Fast-tracking a Lassa fever vaccine

LONDON — The COVID-19 pandemic may have exposed the vulnerability of the world’s health systems, but it also led to a truly impressive achievement: the development and production of life-saving vaccines more quickly than ever before. As our focus shifts to other public-health challenges, we must harness these technologies and apply the lessons learned during the pandemic to address other deadly diseases that require urgent attention. One of these diseases, Lassa fever, has been ravaging West African countries for over 50 years, and yet there is still no vaccine to prevent its spread.

Work is already underway to protect communities against the disease, which causes hemorrhagic fever and kills about 5,000 of the hundreds of thousands of people infected each year in West Africa. The Coalition for Epidemic Preparedness Innovations (CEPI) has invested in six Lassa fever vaccine candidates, four of which are among the first in the world to have entered clinical trials. Collaborating with authorities in Nigeria, Benin, Guinea, Liberia, and Sierra Leone, CEPI is also conducting a multi-country epidemiology study that will inform future clinical trials.

But these initiatives require the same cross-sector collaboration and investment that underpinned the success of the COVID-19 vaccines. That means sustained financing and engagement by governments, the private sector, academia, and philanthropic organisations in the affected countries. It is crucial to build systems within states that can deliver the vaccine once authorised. Domestic leadership is essential, but other stakeholders can also play a crucial role in supporting research and development efforts.

On a more granular level, the revolutionary use of mRNA technology to immunize against COVID-19 has opened new possibilities that could be explored in preventing Lassa fever. Besides the potential for rapid development, mRNA vaccines offer several other advantages, such as increased stability and scalability, reduced risk of contamination, and amenability to modification to address new variants or strains. While challenges such as affordability and availability must still be addressed, the potential contribution of these new technologies to the fight against Lassa fever cannot be ignored. While recognising the potential advantages of mRNA technology, further investigation and research are necessary to evaluate fully its feasibility and effectiveness in combating Lassa fever.

Furthermore, the COVID-19 vaccine trials demonstrated the importance of collaboration and careful planning. The same level of rigor must be applied to clinical trials for Lassa fever vaccines, which must be tested in areas where the disease is endemic and recruit enough participants. It is essential that any vaccine candidate be safe, effective, and inclusive. By investing in robust clinical trials, we can ensure that the vaccines meet the standards needed to gain the trust of the public.

The vast disparity between rich and poor countries’ access to vaccines during the pandemic has highlighted the need for robust global health infrastructure. While efforts like the COVAX initiative were established to enhance access for poor countries, global vaccine distribution remains a complex task. Guaranteeing equitable access to a Lassa fever vaccine will require developing effective delivery mechanisms and putting the most affected and vulnerable communities first.

This is a moral imperative. Governments, international organizations, and the private sector must work together to build local infrastructure, make supply chains more sustainable, and invest in health workers and systems. Without these efforts, there is a risk that those who are most in need will continue to be left behind, perpetuating the inequalities that were exposed by the pandemic.

As we saw with COVID-19, public engagement and communication play a crucial role in the success of any immunisation campaign, and misinformation can hinder efforts to control infectious diseases. Clear and accurate messaging about the safety and efficacy of vaccines, tailored to the specific context of each country or region, is essential to building public confidence. By emphasising public engagement and involving community leaders, healthcare workers, and other stakeholders, we can improve the chances of widespread uptake when a Lassa fever vaccine becomes available.

West African countries must take an active role in driving the agenda for Lassa fever vaccine development and procurement rather than passively waiting for solutions. They can contribute the necessary funding, data, and resources to develop this critical tool for protecting vulnerable communities and strengthening the region’s health security. In addition, countries must proactively consider their strategies for vaccine deployment and the data required to inform such decisions. Thoughtful planning and the identification of key factors, including target populations, distribution channels, and logistical considerations, can help streamline the implementation process once a vaccine becomes available.

The lessons learned from the COVID-19 pandemic and the success of collaborative efforts can serve as both a source of inspiration and a guide for these countries’ policymakers. They have an unprecedented opportunity to protect their populations and demonstrate the power of local engagement and leadership in shaping global health initiatives. If they succeed, the world will be one step closer to a future where vaccines are widely accepted and readily used in the fight against all infectious diseases.

The views expressed here are not necessarily those of CEPI.

Oyeronke Oyebanji, Chief of Staff for Policy and Partnerships at the Coalition for Epidemic Preparedness Innovations, is a doctoral candidate at the London School of Hygiene and Tropical Medicine. Copyright: Project Syndicate, 2023. www.project-syndicate.org