health worker injecting vaccine into an arm
The 100 Days Mission involves a prototype-vaccine ‘library’ that can be quickly adapted for new pathogens © Scott Heins/Getty Images

As we approach a third year of Covid-19, pandemic fatigue is setting in. Governments have several crises demanding their attention and, with the development of vaccines, we can see a misguided belief set in that the pandemic is over.

However, the real issue we now face is how we manage the persistent and evolving threat that endemic Covid and other viruses represent. While it’s undeniable that most countries have moved into a different phase of their coexistence with the virus Sars-Cov-2, it’s still killing thousands of people every week globally and remains in the top five causes of death in the US alone.

The virus has also shown its evolutionary potential on multiple occasions and could mutate further to become more virulent or resistant to vaccines.

And the global viral picture grows ever more complex. We have seen: a resurgence of polio in wealthy countries; the global spread of monkeypox; and the outbreak of Ebola virus in Uganda — all reminders that viral threats are everywhere, and they don’t respect borders. These are all viruses or closely related cousins of viruses we already know and have some form of vaccine or treatment for. Yet we are still on the back foot.

These multiple and constant threats are a symptom of today’s world, where climate change, the destruction of animal habitats by expanding human populations, and the growth of vast transportation networks have created perfect conditions for viruses to jump between species and potentially evolve into epidemics. Without doubt, we have entered a new era of infectious disease, demonstrated in the increasing speed and spread of pathogens.

But, despite the record-breaking pace at which Covid vaccines were developed, as well as great steps forward in the development of vaccines against malaria and other persistent infectious diseases, we always seem to be one step behind whichever virus comes for us next.

What’s clear is the world needs to get faster and smarter in its ability to respond to outbreaks of new infectious diseases. We need to be able to move at a pandemic-preventing pace when something new emerges, whether it is a more transmissible or virulent Covid variant, a rare strain of Ebola or influenza, or a pathogen never seen before in human populations.

My organisation, the Coalition for Epidemic Preparedness Innovations (CEPI), was created specifically to promote the creation of vaccines against emerging infectious diseases. Having played a critical role in the swift development of Covid vaccines, we are now pioneering the vital work needed to help the world get ahead of future epidemic and pandemic threats.

To do this, CEPI, along with G7 leaders and G20 nations, has an ambitious plan — the 100 Days Mission — that will dramatically reduce the time it takes to develop new vaccines against emerging viral threats.

Coupled with improved surveillance, and with swift and effective use of non-pharmaceutical interventions, such as social distancing, delivering a vaccine within 100 days of a new viral threat emerging would give the world a fighting chance to extinguish its potential to spawn a deadly pandemic.

A crucial part of the 100 Days Mission is the building of a library of prototype vaccines — ideally, at least one each against the 25 or so viral families that are known to infect people. These families include: the coronaviruses, which produced Sars and Mers before Covid; the filoviruses, including Ebola and its Sudan strain now spreading in Uganda; and orthopoxviruses, which both smallpox and monkeypox belong to. The vaccines in the library should also draw on rapid-response technologies tested and ready to be adapted to make shots against newly emerging threats.

The progress in research and development in infectious diseases over the past few years has been extraordinary. Developing vaccines against a previously unknown virus in less than 11 months was a scientific triumph. However, the work to prepare for future threats is nowhere near done. The project of building the global vaccine library is in its infancy, and not being tackled systematically, with at best only a few viral families partially covered at present. As we see Covid news replaced by reports of other virus outbreaks, we must recognise that now is the time to intensify investment in pandemic prevention and protecting global health security. With focus and international co-ordination of effort, the global vaccine library could be largely completed in five to 10 years.

CEPI is well aware the 100 Days Mission is bold. But we also believe that with the right kind of leadership and with sustained investment, it is achievable. Ultimately, global progress towards the 100 Days Mission will depend on the political will to rise to the challenge of protecting the world from another devastating event like Covid — and the challenge of creating a future free of pandemics.

The writer is head of the Coalition for Epidemic Preparedness Innovations

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