Dan Page

After seeing the world flounder in response to the Ebola crisis, three academics—Professor Adel Mahmoud of Princeton, Professor Jeremy Farrar of Oxford, and Professor Emeritus Stanley Plotkin of the University of Pennsylvania—had an idea that could help prepare for the next pandemic: Create a global fund for researchers who are developing vaccines that are past the point of being funded by government institutions but aren’t yet attractive to pharmaceutical companies. I recently spoke with Mahmoud about the idea. Our exchange has been edited and condensed.

What problem in vaccine development would the fund address?

It’s a reflection of the difficulties that this world faced when the Ebola outbreak started spreading in West Africa, and we were poorly prepared. In our world, there are a lot of organizations—like NIH, obviously—that support discovery research. We have had three or four—sometimes people will tell you seven—potential vaccines for Ebola that were discovered and put in a freezer. So the area of discovery research, which says, “This is a potential XYZ,” is well-supported.

Now on the other extreme end, when there is an attractive vaccine, particularly for the Big Pharma companies, they will go after it and spend their own money if the vaccine seems to have a market or a need—or there is a global crisis, like what happened with Ebola. Two major pharmaceutical companies took the initiative to develop vaccines and test them. But before this, the response was a failure on a lot of levels. We did not have a vaccine in spite of the fact the virus was discovered over 40 years ago. Possible vaccines were in the freezer—they weren’t ready to be developed and deployed. They had not gone through testing.

In between the discovery and a global disaster, there is what we call the “valley of the death.” That area is where discovery research is being conducted in government laboratories and in academia, but there is no clear-cut use for the vaccine, except preparing for the unseen future, or it is not commercially viable. That is the gap. We need a vaccine for MERS (Middle East Respiratory Syndrome), for example, or SARS (Severe Acute Respiratory Syndrome).

How would the global vaccine fund work?

First, we have to raise the money. Theoretically, money for something like that would need to be raised from government, from philanthropy, or from industry. It should have a board, a medium-sized board of about 12 to 15 ideally, not a big board. The board should represent the key elements in the process of that fund: government, some industry, biotechnology, the philanthropic organizations, maybe the academic and social organizations, and some of the international organizations. It would then open its processes in a very transparent way to be judged by an independent scientific volunteer committee from universities, government, and research institutions. It would have funding based on proposals that are submitted and recommended, and it would absolutely monitor progress and deliverables.

How much money would you want the fund to raise?

Our proposal is for a $2 billion fund. We’re probably talking about between $100 and $200 million to take a candidate product discovered in a laboratory to the end. So, if you have $1 billion, you can fund between five and 10 projects. If you have the $2 billion, you can fund between 10 and 20 projects.

How would you replenish the money?

The main source is to go back to the funders who gave the money and say, “Look, we have accomplished what we set out to do, and we need some money.” Another theoretical angle—and at this point it’s very theoretical—is that if the fund helps the development process for a vaccine, and it is picked up by the industry and sold in the developed world, then we say, “We need you to put back some of the profits into the fund.” But it would mostly be from fundraising.

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