Wanted: A big vaccine project to prevent the next pandemic

While countries are spending more on health, it’s vital to ensure that future coronavirus pandemic have the right vaccines to tackle them.

Three coronavirus health threats in two decades, one deadlier than the other. Sars was the first in 2003 in South-east Asia. In 2012, Mers was mostly centred in the Middle East. We now have Covid-19 that has not spared any part of the world and is making us cower in fear of coronaviruses, four of which are known to cause the colds.

In all three threats, there is a common winged mammal that is allegedly the original host of the pathogens – the bat. Some researchers claim it is the horse-shoe variety that lives in caves and is a reservoir of thousands of coronaviruses.

Human encroachment into bat territory — caves and rainforests — has been blamed for the spread of these diseases, but again, there is no confirmed evidence from any quarter.

In 2003, when Sars spread across most of South-east Asia, there were concerns in other parts of the world but, mercifully, the disease disappeared as quickly as it came, mysteriously.

The World Health Organisation reported 8,000 infections and 774 deaths from the disease until 2004 and there was no attempt to develop a vaccine.

Some scientists claimed civets contracted it from the bats and spread it to humans. In China, these ‘cats’ were culled in thousands without proof of their guilt in the spread of the pathogen.

With Mers, the original host was again the humble bat, while the intermediary host was the camel. The spread was limited to the Arabian Peninsula, though cases were observed in 27 countries as a consequence of travel.

But Mers claimed 858 lives and there is little evidence to suggest that the threat is over. Last heard, another case has been detected in Saudi Arabia.

Lockdowns and travel bans were not imposed and life went on normally, until Sars-Cov-2 that causes Covid-19 appeared last year and changed the course history for the worse.

Sars, the progenitor of Sars-Cov-2, took almost two decades to become deadlier. Its impact has been devasting with 178 million cases and 3.8 million deaths so far. The good news is that vaccines against the Covid-19 coronavirus indeed work, and were developed and delivered in less than a year, though some experts were doubtful they could be fast-tracked to the production stage after three phases of trials.

Normally, it takes three to five years to develop, trial and produce vaccines but what happened with Covid-19 was truly remarkable in scale and speed. We now have mRNA (Pfizer, Moderna), inactivated (Sinopharm, CoronaVac) and viral vector (J&J, Sputnik V, AstraZeneca) vaccines. More vaccine candidates are in different phases of trials and development.

With variants and mutations of the original pathogen emerging, there’s not only a need to speed up vaccine production to meet demand, but also need to produce more potent jabs to combat these variants.

While this is being done, countries must ramp up basic health infrastructure that was woefully inadequate to deal with this pandemic. Hospital wards were overflowing, thousands died on the streets for want of oxygen, others contracted fungal infections after they recovered. The human and financial costs destroyed families.

According to the WHO, governments provide an average of 51 per cent of a country’s health spending, while 34 per cent is borne by the individual.

This pushes more than a 100 million people into poverty every year in normal. That figure could be 150 million following the Covid-19 impact, according to some estimates. The world health body says governments in lower-middle income countries spend $60 per person on health annually while it is $270 per person in upper-middle income countries.

While countries have since been spending more on health, it’s vital to ensure that future coronavirus pandemic have the right vaccines to tackle them.

Sars, Mers and Sars-Cov-2 show that coronaviruses are getting more potent and virulent. The biggest fear among the scientific community is the emergence of super-coronaviruses, which could cause immense damage to humanity.

Experts are already saying that we could be living with Covid-19 for the foreseeable future. It will remain endemic in populations, according to the WHO.

Seasonal and regional cluster will emerge, and containment strategies should be in place. Surveillance is key in this scenario and early reporting of new strains in populations will be critical to get Sars-Cov-2 strains under control.

The conservative thinking about this coronavirus is that pangolin could have the intermediary host. Again, mostly conjecture. In the early days of the outbreak last February, the snake was also a suspect.

For all we know, Sars-Cov-2 could be the first super-coronavirus that humans may be encountering. There are super-spreaders for this pathogen who have travelled millions of kilometres, thanks to air travel.

But there is hope, a slender emotion that civilisation clings on to in times of a crisis like this — a vaccine that targets all coronaviruses, a pan-coronavirus vaccine. This is not a new idea but was discussed at the National Institute of Allergy and Infectious Diseases (NIAID) in 2017. Grants, however, were not forthcoming, until last year, when this rapidly evolving pathogen made the NIAID change its mind on its backing for the super-jab.

The Coalition for Epidemic Preparedness Innovations, a non-profit, allocated $200 million last year to fast-track the creation of vaccines against beta coronaviruses like Sars-Cov-2. Two dozen research groups are actively pursuing such a jab – a ‘super-vaccine based’ on the novel mRNA and a cocktail of inactivated viruses.

The current coronavirus pandemic could continue in waves until 2025, according to some experts of the International Vaccine Institute this writer spoke to last month, but there’s hope with a pan-coronavirus vaccine. Animal trials are progressing, but it may be hard to predict what the next pandemic would look like.

While countries should spend more on healthcare, it’s important to develop these vaccines with an eye on the future. Big Pharma and Big Government should collaborate and take this ‘Big Vaccine’ project forward. If they could do it in a record 10 months with Covid-19 jabs, a pan-coronavirus vaccine is not an impossible task.

allan@khaleejtimes.com