But three years into the coronavirus pandemic, the U.N.-backed program to build a network of self-reliant research and manufacturing sites is struggling. It is seeking a large increase in funds to ensure its sustainability, its backers say, raising concerns about the long-term future of the program.
The United States has yet to respond to a funding request for $100 million, sent late last year by the effort’s backers. The support would about double its funding overall.
“I’m really worried about the financial future of the mRNA vaccine hub,” said Lawrence Gostin, a professor of global health law at Georgetown University, noting that the United States is the “big wallet” behind such global health efforts, setting the agenda.
The United States has offered no funds so far for the program, which is being organized primarily by the Medicines Patent Pool, a U.N.-supported public health organization. Canada, South Africa and several European governments completed the initial round of funding, which was designed to cover five years of work.
International efforts to learn from the coronavirus pandemic are foundering in the face of mounting fatigue and outright opposition, with much of the world focused on the war in Ukraine and its effects, tensions between Washington and Beijing, and broader economic problems.
Plans for a binding international accord on pandemic preparedness, under discussion at the World Health Assembly, are facing conspiracy-theory-tinged backlash from the far right. The World Bank, meanwhile, told reporters this month that a fund it had set up to help lower-income nations prepare for the next pandemic had received only $300 million in pledges, despite calls for $5.5 billion.
In view of the ambitious scale of the mRNA vaccine hub program, its funding request of $100 million would be comparatively modest — “one one-hundredth of one percent (0.01%) of annual U.S. military spending,” aid and advocacy groups including Oxfam America and Public Citizen wrote in a letter sent to President Biden on Friday, urging him to support the program.
U.S. officials have praised the initiative and provided technical support and training. Secretary of State Antony Blinken, speaking at the U.S.-Africa Leaders Summit in December, applauded the program as an investment “in future tech know-how and production in Africa, by Africans, with all of the health, science, and economic benefits that this brings.”
It is not clear why the United States has not offered any funding to the program. A State Department spokesperson confirmed last week that the request had been received, but said there were “no funding announcements at this time.”
Charles Gore, the executive director of Medicines Patent Pool, said the letter had been sent to the State Department via the Department of Health and Human Services late last year. He said he hoped the United States would offer the funding eventually, after overcoming bureaucratic hangups.
The program has shown significant initial scientific success. The mRNA vaccine hub outside of Cape Town, South Africa — the only one up and running — last year was able to reverse-engineer Moderna’s mRNA vaccine by using publicly available information, despite the refusal of the U.S. drug company to share its formula.
Early testing data has shown the coronavirus vaccine developed by the hub to be successful, and the hope is to go into human trials soon, Gore said. But the effort has faced logistical holdups, along with concern from advocacy groups that Moderna could use South Africa’s loose patent laws to block the local manufacturing of mRNA vaccines in the country.
While the hub in South Africa is fully funded, more money is needed to help establish the 15 partner vaccine manufacturing sites in countries including as Brazil, India and Nigeria, Gore said. The $100 million would allow these sites to invest in the infrastructure they need to work on mRNA vaccines and begin doing their own research and development.
“Initially the idea was that they should come fully funded themselves,” Gore said of the partner sites. “But the reality is that that’s not the case.”
Petro Terblanche, the managing director of Afrigen Biologics, the South African company that worked with researchers from the University of the Witwatersrand to reverse-engineer Moderna’s vaccine, said that the United States had provided “unparalleled” technical support, but that money was needed to address “sustainability.”
The manufacturing partners need to order specialist equipment and supplies that are specific to mRNA research, which uses an enzymatic process rather than the live cells used in more traditional vaccine research. There are long waits for orders to be delivered, as much as one year in the case of some key equipment, Gore said.
The program’s backers acknowledged that new vaccines would arrive too late to alter the trajectory of the pandemic. Instead, the hope is to use the technology as a platform for other mRNA vaccines and in future outbreaks. Afrigen has started to research new possibilities, including vaccines for tuberculosis and HIV.
Only two vaccines that have come to market use mRNA technology, and both are made by U.S. companies — Moderna and Pfizer, working with the Germany company BioNTech. Moderna has only offered limited cooperation to the hub, allowing its vaccine to be used for comparative testing purposes. Moderna and BioNTech have both announced plans to bring mRNA manufacturing to Africa.
Gostin said he worried that the WHO and the Medicines Patent Pool did not have a “robust funding model” in place for the hub program and may have underestimated the hubs’ total costs.
It was unlikely that the United States would fund the program, despite the nonfinancial support it has given, Gostin said, because of the potential complications from intellectual property law for U.S. companies and the high levels of scrutiny seen on global health funding at the moment.
“The U.S. is under intense budget pressure to not send money outside of the United States,” he said. “There are a lot of political overtones.”
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