Developing vaccines for underserved populations
Vaccine development for underserved populations depends on manufacturing technologies that can be transferred locally and financial arrangements suited to limited commercial returns.
Manufacturing compatibility
In 2022, the Developing Countries Vaccine Manufacturers Network comprised about forty institutions in Asia, Africa and Latin America, with yeast fermentation for recombinant protein vaccines among their widely used technologies. Bangladesh, China, India and Indonesia already used that approach to produce recombinant hepatitis B vaccines locally.
The Texas Children’s Hospital and Baylor College of Medicine Center for Vaccine Development selected technologies compatible with those manufacturers wherever possible, regarding yeast fermentation as a practical route to local production. Because the process used no animal or human cells or proteins, it could also support production of halal vaccines for Muslim-majority countries.
Neglected-disease programmes and financing
The centre developed vaccines against parasitic diseases affecting Africa, Asia and Latin America, including schistosomiasis, hookworm, Chagas disease and leishmaniasis. It described these as antipoverty vaccines because the diseases can perpetuate poverty through effects on child development, work, productivity and pregnancy outcomes.
In its co-director’s 2022 assessment, pharmaceutical and biotechnology investment largely favoured North America, Western Europe and Japan, leaving these neglected-disease markets commercially unattractive. The centre therefore sought sustainable financial models for vaccines expected to yield much smaller returns than products intended for those wealthier markets.
By late 2022, its programmes included human hookworm and schistosomiasis vaccines, with the latter in phase 2 and also addressing female genital schistosomiasis. A prototype Chagas vaccine was expected to enter phase 1 in Mexico in 2023.
COVID-19 access and technology transfer
In the co-director’s 2022 account, North American and European purchases had absorbed available Pfizer and Moderna doses, leaving large unvaccinated populations in Africa, India and Southeast Asia. He linked the emergence of Delta in unvaccinated populations in India and South Asia and Omicron in unvaccinated or undervaccinated Southern African populations to vulnerabilities created by inequitable vaccine access.
The centre began coronavirus-vaccine development for SARS and MERS around 2012 and later extended it to COVID-19. It applied its low-cost SARS and MERS vaccine technology to COVID-19 and transferred it without patents to manufacturers that scaled production in India and elsewhere. Its transfers included India, Indonesia, Bangladesh and Botswana, supported by local governments and private philanthropy after exclusion from Operation Warp Speed and little G7 support.
Hyderabad-based Biological E produced the transferred vaccine as Corbevax and owned its technology, an arrangement the centre presented as shifting ownership to a low- or middle-income-country producer and demonstrating what academic–manufacturer partnerships could achieve without a multinational pharmaceutical company. Corbevax received emergency-use authorisation in 2021 and was first given to adolescents on 15 March 2022. By late 2022, more than seventy-five million doses had been administered to Indian adolescents aged twelve to fourteen, and it was also being used as an adult booster. The centre hoped to reach one hundred million doses by the end of 2022 or early 2023; WHO approval was still anticipated, while Biological E pursued uptake in other low- and middle-income countries.
A similar antigen developed with Indonesia’s BioFarma had received Indonesian approval as IndoVac by late 2022. The centre expected its animal- and human-material-free technology to make IndoVac one of the early halal vaccines for Muslim-majority countries.