Stephen Buranyi writes:

Coronavirus appears to be with us for the long haul. Despite the unprecedented attempts at isolation and containment, with about 50 million people locked down and economic activity virtually halted in China, cases have spiked in recent weeks. Sixty-seven countries are now reporting a total of more than 8,000 infections outside China. The World Health Organization has been wary of using the word pandemic, but last week it advised countries to prepare as if one were imminent.

On the same day, in a rare bit of good news, the US National Institute of Allergy and Infectious Diseases (NIAID) announced it had already received the first candidate for a vaccine against the novel virus, now being called Sars-CoV-2 – produced by a company called Moderna – and that trials could begin as early as April. Anthony Fauci, the institute’s director, said that just three months between discovery and trials was a new record, noting that “nothing has ever gone that fast”, before dropping the other shoe: even with the rapid start, completing the trials and scaling up production would take until at least next year, and there was no guarantee it would even get to that stage.

Vaccines remain science’s best – and virtually only – weapon against viruses, and yet the timeline for developing a vaccine, measured in years, seems hopelessly mismatched to a pandemic, which can spread, kill and often disappear in a matter of weeks or months. The modern record doesn’t inspire much confidence. There have been multiple international viral outbreaks over the past two decades – Sars-CoV-1, Mers, Zika, Ebola – that all provoked similar races to produce a vaccine. Yet to date only the efforts on Ebola have been successful, with a vaccine being approved last year.

Why is this? Vaccines for epidemics have to overcome the same scientific and regulatory hurdles as other promising treatments, but they also suffer from a near total lack of interest from the markets that drive the pharmaceutical industry. Only a few massive companies retain the ability to develop and produce a vaccine from start to finish, partly because of the expense and the timescales involved and partly because they’ve consolidated the patents on manufacturing processes – a situation analysts openly call an oligopoly. A success for one of these companies is a treatment for a widespread, persistent disease that they can sell every single year in perpetuity. The last industry blockbuster was Merck’s HPV vaccine Gardasil, in development for nearly 20 years, released in 2006, and still bringing in over £1bn annually. There is no way to easily apply their slow-burn research and profit model to an epidemic. As the leader of the UK’s Ebola response, Adrian Hill, told the Independent in 2014, “Unless there’s a big market it’s not worth the while of a mega-company … There was no business case to make an Ebola vaccine for the people who needed it most.”

Even if research begins during a pandemic, the unpredictable nature of outbreaks means work is often shelved if the crisis dies down, and so progress halts until the next time a similar infection flares up. Sars and Mers were also coronaviruses but after they petered out, work on them essentially stalled. [Continue reading…]