European strategy for vaccine development against infectious diseases

A Strategy for International Cooperation in the COVID-19 Pandemic Era: Focusing on National Scientific Funding Data

The coronavirus crisis may lead to a deeper understanding of international collaborations for developing antivirals and vaccines that are essential to protect us from current and future health security threats. Beyond technical solutions, the government of South Korea needs to establish a timely strategic investment in coronavirus-related research and development (R&D) in order to enhance the capabilities for managing this new uncertainty in regard to the domestic health crisis. Thus, this study aims to provide useful information about the status of global coronavirus-related research from the South Korean government's perspective. National funded projects stemmed from leading nations such as the United States, countries of the European Union, and Japan between 2012 and 2018. Six research fields were derived by clustering analysis and an expert-based approach, and then matched to those of South Korea. The comparative analysis among them allowed for the identification of the nations' strengths and weaknesses, thereby laying the groundwork for strategic international research collaborations.

Clinical Development of New TB Vaccines: Recent Advances and Next Steps

Mycobacterium tuberculosis (Mtb) kills more people worldwide than any single infectious pathogen, yet the only vaccine licensed against tuberculosis, Bacille Calmette Guerin (BCG) is approaching its centenary. Two recent advances in clinical tuberculosis vaccine development have invigorated the field. BCG revaccination of interferon-gamma release assay (IGRA) negative adolescents provided 45% protection against sustained Mtb infection defined by IGRA conversion; and the protein-subunit vaccine M72/AS01_E provided 50% protection against progression from Mtb infection to tuberculosis disease in IGRA-positive adults. These findings provide encouraging evidence for pre-exposure and post-exposure approaches to vaccination against tuberculosis, both of which may be necessary to rapidly interrupt the cycle of Mtb transmission and sustain long-term impact on global tuberculosis control. New trials are needed to demonstrate efficacy of M72/AS01_E with greater precision, in a wider age range, in diverse epidemic settings, and in populations that include Mtb-uninfected and HIV-infected persons. Modeling the impact of mass campaigns with M72/AS01_E and other fast-follower vaccine candidates will be crucial to make the use case and demonstrate public health value for TB endemic countries. The size and scope of the next generation of efficacy trials, and the need to expand and accelerate the existing clinical development pipeline, will require public and private consortium funding and concerted political will.

Towards improved process efficiency in vaccine innovation: The Vaccine Innovation Cycle as a validated, conceptual stage-gate model

Continuing investments in vaccine innovation are insufficiently translated into market entries of novel vaccines. This innovation paradox is in part caused by stakeholders lacking complete understanding of the complex array of steps necessary for vaccine development and collaboration difficulties between the wide variety of stakeholders involved. Models providing cross-domain understanding can improve collaboration but currently lack both comprehensibility and granularity to enable a prioritized view of activities and criteria. Key opinion leaders (KOLs) were asked to contribute to the definition of a vaccine innovation cycle (VIC). In a first step, 18 KOLs were interviewed on the stages (activities and results) and gates (evaluation criteria and outcomes) of vaccine innovation. This first description of the VIC was subsequently validated and refined through a survey among 46 additional KOLs. The VIC identifies 29 distinct stages and 28 corresponding gates, distributed in ten different but integrated workstreams, and comprehensibly depicted in a circular innovation model. Some stage-gates occur at defined moments, whereas the occurrence and timing of other stage-gates is contingent on a variety of contextual factors. Yet other stage-gates continuously monitor internal and external developments. A gap-overlap analysis of stage-gate criteria demonstrated that 5 out of 11 criteria employed by vaccine developers correspond with criteria employed by competent (regulatory) authorities. The VIC provides a comprehensive overview of stage-gates throughout the value chain of vaccine innovation. Its cyclical nature highlights the importance of synchronizing with unmet needs and market changes, and conceptualizes the difference between incremental and radical vaccine innovation. Knowledge on the gap between internal and external criteria will enhance the viability of newcomers to the field. The VIC can be used by stakeholders to improve understanding and communication in forming collaborative alliances and consortia. Such a boundary-spanning function may contribute to the reduction of process inefficiencies, especially in public-private partnerships.

Keeping the Person in Personalised Healthcare

Proponents of personalised medicine believe that the involvement of the patients, including in "risk-sharing agreements," will result in cost savings, the use of the genetic makeup of an individual patient as the starting point will save resources and, indirectly, there will be great potential for startups and new business in many areas. But how can Europe ensure that the "person" is central stage and allow us to focus on the development of personalised medicine for his or her ultimate benefit? The EU has a clear role to play, argues the author. One way for this to happen is for the EU to focus investment in guidelines for governance. This will go a long way to ensuring that the citizen is the principal factor when it comes to utilising the new wealth of innovation in health. The citizen must always come first when innovation is harnessed.