READINESS FOR EMERGING
INFECTIOUS DISEASE OUTBREAKS
Public–private partnerships to advance
rapid availability of medical countermeasures
As recent disease outbreaks have shown, our national health security is increasingly tied to global health security.
Yet, it can be extremely challenging to establish strong, sustained public and private investment to develop
medical countermeasures (MCMs) to prevent and mitigate health effects before an emerging infectious disease
becomes a public health emergency in the United States and worldwide.
Participants at a workshop of the Institute of Medicine, a division of the National Academies of Sciences,
Engineering, and Medicine, discussed the importance of public–private partnerships in funding rapid creation of
MCMs. Their thoughts on the current challenges and potential opportunities for improvement are below.
WHAT ARE SOME CURRENT CHALLENGES IN RAPID DEVELOPMENT OF MCMs?
FUNDING
for MCM development
In recent years,
in the public sector has continually decreased.
WHAT ARE SOME OPPORTUNITIES FOR IMPROVEMENT?
Improving business market
opportunity, like long-term
contracts for product development,
manufacturing, and procurement.
Providing multiyear federal
appropriations to prevent delays
in or termination of viable
pharmaceutical development.
? Daniel Abdun-Nabi,
? David Vaughn, GSK Vaccines
Emergent BioSolutions
Establishing clear
development paths and
Involving economists and global
funding for small companies
risk analysts to better understand
and convey the impacts of inaction. to spread costs and risk.
? John Rex, AstraZeneca
? Wouter Latour, Vaxart
Prior to and during a public health emergency,
between the
lacking
government and private partners can create
gaps in information and challenges in presenting
aligned needs and costs to the public.
COMMUNICATION
WHAT ARE SOME OPPORTUNITIES FOR IMPROVEMENT?
Developing clearer language
for communicating with the
public about vaccines and
treatments for emerging
infectious diseases.
Engaging the media to increase
public understanding of the cost
of inaction and the need for MCM
vaccines to sustain the national
funding base.
? Jeremy Farrar, Wellcome Trust
? Peter Daszak, EcoHealth Alliance
Ensuring that the public
understands that there is
currently not a sufficient pipeline
for MCMs ready to respond
quickly to an array of threats.
Increasing communication and
coordination around sharing risk
and cost between government
and industry partners.
? Rajeev Venkayya,
? Monique Mansoura,
Takeda Pharmaceuticals
Novartis Vaccines and Diagnostics Inc.
Many opportunities have been identified within
, but
MCM
sufficient support of these initiatives could assist
in more realized and sustainable progress.
RESEARCH & DEVELOPMENT
WHAT ARE SOME OPPORTUNITIES FOR IMPROVEMENT?
Developing multi-target drug
platforms that could be used
for more than one infectious
disease and use resources
more efficiently.
Using animal and human data
to identify an immune marker
that can predict protection in
vaccines can help accelerate
regulatory approval.
? Mark Feinberg, Merck & Co., Inc.
? Marion Gruber, FDA
Having an orphan drug–type1
incentive to encourage
development of MCM for
uncommon infectious diseases.
Having Phase III–ready2 assets
available, even without licensure,
to cut the time needed to deploy
approved vaccines.
? Robert Garry, Tulane University
? Joseph Larsen, BARDA
Often public health emergencies are not deemed
; however, they
issues of
can still have national security implications.
NATIONAL SECURITY
WHAT ARE SOME OPPORTUNITIES FOR IMPROVEMENT?
Promoting better public
understanding of the social,
economic, and behavioral risks
of emerging infectious diseases
can help make the connection
to national security.
Augmenting investment in diagnostics can be key to global
capacity building for emerging infectious disease response.
? Michael Osterholm, CIDRAP,
? Andrew Weber, U.S. Department of State
Prioritizing top emerging
infectious disease threats to
ensure coordination amongst
national resource and labor
distribution would help to
properly address identified
threats.
University of Minnesota
An orphan drug is defined as a drug intended to treat a condition affecting fewer
than 200,000 persons in the United States, or which will not be profitable within
7 years following approval by the FDA. For more, see
http://www.fda.gov/downloads/Drugs/DevelopmentApprovalProcess/
SmallBusinessAssistance/UCM311928.pdf
1
According to the NIH, Phase III clinical trials are designed so the drug or treatment is given
to large groups of people to confirm its effectiveness, monitor side effects, compare it to
commonly used treatments, and collect information that will allow the drug or treatment
to be used safely. For more, see https://www.nlm.nih.gov/services/ctphases.html
2
Establishing a cabinet-level power
for public health, such as a seat at
the National Security Council, that
can obtain resources from both
governmental entities and private
industries, could help create a
higher profile for public health.
? Tara O’Toole, In-Q-Tel
Focusing more proactive efforts
during inter-epidemic periods to
build sustainable progress,
instead of reacting to each
individual emergency.
? Gerald Parker,
Texas A&M Health Science Center
? Robin Robinson, BARDA
WHAT IS THE COST OF INACTION?
FINANCIAL COST OF SARS TO FINANCIAL COST OF EBOLA
PROJECTED COST OF A MODERATE
GLOBAL ECONOMY IN 2003: TO WEST AFRICAN ECONOMIES FLU PANDEMIC:
$
IN 2014: $
$
MORE THAN
BY END OF 2015
40 BILLION
Sidorenko, A. A., and W. J. McKibbin.
2009. What a flu pandemic could cost the
world. Washington, DC: The Brookings
Institution.
32 BILLION
World Bank. 2014. Update on the economic
impact of the 2014 Ebola epidemic on Liberia,
Sierra Leone, and Guinea. Washington, DC:
World Bank Group.
1 TRILLION
Burns, A., D. van der Mensbrugghe, and H. Timmer.
2006. Evaluating the economic consequences of avian
influenza. Washington, DC: World Bank.
Learn more and download the free workshop
summary at nas.edu/rapidMCMresponse
Disclaimer: This infographic summarizes information presented at a workshop. Statements and opinions of opportunities for improvement are those of
individual participants; are not necessarily endorsed by the National Academies of Sciences, Engineering, and Medicine; and should not be construed as
reflecting any group consensus.

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