The Guinean village of Meliandou lies in a poverty-wracked triangle of forest in West Africa on the border with Liberia and Sierra Leone. It was there, according to the World Health Organisation (WHO), that on Boxing Day 2013 a two-year-old boy fell seriously ill. A couple of days later, he died.
No one knew it then, but that boy was the first case in a three-year ebola epidemic that is known to have infected almost 30,000 people and killed more than 11,000, though the true rates are likely to be much higher.
三级成人视频Some 18 months after death came to Meliandou, it triggered action 4,000 miles away, in Downing Street. In June 2015, David Cameron, then prime minister, established the UK Vaccine Network (UKVN) “to ensure that the UK was at the forefront of the global fight against future disease outbreaks”.
But Cameron wasn’t just worried about outbreaks abroad. He was worried about their impact on an unready Britain.
UKVN set up a working group of experts, some of whom today have become household names. Chris Whitty, then of the London School of Hygiene & Tropical Medicine, now the Chief Medical Officer, was one. Prof Sarah Gilbert, now leading Britain’s most advanced effort to develop a Covid-19 vaccine at Oxford University’s Jenner Institute, was another. The group drew up a priority list of 13 diseases that caused them most concern. It included plague, ebola, dengue, rift valley fever, as well as the coronavirus behind Middle East Respiratory Syndrome (Mers).
Last September the panel released a report, revealing progress in two crucial areas – R&D and manufacturing vaccines against epidemic diseases. On the former, they were upbeat. The post-ebola panic had led “to the prioritisation of spending in emerging diseases vaccine research and development from the UK”.
But on manufacturing, they were gloomy. “We have very little left of what was once the world’s leading vaccine industry,” says Karl Simpson, a biochemist with 40 years of experience in the vaccine industry, who co-authored the UKVN working group report. “Today, manufacturing [vaccines] at scale in this country, unfortunately, is not possible. And I think our capacity to suddenly turn over new manufacturing capability to Covid-19 is wishful thinking.”
三级成人视频It is a problem that has been a long time in the making, and is based on the fact that vaccines – complex, live agents, which need to be frequently updated – are highly sensitive to the economies of scale. Costs drop (and profits rise) the more you make.
In the last decades, that logic has driven huge consolidation in the vaccine business. Wellcome, founded in Britain in 1880, merged with Glaxo in 1995, and SmithKline Beecham (itself the result of successive mergers) in 2000, to form GSK, which in 2014 bought the vaccine business from its competitor, Novartis. Today WHO figures show that 80pc of the vaccine market is shared by just four companies: GSK; Pfizer, Merck and Sanofi-Pasteur. And while GSK is British, its vaccine hub is in Belgium.
三级成人视频In fact, Britain has only two vaccine factories, run by AstraZeneca and Seqirus. And only the latter, at Speke, near Liverpool, makes injectable vaccines of the type used to treat the overwhelming number of viruses.
“Long gone are the days when Wellcome was one of the world’s leading vaccine manufacturers,” says Simpson.
The Government admitted as much when in 2017 it announced a plan to build a new £66m Vaccine Manufacturing Innovation Centre (VMIC). “The UK has strong expertise in researching new vaccines,” it noted. “However, there are gaps in our ability to develop, commercialise and manufacture new vaccines.”
三级成人视频But even when VMIC is up and running in 2022, its focus is likely to be on pilots and medium-scale projects producing just tens or hundreds of litres of vaccine.
三级成人视频The cost of building a major vaccine factory alone is about £800m. So as the vaccine industry has contracted, countries have stepped in.
In America, the US government had committed to a $1bn (£800m) Covid-19 vaccine deal with titan Johnson & Johnson, co-financing research through the Biomedical Advanced Research and Development Authority (Barda).
三级成人视频“If you look at long-term preparedness, the US government has put huge amounts of money in with Barda and the military,” says Hugo Fry, Sanofi’s UK general managing director.
In India, public sector contracts have supported a dramatic growth in domestic vaccine manufacturing, with the country now making more doses each year than the top four vaccine manufacturers. China and South Korea, too, have stepped in to support, or create, vaccine manufacturing capacity. “Some nations,” says Simpson, “decided that it was strategically important to maintain their manufacturing capacity or to build it in the first place.”
Such national capacity is critical at a moment when every country is scrambling to secure supplies to battle Covid-19. For example, Matt Hancock, the Health Secretary, famously put Germany’s crucial advance in testing down “in large part to [Swiss-German] Roche, one of the biggest diagnostic companies in the world”.
What will happen with vaccines? “The United States has made it quite clear that Americans come first,” says Simpson. In Britain, by contrast, “there is evidence,” says Fry, “that the eye has been taken off the ball” by successive governments. Cost-cutting, he says, led Britain’s major vaccine buyer, the NHS, to initiate a price war. “If government and the NHS go into vaccines thinking we’ll drive down prices, the supply will just dry up.”
Rather than encouraging competition, that tactic means, for some vaccines, the UK is reliant on just a single manufacturer. The latest minutes of the official Joint Committee on Vaccination and Immunisation (JCVI) notes “concerns regarding resilience in the supply chain … it would be preferable to have the option of more than one supplier”.
三级成人视频Within government, according to multiple sources, battles have been fought to defend the UK manufacturing capacity and bolster funding. One such champion, apparently, was David Salisbury, director of immunisation at the Department of Health. After he left in 2013, said one source, “vaccines didn’t have the same role”.
三级成人视频Ironically, the Chief Medical Officer (CMO), who now finds himself battling a pandemic in a country without large scale vaccine manufacturing capacity, was among those who strenuously challenged the vaccine policy.
“Since Chris Whitty has taken over as CMO things have changed [for the better],” said one source. The Government has committed £250m to Cepi – the international coalition to find a vaccine. But that will fund research. “It won’t go any way to facilitating manufacturing at scale,” says Simpson.
“We need to restore some serious manufacturing capability in the UK,” he says. “To do so would cost a few billions. Frankly, that’s a mere blip now. Because what are we going to do when the next great pandemic hits? We’ve got very limited manufacturing capability here. Think about plague, or monkey pox.”
三级成人视频Britain suffered its first outbreak of the latter, which is fatal in up to 10pc of cases, with four cases in 2018. There is currently an outbreak in Nigeria. “There are plenty of other things which could come back to haunt us.”