Thanks to the Coalition for Epidemic Preparedness Innovations, Duke’s vaccine programs have the potential to receive a funding boost in the future.
The CEPI—a public-private coalition aiming to facilitate vaccine development—recently raised $460 million from the Bill and Melinda Gates Foundation as well as the Japanese, German and Norwegian governments. The coalition will use this funding to finance the development of vaccines for three deadly emerging infectious diseases—Middle East respiratory syndrome-related coronavirus, Lassa fever and Nipah virus.
“Our aim is to take part in the clinical trial of MERS and Nipah vaccines at Duke-NUS,” wrote Linfa Wang, director of the emerging diseases program at Duke-NUS, in an email. “It’s too early to tell whether we will be successful in getting funding from CEPI, but we will do our best.”
The Duke Human Vaccine Institute has not yet decided whether to apply for a grant from CEPI, explained Thomas Denny, chief operating officer of the Duke Human Vaccine Institute.
“We try to stay abreast of any entity that’s out there providing funding to support the types of things that we do, and we try to then decide whether we can be competitive,” Denny said. “We’ll look at it and see where it’s relevant, and if we think we can mount a competitive response, I’m sure we’ll try it.”
The DHVI was formed in 1990 as an interdisciplinary effort to combat HIV and the disease's startling ability to rapidly mutate. Although a significant portion of the DHVI is still devoted to research on HIV and AIDS, it has transitioned to focus on a broader range of pathogens.
One of the more notable projects involves replacing the annual influenza vaccine with a vaccine that would not have to be administered yearly.
“It’s a challenge to get society vaccinated every year, and if you could develop a vaccine that would give you a broad coverage over multiple years, then it makes vaccine coverage rates more effective than where we are today,” Denny said.
Denny went on to note that the DHVI also funded research on cytomegalovirus and Zika.
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The vaccine program at Duke-NUS, however, concentrates on emerging diseases because of their relevance to Singapore.
“The Emerging Infectious Diseases (EID) Programme was included as one of the five core Signature Research Programmes (SRP) in response to many of the global EID outbreaks,” Wang wrote.
Wang noted that the EID program’s initial objective to study dengue virus has been met with considerable success. Three clinical trials involving Duke-NUS researchers are already in the works, with more soon to follow.
Gregory Gray, professor of medicine and researcher in the program, explained that his lab studied animal-borne diseases. These include avian flu, swine flu and MERS.
“Some of the emerging pathogens have tremendous explosive potential to cause tremendous morbidity and mortality, economic loss, etc.,” Gray said, pointing to the widespread effects of the Ebola and Zika epidemics.
He emphasized that it is crucial to be able to respond quickly to these unpredictable emerging infectious disease threats.
Funding vaccine development
The DHVI's mission to to be prepared to respond to society's threats, Denny explained.
"The challenge, though, is whether you have the money to focus on all those new threats,” he said.
He noted that a difficult aspect of conducting research on newly emerging diseases is obtaining the funding with enough speed to begin investigation into possible vaccines.
“When Zika hit us 18 months ago, we didn’t have a pot of money that was just sitting there that you could divert to doing some Zika work,” Denny said.
In such cases, the DHVI must wait for the National Institutes of Health or Centers for Disease Control and Prevention to obtain congressional funding to develop a vaccine. Denny added that even after the NIH or CDC receives the funding, labs must apply for grants, which then have to be reviewed before the money is finally allocated.
Currently, the DHVI is mostly funded by the NIH and the Bill and Melinda Gates Foundation.
“One of the challenges is that you can’t do everything. You try to lead in the area where you have faculty that are strong, and you go where you can get funding," Denny said.
Denny also explained why the DHVI has chosen to focus more on priority pathogens as opposed to emerging infectious diseases.
“Typically, the agents that are at risk to us are the ones that receive the funding priorities that enable people like us to go after them and do research,” he said.
Looking to the future
Wang emphasized the need to alter the traditional approach to vaccine development in the coming years.
“Vaccine development is a long and costly process,” he wrote. “It is hence extremely important to conduct research and vaccine development for EIDs [emerging infectious diseases], as our conventional research/development strategy for existing priority pathogens (such as HIV, HepC) will not work for EIDs.”
Gray also noted the importance of global collaboration against potentially dangerous pathogens.
“These emerging infectious diseases don’t respect any borders,” Gray said. “They impact the countries without resources as well as the countries that are economically much more sound.”