In early 2017 experts worried about a yellow fever epidemic in Brazil, the worst in decades, that had already killed more than 200 people. Ironically, just one year before, Brazil had sent 18 million doses of yellow fever vaccine to West Africa, because an outbreak of yellow fever was spreading so rapidly that the entire World Health Organization stockpile of yellow fever vaccine was depleted -- twice.
The situation in Africa was so pressing that public health officials recommended the use of 1/5 of the standard vaccine dose, in order to “stretch” available stocks of vaccine. Thankfully even a reduced dose of this vaccine is highly effective in preventing a disease that at one time killed 10 percent of the population of Philadelphia. Ominously, in 2016, for the first time, there were 10 cases of yellow fever in Beijing, as some of the 100,000 Chinese working in Africa returned home while infected. Luckily there was no further spread among unvaccinated populations of Asia, where yellow fever has not existed
For yellow fever, an effective vaccine has been available for decades. If the 2016 and 2017 outbreaks of yellow fever remind us that adequate vaccine supply and appropriate vaccine use are necessary for successful defense against infectious diseases, the stories of zika and Ebola -- for which no vaccines exist -- make a different point: The development of new technologies for global health takes time, money and political commitment. Getting for-profit companies interested in global health requires innovative thinking and a mechanism to incentivize these efforts. One such initiative is the “Global Health Innovation Technology Fund,” launched in 2013 as a joint investment of the Japanese government, leading bio and pharmaceutical companies, and the Bill and Melinda Gates Foundation. A similar type of fund should be considered in Korea as a program that would harness the technological prowess of Korean companies and universities for the benefit of vaccines, drugs and diagnostics for global health.
Japan’s GHIT is considered a big success story. In GHIT the Japanese Ministry of Health, Welfare and Labor and the Ministry of Foreign Affairs contribute 50 percent of the funding, while the Gates Foundation and five Japanese companies contribute 25 percent each. The partnership had five participating companies initially, but now 16 companies participate. This year the Japanese government announced that it would add $130 million more to the fund, and GHIT has already invested more than $75 million in over 70 projects to develop drugs, vaccines and diagnostics. These grants are awarded on the basis of commercial potential and the likelihood of “efficient and effective” development of innovative technologies with the capacity to save lives and improve the health of people around the globe.
In Korea there are examples of successful public private partnerships. Shin Poong Pharmaceuticals, with the assistance of the Medicines for Malaria Venture, a product development partnership funded by the Gates Foundation, developed a new drug to fight against malaria. Similarly, the International Vaccine Institute, a non-profit international organization based in Korea, with funding from Korea, Sweden, and the Gates Foundation developed a vaccine against the disease cholera and transferred the manufacturing technology to EuBiologics, a small Korean biotechnology company.
Last year EuBiologics signed a long-term vaccine supply contract with UNICEF for the global cholera vaccine stockpile managed by WHO. One million doses of this vaccine were sent to Haiti to deal with a cholera outbreak that occurred just after Hurricane Matthew devastated the island. Both of these development activities represent opportunities that were “isolated” efforts in malaria and cholera; GHIT extends that model more broadly to infectious diseases of global importance.
A Korean GHIT would have value at multiple levels. Products developed by Korean GHIT are, by design, commercializable and of value to the global health. It signals a commitment to the goals of sustainable development and health (the United Nations Sustainable Development Goal 3). It highlights Korean leadership as the current chair of the Global Health Security Agenda. Successful products have a potential to create new companies and new jobs -- and will give Korean universities, research institutes and companies an opportunity to apply their creativity to the pressing problems of global health. Given existing commitments to biotechnology, the GHIT leverages Korean taxpayer monies with funding from companies and from private philanthropy. Korea’s stated goal is to develop 17 new drugs by 2020 and to emerge as one of the top five vaccine producers in the world by 2025. A Korean GHIT could be the engine that turns ideas into better health, and a more competitive biotechnology industry.
By Jerome Kim
Jerome Kim is MD, director general of International Vaccine Institute. -- Ed.