Here at the World Vaccine Congress, we are looking forward to our next event in Barcelona in October 2022. Speaking at the Congress will be Dr Charlie Weller, Head of Prevention, Infectious Disease at the Wellcome Trust. We caught up with her about what we can expect from her panel and some of the things that have been on her mind recently.
Vaccines in the AMR toolbox
Dr Weller’s panel will focus on the “global burden” of AMR. We asked what role vaccines can play in alleviating this. She described the role of vaccines as “huge” but “under-recognised and under-valued as part of our global toolbox” against AMR.
“Vaccines directly prevent infection, carriage, and transmission of infectious diseases by inducing immunologic protection against individual pathogens”.
Furthermore, Dr Weller believes that through the development of new vaccines and increasing the use of current vaccines we can reduce our reliance antimicrobial therapy and add another approach in our toolbox. It’s important to remember that “vaccines can also reduce the symptoms that can lead to antibiotic seeking behaviours” so use of viral vaccines such as for influenza or rotavirus can also have an indirect impact on AMR.
When we considered the fact that AMR is one of the WHO’s top ten global health threats, we asked how the necessary collaboration and cooperation for “multi-sectoral action” could be achieved. Dr Weller stated that it is imperative to look to other areas and sectors. She referred to CEPI – the Coalition for Epidemic Preparedness Innovations. This is a foundation that draws together donations from different areas to fund vaccine development projects. She also thinks that “prioritisation and clarity on what needs to happen” are important to steer funding and activities. We often hear the term ‘global world’ thrown around, and this might be one instance where it is particularly important to connect the different projects to form one concerted effort.
Dr Weller’s experience
Dr Weller is a hugely experienced researcher whose time at Wellcome has included the development of vaccine strategies and epidemic responses. Her background enabled her to see that the “AMR and vaccines communities were relatively separate and not coming together”. As vaccines remain a “relatively under-recognised tool for combatting AMR”, Wellcome has invested in building evidence for this over the last 5 years. Alongside “building the evidence base”, Dr Weller’s team has “evaluated the possibilities for vaccine development in the WHO AMR list”. This was further developed by the WHO in their first-ever report on the pipeline of vaccines against AMR bacterial pathogens.
Keeping the pressure on
We asked Dr Weller about the potential distractions that arise when new diseases emerge. She believes that it is “critical” to maintain momentum in research and development “otherwise the disease we have taken our eyes off becomes the threat of tomorrow”. A recent example of this is monkeypox, which has “been around for years but not had the momentum or attention” that it demands.
“AMR is a slow burn pandemic”.
Dr Weller warns that, “in a similar way to climate change”, AMR will require a “coordinated and multifaceted approach”. She also thinks we will need to prepare for “not only pathogens that are currently drug resistant” but also those that are “on a trajectory to become drug resistant”. While keeping the pressure on AMR, Dr Weller also believes that we must be sensitive to pathogens that “lead to antibiotic seeking behaviours”, such as respiratory viruses, including influenza.
Vaccine challenges and potential solutions
As an expert in vaccine development and taking a lead on such projects, Dr Weller has an insight into some of the challenges that her community is facing. She suggested that in a “limited commercial market” the challenge is “who finances vaccine development”. The “normal commercial markets do not drive the financing”, she states. AMR fits into this, but “also diseases that disproportionately affect LMICs and epidemic diseases”. Thus, organisations like CEPI have been created to “focus on equitable access to try and overcome the challenge of limited or unknown commercial markets”.
She directed us to a 2021 report by Wellcome that states that “without significant reform of the markets and ecosystem which drive vaccine development”, the world won’t see vaccines against some of our most infectious diseases.
Dr Weller’s role is pivotal in public health responses so we wanted to understand how she thinks the scientific community can keep the attention and the approval of the public. She emphasises the importance of “support” for scientists, to empower them to “convey complex situations and uncertainty”.
“There is a key role for the media, and journalists need to have support to report a balance of views with evidence to back them up”.
She is wary of “overinterpretation” by the media and identifies the Science Media Centre as a “great example of the close interaction between media and scientists”. Clearly this is a relationship to be nurtured.
Facing the future
Finally, we asked Dr Weller about health threats that we might be able to anticipate. Interestingly, she suggests that the danger lies with us as much as the diseases: “we need to have a greater understanding of the sources and drivers of infectious diseases”. She is concerned that “lack of forward planning and preparedness” will undermine the strides we continue to make.
“In addition, we need to match [this understanding] with affordable and accessible medicines that can be used to control escalating infectious diseases”.
We are grateful to Dr Weller for her time and the thoughtful answers she provided to our questions! To hear her live at the World Vaccine Congress in October, get your tickets here.