Influenza belongs on the CEPI 2.0 Agenda
Influenza research indisputably accelerated the response to COVID-19. This same expertise and infrastructure should be leveraged to stop the next pandemic. Read more to learn why influenza should be on the CEPI 2.0 Agenda for investment.
In a world craving optimistic predictions on the future course of COVID-19, many greet the potential transition from pandemic to endemic as good news.
Others, however, warn against fatigue and complacency, and of taking false comfort in declarations of endemicity, a term without a firm definition. Both camps compare SARS-CoV-2 to influenza and speculate as to whether or when the two viruses will become equally disruptive.
They should be careful what they wish for.
Aspiring to influenza-like COVID-19 is to accept another disease known to kill 290,000 – 650,000 and hospitalize 5 million every year, in addition to posing a certain and severe pandemic threat. A virus as deadly as the 1918 strain, which killed about 3 percent of the world’s population, would today cause more than 230 million deaths. And just as official COVID-19 case counts and mortality rates vastly underestimate the immediate toll of the pandemic—let alone social and economic consequences expected to last for generations—the same is true for the true burden of seasonal influenza, particularly in low- and middle-income countries.
Instead, as recently advocated by three former members of the Biden-Harris COVID-19 Advisory Board, we must recognize and address SARS-CoV-2 as “but one of several circulating respiratory viruses that include influenza, respiratory syncytial virus (RSV), and more.” This will entail developing adaptable defenses like the viral vector and mRNA vaccine platforms that have proved crucial to subduing COVID-19. The Coalition on Epidemic Preparedness Innovations (CEPI), a preeminent supporter of platform-based and prototype pathogen approaches to vaccine development, aims to build on its COVID-era leadership to further advance the design, rapid production, and equitable distribution of pandemic-preventing vaccines.
At this week’s Global Pandemic Preparedness Summit, jointly sponsored by the UK government, CEPI made the case to pursue those goals through a five-year, $3.5 billion pandemic plan it calls CEPI 2.0. Beyond the development of next-generation COVID-19 and pan-coronavirus vaccines, CEPI’s sights are trained on select emerging viral diseases of high pandemic risk: Ebola, Lassa, Middle East Respiratory Syndrome (MERS), Nipah, Rift Valley Fever, and Chikungunya—along with the yet unidentified Disease X: a role fulfilled for the first time, but surely not the last, by COVID-19. Missing from this list, which has defined CEPI’s purview since its inception in 2017: influenza.
Missing from this list, which has defined CEPI’s purview since its inception in 2017: influenza.
CEPI’s agenda explicitly should invest in pandemic influenza, which could be accomplished by leveraging existing expertise, funding and infrastructure directed toward the improvement of influenza vaccines.
Previously CEPI has omitted influenza from its portfolio on the grounds that flu research received a disproportionate share of funding in comparison with research on other diseases with pandemic potential. That stance may once have been defensible, but post-COVID reality favors an approach that encompasses the spectrum of likely pandemic agents. By not including influenza among its priority pathogens, CEPI has forfeited an opportunity fully to engage the respiratory virus vaccine community in research and development applicable to multiple pathogens. This is a disappointment, given CEPI’s self-described role as “an organising force for global R&D collaboration and scientific innovation.”
Driven by the laudable aspiration to achieve development—within 100 days of pathogen detection—of safe and effective vaccines to thwart epidemic and pandemic threats, CEPI 2.0 comprises three pillars: preparing for known threats; transforming future responses to novel threats by enabling science programs and manufacturing innovations; and, connecting with global manufacturing and research networks to initiate establishment of a pandemic preparedness and response ecosystem. Each pillar represents an opportunity for the influenza community to both contribute to and benefit from CEPI’s mission.
Decades of influenza vaccine research informed the rapid development of diverse, effective vaccines against COVID-19. The future lies in durable, broadly-protective vaccines like those long sought for influenza, and now—supported by CEPI—for betacoronaviruses; synergies between those efforts could only be enhanced by CEPI’s embrace of influenza. This is but one example of the potential benefits to be realized by directly connecting CEPI’s investments on behalf of its existing pathogen portfolio with the influenza vaccine ecosystem’s thousands of researchers and capacity for sustainable inter-pandemic manufacturing and delivery systems: a strategic collaboration emblematic of a comprehensive approach to pandemic preparedness and prevention.