Bill Gates calls for new ideas for a universal influenza vaccine

Devex
By Catherine Cheney

Vials of vaccines. Photo by: Sanofi Pasteur / CC BY-NC-ND

SAN FRANCISCO — On Friday, billionaire philanthropist Bill Gates announced the launch of the $12 million Universal Influenza Vaccine Development Grand Challenge.

This year marks the 100th anniversary of an influenza pandemic that killed an estimated 50 million people around the world and current influenza vaccines underperform compared to those used against other vaccine-preventable diseases. The United States Center for Disease Control estimates the vaccine was only effective in 36 percent of cases in this most recent flu season, which was the worst in the U.S. in nearly a decade.

While there is a healthy market for the seasonal flu vaccine, because the virus constantly mutates, there is a need for a new version every year and the manufacturing cycle cannot keep up with the strains. This dynamic makes it difficult for people in low- and middle-income countries to access the vaccines and creates a lag that would be costly and deadly if the world is faced with another influenza pandemic.

The goal of the grand challenge, launched by the Bill & Melinda Gates Foundation, together with Google co-founder Larry Page and his wife Lucy, is to fund ideas that can result in human clinical trials, encourage interdisciplinary collaboration with people outside of traditional influenza research, and support transformative rather than incremental research. Gates broke the news during a talk at the Massachusetts Medical Society annual meeting, where he stressed the high stakes through an animation showing how quickly the 1918 flu virus spread across the United States. A simulation showed that today, an airborne pathogen could kill 33 million people in six months.

“Scientific advances and growing interest on the federal level, in the private sector, and among philanthropic funders makes development of a universal flu vaccine more feasible now than 10 or 20 years ago,” he said.

The Gates Foundation frequently uses the Grand Challenge model to support innovative ideas for its global health and international development objectives. This request for proposals is for pilot awards of up to $2 million over two years. One or more pilot projects could be invited to apply for a full award of $10 million after demonstrating promising proof-of-concept data. The pilot award recipients can also apply for additional funding, including grants, program-related investments, or contracts.

The goal is to identify “game changing” solutions that offer protection against Influenza A and Influenza B viruses for at least 3 to 5 years and will be ready to start clinical trials by 2021. Some of the examples of researchers and disciplines the Gates Foundation listed in a press release provided to Devex in advance of the announcement include: “computational and systems biologists, virologists, immunologists, bioinformatics, artificial intelligence, deep learning, machine learning, the HIV/AIDS and cancer immunotherapy research communities, etc.” Despite the focus on technology-enabled solutions, the press release outlines the importance of access and affordability, especially in developing countries, where the foundation emphasizes that vaccines must be suitable for delivery through existing immunization programs.

The Gates Foundation is also a key supporter of the Coalition for Epidemic Preparedness Innovations, which brings together industry, government, and philanthropy to finance and coordinate the development of new vaccines for epidemics. One of the criticisms of CEPI’s chosen list of pathogens — Lassa fever, Nipah, and the Middle East respiratory syndrome, MERS — was that influenza was missing from the list despite warnings from the CDC about its potential to cause a pandemic. In a prior interview, CEPI board member Peter Piot said this is because influenza is a disease where the private sector can make a profit — but to date, that has not resulted in a vaccine that would lower the threat year to year and reduce the risk of a pandemic.

Gates outlined a number of related efforts around innovations in pandemic preparedness, including those by CEPI and the Gates Foundation’s research partnerships, like a collaboration between the Icahn School of Medicine at Mount Sinai, the pharmaceutical company GlaxoSmithKline, and PATH, an international health organization also based in Seattle, Washington.

The Gates Foundation is already supporting ideas for universal flu vaccines, including the National Institute of Allergy and Infectious Diseases, which has a vaccine candidate that is expected to advance to human safety trials in a year, and Gates mentioned other developments he finds promising, like work on an influenza antiviral by a Japanese pharmaceutical company Shionogi. He also noted that Larry and Lucy Page are funding the Sabin Vaccine Institute through their donor-advised fund in order to support a comprehensive advocacy approach to speed the development of next generation influenza vaccines.

Gates acknowledged that vaccines cannot be the only answer when the world has to respond to rapidly spreading pandemics. Vaccines take time to develop and deploy, and it takes time for their protective immunity to kick in, he explained. Gates said that in addition to these new tools, like vaccines, drugs, and diagnostic, the world also needs an early detection system, strong health infrastructure, and global response system.

“If history has taught us anything, it’s that there will be another deadly global pandemic,” Gates said. “We can’t predict when. But given the continual emergence of new pathogens, the increasing risk of a bioterror attack, and how connected our world is through air travel, there is a significant probability of a large and lethal modern-day pandemic occurring in our lifetimes.”

Global health security was a major focus of his talk, with Gates arguing that the world needs to prepare for pandemics the way the military prepares for war.

“We need better coordination with military forces to ensure we can draw on their mobilization capacity to transport people, equipment, and supplies on a mass scale. We need a reserve corps of trained personnel and volunteers, ready to go at a moment’s notice. And we need manufacturing and indemnification agreements in place with pharmaceutical companies — with expedited review processes for government approval of new treatments,” he said.

Gates was also sure to mention the critical role of governments in pandemic preparedness, noting how the United States Congress has directed the administration to come up with a comprehensive plan for strengthening global health security, saying it could be an important first step in the U.S. playing a leading role.