Although much was made of the announcement on 9 November by Pfizer that its phase-three trial for a Covid-19 vaccine had shown effectiveness of more than 90% – followed a week later by a similar development from Moderna – the World Health Organisation (WHO) doesn’t expect widespread vaccinations against the virus until mid-2021.
Given that the data behind both the Pfizer and Moderna vaccines still has to be peer-reviewed, and there are questions to answer regarding cost, distribution and how effective they are in the long term, the race is still on among an elite group of global biotech hubs to assert scientific supremacy by delivering an effective Covid-19 vaccine that can be safely distributed on a global level. Pfizer and Moderna have established themselves as the early front runners, but they may not be the final victor.
Of the top ten teams in phase-three human trials, four are Chinese, four are from the US, and there is one each from the UK and Russia. As the battle of the superpowers rages elsewhere across economic and political lines, the vaccine discovery playing field looks eerily familiar.
• UK – University of Oxford/AstraZeneca
• US – Janssen Pharmaceutical Companies
• US – BioNTech/Fosun Pharma/Pfizer
• US – Novavax
• US – Moderna/NIAID
• China – Sinovac
• China – CanSino Biologics Inc./Beijing Institute of Biotechnology
• China – Beijing Institute of Biological Products/Sinopharm
• China – Wuhan Institute of Biological Products/Sinopharm
• Russia – Gamaleya Research Institute.
According to Investment Monitor chief economist Glenn Barklie, biotech investment has not only bucked the global economic downward trend in 2020, but he expects to see significant investment going further.
“The Covid-19 pandemic has expedited the growth in biotech foreign direct investment [FDI],” he says. “Boston and Cambridge in Massachusetts, Cambridge in the UK, Singapore, Dublin and Shanghai are all at the forefront of biotech investments.”
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Biotech hubs, therefore, have much to gain from this influx of FDI if they can garner global prestige from a vaccine discovery.
US to win the Covid-19 vaccine race?
According to Pitchbook, the second quarter of 2020 saw more than $6.4bn of venture capital funding into US-based biopharma firms, the highest in any previous quarter in the sector’s history. And, indeed, the US is closest to a deliverable solution with the Pfizer/BioNTech team announcing its vaccine in early November, and the Moderna team on November 16.
The Pfizer announcement came just after Donald Trump – who has questioned the safety of other vaccines in the past and had signalled in April that the US would cut its funding to the WHO – had lost the presidential election. President-elect Joe Biden has pledged to rejoin the WHO, signalling a return to a spirit of global cooperation.
However, as weaknesses in the global supply network were exposed at the height of the Covid-19 pandemic, there may well be a move towards onshoring vaccine manufacturing. Pfizer-owned sites in Massachusetts, Michigan and Missouri have been identified as manufacturing centres for the Pfizer/BioNTech vaccine with further sites under selection. German company BioNTech plans to ramp up its production capacity in its home country to increase global supply capacity.
Another challenge for the widespread distribution of the Pfizer/BioNTech solution is cost. The vaccine uses the novel mRNA technology, which requires costly liquid nitrogen cold storage. The US is reportedly being charged $39.09 per dose of the Pfizer vaccine, while the Oxford/AstraZeneca vaccine has been offered to EU countries for $2.96. Even if the US-based vaccine is available first it may not ultimately be the most widespread when weighed against a cheaper alternative.
What about a Chinese vaccine?
According to patent data from research company Cityglobe, the US produced more than half of all antigen and antibody-based vaccine biotech patents between January and October 2020, which puts the country at the cutting edge of research. The US vaccines currently in advanced clinical trials use the mRNA method – genetic messenger molecules that carry DNA code – to generate immunity to a part of the SARS-CoV-2 virus known as the spike protein. China’s vaccine candidates are using more conventional methods – administering a weakened dose of the virus to provoke an immune response – which many believed would be a quicker route to a working vaccine until the Pfzer BioNTech announcement.
Using more tested methods does not mean China is not a contender in the vaccine arms race. China’s business expenditure on research and development (R&D) in pharmaceutical manufacture grew by 264% between 2010 and 2017, according to Cityglobe.
