Vaccination alone will not halt the next global pandemic

A US$1-billion initiative was launched in January 2017 with the aim of having vaccines ready in order to prevent the next global pandemic. The Coalition for Epidemic Preparedness Innovations (CEPI) was launched at the World Economic Forum in Davos, Switzerland, with US$460 million in backing from Norway, Germany, Japan, the Wellcome Trust and the Bill & Melinda Gates Foundation.1-3 The organization expects to raise the full US$1 billion that it needs for the next 5 years by the end of this year. 1-3 Moreover, CEPI has selected 3 pathogens on which to focus their initial vaccination efforts. 1-3 However, the vaccines for these pathogens are in the very early stages of development (preclinical stage) and may take decades before they are ready for use in an epidemic. 2 Despite Bill Gates’ claim that DNA/RNA vaccines (third-generation vaccines) can serve as a ‘vaccine pipeline’ to accelerate vaccine development against other pathogens, there is no licensed DNA or RNA vaccine approved by the US Food and Drug Administration for human use. 4 There is no Th1-adjuvant in existence which may prove to be a vital component of a future viral vaccine. Furthermore, a vaccine, once developed, cannot be tested in a Phase II or III Clinical Trial as there are few or no cases outside an epidemic for most of the potential pathogens. I believe CEPI's focus solely on vaccination is a mistake. CEPI needs to carefully consider other innovations (passive immune therapy, antiviral drug discovery, adjuvant discovery, high-throughput viral genome sequencing) and capacity building initiatives (diagnostics, real-time reporting, zoonotic surveillance in animal reservoirs, mathematical modelling, GIS risk mapping) that will compliment vaccination.