterial stomach infections.
All in all, I found the conference to be hopeful and inspiring for the industry and for global health. We are finding new ways to get vaccines more rapidly and inexpensively into countries that need them. New technologies will make vaccines more streamlined and efficient and because companies no longer think they need to “go it alone,”partnering is the norm for achieving success. If you want to read the detailed blog posts from all the sessions I attended, please check out the Vaccine Nation blog.