China’s growth in innovation, measured by the OECD definition of biotech patents filed, grew even faster, from 692 in 2017 to 1,323 in 2019 – not far behind the 1,589 biotech patents granted by the European Patent Office that year. However, China racing ahead in the biotech field does not present a significant challenge to the US’s lead position just yet, according to Cityglobe CEO Dr Marek Banczyk.
While China’s global exports of pharmaceuticals grew twice as fast as US pharma exports in the past five years, in bilateral trade of final products the US still leads. This balance is mainly due to the existing high level of US vaccine exports, which grew 84.91% during 2015–19.
OECD figures show business expenditure on pharmaceutical manufacturing R&D in China was still only $13.02bn in 2017, compared with $66.2bn in the US for the same year.
This private R&D spend is dwarfed by the true total of joint public and private investment in China, according to Banczyk.
“There are reports that China is investing up to $800bn in biotech, which exceeds official OECD figures by multitudes, so there is a conflict there, especially that this figure is at least one order of magnitude higher than what the biotech market of China is currently worth,” he says.
The real figure may never be known, which characterises yet another problem in the search for a vaccine – one of trust.
Wherever the vaccine is created, trust is paramount
China has publicly advocated the WHO’s collaboration of scientists, business and global health organisations through its ACT Accelerator programme designed to speed up the pandemic response and eventually facilitate the equitable global distribution of vaccines. This seems to indicate the country’s willingness to cooperate if it were to deliver the first vaccine.
While Russia advances to phase-three trials with its Sputnik V vaccine at the Gamaleya National Centre of Epidemiology and Microbiology, accusations of international espionage have eroded trust in its effort to deliver a vaccine. The UK’s National Cyber Security Centre (NCSC) has said that Russian hackers have targeted organisations involved in developing a coronavirus vaccine in the UK. The NCSC said the hackers were “almost certainly” part of Russian intelligence services.
The Oxford vaccine team punches above its weight
While the US and Chinese vaccine research teams have resources and funding stacked on their side, the team at Oxford has emerged as a plucky outlier punching above its weight.
Professor Chas Bountra is Pro-Vice Chancellor for Innovation at the University of Oxford as well as Professor of Translational Medicine in the Nuffield Department of Clinical Medicine and Associate Member of the Department of Pharmacology at the University of Oxford. To the question of why the Oxford team has been so successful, Bountra says Oxford’s talent pool forms the cornerstone of the project. He describes a combination of superstar biotech academics all with an entrepreneurial outlook that led them to partner with UK pharmaceutical giant AstraZeneca.
Marc Howells, vice-president and global head of talent and learning at AstraZeneca, says the pandemic has further highlighted the scarcity of talent in such specialist areas as biotech engineering and vaccine development.
“Many companies including AstraZeneca are recognising this trend and adjusting our approach to sourcing talent with a more flexible approach in order to reach a wider, more global talent pool – the pandemic has shown us that people can work effectively from a range of locations, which also results in a more diverse workforce as well as solving talent scarcity,” he says.
Barklie concurs on the workforce issue: “The necessity of high-quality talent, especially for R&D operations, is certainly a barrier for many locations. Strong connectivity to universities and other research agencies is of key importance.”
Bountra has high hopes that the Oxford biotech hub can eventually emulate Stanford or Boston with their billionaire endowments and start-up ecosystems. Even without the above, he says: “What we have achieved here at Oxford is little short of amazing. With a single-minded focus, an entrepreneurial mindset and no commercial agenda, we have achieved in eight months what would ordinarily have taken eight years.”
Ultimately, the Covid-19 vaccine challenge is a global one and Bountra believes that rather than focusing on who is first, the world needs a number of vaccines to stand a chance of getting them to everybody who needs them.
“We shouldn’t be nationalistic about it,” he says. “When a vaccine is launched it will be science and data driven, at which point everybody is happy that it is efficacious and safe.”
Whichever team is first to market with a working vaccine, Bountra imagines two or three in the running will be delivered within a similar timeframe. This is the best-case scenario and would mean a depoliticization of the vaccine delivery. Prestige and investment may follow for the biotech hubs that produce a vaccine, but first and foremost will be the safety of populations and a return to some kind of normality.