Earlier this month, the Nobel Foundation awarded the 2023 Nobel Prize in Physiology or Medicine jointly to scientists Katalin Karikó and Drew Weissman in recognition of their decades of research into mRNA vaccine technology, now familiar to many of us nonscientists due to its use in COVID vaccines. The game-changing mRNA technology enabled the development and production of effective COVID vaccines with unprecedented speed, vaccines which are credited with having saved millions of lives worldwide. Now, mRNA technology is being used to develop new vaccines for a variety of other diseases, including Zika, Ebola, flu and even cancer.
Vaccines using mRNA technology present a few advantages over conventional vaccines, including safety and efficacy. But among the most important of mRNA’s advantages is its sheer capacity for production — that is, its potential to enable fast, inexpensive and easily scalable vaccine manufacture. Nowhere is this more important than in low- and middle-income countries (LMICs), whose citizens have traditionally lacked access to much-needed medicines compared to wealthier countries.
The speed and efficiency of mRNA technology prompted the Bill & Melinda Gates Foundation to invest a total of $40 million recently to help LMICs build their own mRNA-based research and manufacturing capacity. Announced at Gates’ Grand Challenges meeting this month in Dakar, Senegal, the new funding reflects what Gates says is mRNA technology’s capacity to significantly lower the costs of research and manufacturing and enable expanded access to lifesaving vaccines. Scientists are looking to mRNA technology to enable the creation of vaccines for a range of infectious diseases that are particular threats to people who live in LMICs in Africa and elsewhere. That includes diseases like malaria, tuberculosis and Lassa fever.
The foundation has committed $5 million apiece to the Institut Pasteur de Dakar in Senegal, and to Biovac in South Africa. Both are research institutes with vaccine manufacturing experience, and the money will let them acquire mRNA technology. Additionally, to further advance the technology and lower costs of commercialization, Gates will provide $20 million to Belgium-based Quantoom Biosciences, which has developed technology to make mRNA vaccine production easier and less expensive.
Gates said it will grant another $10 million to other LMIC-based vaccine manufacturers to be named later. The newly announced grants follow $55 million in previous investments by the foundation in mRNA manufacturing technology. Previous Gates grants have gone to Quantoom and other organizations or companies working on novel mRNA platforms, both in the U.S. and in other countries, including Leiden University Medical Center in the Netherlands, MIT, SK bioscience in South Korea, Elarex Inc. in Canada, and others.
The Gates Foundation has been working with vaccine manufacturers in LMICs for more than 20 years and is a top funding force in efforts to build vaccine capacity in those countries. In 2022 alone, for example, Gates committed $194 million specifically to vaccine development, according to its annual report.
But while the push to develop COVID vaccines was a genuinely historic accomplishment for science and the pharmaceutical industries, it also highlighted inequities in vaccine access between wealthier and poorer nations. Due to its size, assets and capacity, the Gates Foundation is in a position to work in public-private partnerships with governments and international vaccine organizations — such as the World Health Organization, Gavi and UNICEF — to build vaccine equity. Of course, it’s also worth noting that the Gates Foundation’s preponderant position as the world’s leading private global health funder has also exposed it to criticism on that front, criticism that also extends to stances taken by Bill Gates himself.
At the same time, the Gates Foundation is hardly the only major philanthropy in the picture here. Vaccine equity has also risen as a priority for other important global health funders, including U.K.-based Wellcome Trust (Wellcome’s U.S.-based health research accelerator spinoff Wellcome Leap has also been pushing mRNA technology) as well as the Rockefeller Foundation, Mastercard Foundation, Open Society Foundations and LEGO Foundation, among others.
Meanwhile, one notable element of Gates’ recent grants is a focus on local capability — putting RNA vaccine development technology into the hands of drug manufacturers based in and run by people in LMICs. That’s true of the awards to Senegal’s Institut Pasteur de Dakarl and to South Africa’s Biovac, at least. (Not so much with the Belgium-based Quantoom Biosciences.) This will give regional health professionals and decision-makers more power to respond to local health priorities like malaria and TB — health threats that they are in the best position to understand and that have not been top areas of focus for first-world pharma.
The lopsided record of COVID vaccinations, which were available more quickly and widely in the U.S. and other wealthy countries than in many LMICs, demonstrates that building local, end-to-end vaccine manufacturing capacity worldwide is an absolute must as the threat of serious disease, epidemics and pandemics continue to rise.
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