India to lead global coalition to fight epidemics [Health]
India is all set to lead the global fight against epidemics as it is a key member of the newly formed Coalition for Epidemic Preparedness Innovations (CEPI) with its headquarters at the Norwegian Institute for Public Health, in Oslo.
The coalition will not focus on diseases that already have sufficient attention, but will be guided by WHO’s R&D blueprint (2016), which lists eleven illnesses to focus on, including Chikungunya, Middle East Respiratory Syndrome (MERS), CrimeanCongo Haemorrhagic fever.
When disease outbreaks occur, depending on the mode of transmission they can spread very rapidly to affect people very far from where the outbreak starts. In India, we recognise that preparedness to handle outbreaks also includes strategies for prevention.
For known and as yet unknown diseases, vaccines offer the potential to be deployed rapidly and on scale to prevent both disease and its further transmission.
India, represented by the Ministries of Science and Technologies and Health and Family Welfare, intends to stand shoulder-to-shoulder with governments and agencies, such as the World Health Organization, the Wellcome Trust and others to develop the strategies for partnerships, technical development, regulatory and ethical approaches and find the resources and commitments needed for coalition.
There are relatively few efficacy studies of vaccines developed in India. Last vaccine developed in India which underwent efficacy study was rotavirus vaccine made by Bharat Biotech with the support of the Department of Biotechnology, and this is now being used by the MOHFW in four States, with plans to expand nationally in the near future.
Coalition will focus on diseases that have the potential for causing outbreaks. Among the known diseases that may be targeted is Chikungunya, for which a vaccine has been developed in India, but its effectiveness in preventing the disease needs to be evaluated.
For testing any new vaccine, safety is paramount and the vaccine is first tested in a small number of healthy people in phase 1 studies. Only then does the study move to a slightly larger number of people in phase 2 to figure out what dose is best to produce the best immune response.
After that, come larger scale phase 3 efficacy studies to test whether vaccine can prevent disease in its target populations. While phase 1 and 2 studies can be done anywhere, phase 3 studies require a population where disease is reasonably likely to occur, so phase 3 would have to be where outbreak is happening.
The goal of the coalition is to focus on diseases which do not have a large market in global terms; therefore, targets have been identified through a careful process of considering candidates that have been through some pre-clinical testing, but might not proceed to further testing because vaccine manufacturers do not consider the returns to be sufficient for the investment they need to make.
Anticipated requirements for funding is about 200 million US dollars per year.
India is home to one sixth of the world’s people. Our people live and travel everywhere. India will play a role in working not only with industrialised countries, but also with less resourced settings, particularly in Asia and Africa
The India-Africa Health Summit, organised by the ICMR and supported by four Indian ministries is an example of the kind of engagement where we could work with African countries likely to be affected by outbreaks that need to build capacity in science, medicine and manufacturing.