Emerging infectious diseases: A proactive approach

Abstract

Infectious diseases are now emerging or reemerging almost every year. This trend will continue because a number of factors, including the increased global population, aging, travel, urbanization, and climate change, favor the emergence, evolution, and spread of new pathogens. The approach used so far for emerging infectious diseases (EIDs) does not work from the technical point of view, and it is not sustainable. However, the advent of platform technologies offers vaccine manufacturers an opportunity to develop new vaccines faster and to reduce the investment to build manufacturing facilities, in addition to allowing for the possible streamlining of regulatory processes. The new technologies also make possible the rapid development of human monoclonal antibodies that could become a potent immediate response to an emergency. So far, several proposals to approach EIDs have been made independently by scientists, the private sector, national governments, and international organizations such as the World Health Organization (WHO). While each of them has merit, there is a need for a global governance that is capable of taking a strong leadership role and making it attractive to all partners to come to the same table and to coordinate the global approach.

Keywords: Ebola; Zika; emerging infectious diseases; human monoclonals; vaccines.

Fig. 1.

Schematic representations of the progression of some emerging diseases (Top), the progression of vaccine development activities following an emerging infection (Middle), and the steps required for vaccine delivery using the present, reactive, approach compared with the proposed, proactive, approach for vaccines and human monoclonals (Bottom). Temporal scales and frequency of cases are for illustrative purposes only and differ for each disease. Industry indicates large vaccine manufacturers.

Fig. 2.

Schematic representation of the most common viral vectors used to deliver synthetic gene coding for vaccine antigens into a mammalian cell (Left) or fully synthetic vaccines based on RNA and DNA (Right).

Fig. 3.

Schematic of a global collaborative approach to emerging infectious diseases. Dotted lines represent funding flows. Solid lines represent processes and information.