Date: 14 November 2018
The NIHR has awarded £5 million of global health funding for research into how infectious diseases spread and develop into epidemics in low- and middle-income countries, so that new vaccines can be tested in clinical trials or used more effectively in future outbreaks.
Vaccines are an important way of responding to outbreaks of deadly infectious diseases - such as Ebola, Plague, Zika and Chikungunya - and for immunisation to prevent outbreaks.
The best way to test the efficacy of new vaccines is during a disease outbreak, but outbreaks occur sporadically and unpredictably. In addition, the main public health priority during an epidemic is to prevent spread and protect lives rather than undertake clinical trials.
Other factors, such as human behaviour, can also influence how effectively vaccines can be tested and rolled out during epidemics.
This new funding will support research into how epidemiological models, tools and technologies can assist with clinical trials and deployment of new vaccines in outbreak situations in low- and middle-income countries.
This research is funded by UK aid funding from the Department of Health and Social Care and delivered through the National Institute for Health Research (NIHR) Policy Research Programme.
The funding for this research call was recommended by the UK Vaccine Network, chaired by Professor Chris Whitty, Chief Scientific Adviser to the Department of Health and Social Care, following the 2014-2016 Ebola outbreak.
The network supports research to help low- and middle-income countries prepare to use vaccines to prevent and respond to future infectious disease outbreaks.
Professor Chris Whitty said: “This research is part of a concerted effort to control outbreaks of the world’s deadliest diseases. Supporting research into promising vaccines and ways of delivering them has the potential to save thousands of lives in the future. I am delighted that the NIHR, with UK aid funding, is supporting world-class global health research that will deliver benefits for patients and the public in low- and middle-income countries.”
The £5 million of new funding has been awarded to five research projects: three of which will be led by researchers at the London School of Hygiene & Tropical Medicine and two by the University of Oxford.
At the London School of Hygiene & Tropical Medicine, Professor John Edmunds and colleagues have been awarded £1.5 million for the Vaccine Efficacy Evaluation for Priority Emerging Diseases (VEEPED) consortium.
Their research will use dynamic modelling techniques to investigate how different infectious diseases emerge and spread. The researchers will then use these models to investigate which trial designs might have the best chances of successfully testing a new vaccine during an epidemic, as well as how existing vaccines might be optimally deployed in practice.
Professor John Edmunds said: “The Ebola outbreak in West Africa highlighted the need for new vaccines to help prevent and control outbreaks of rare and highly dangerous infectious diseases. However, testing vaccines against these diseases is very difficult, as the outbreaks are unpredictable and often short-lived. The VEEPED project will use mathematical and statistical models to design vaccine trials against these highly virulent pathogens and suggest how these vaccines might best be used to control these outbreaks.”
Dr Chrissy Roberts and his team have been using tablets and an app called Open Data Kit to collect data for research studies. Their new research will develop this software and other electronic tools for use in outbreak emergency situations, allowing the emergency response to collect and use data to make decisions during an epidemic.
Human and sociopolitical perspectives on vaccines and outbreaks - including political and economic factors, health system perspectives, and community perceptions and experiences of vaccination - can affect whether vaccines can be used effectively in an emergency situation. Dr Shelley Lees and colleagues at the London School of Hygiene & Tropical Medicine will use anthropological approaches to explore these factors and their influence on vaccine deployment in five countries.
Dr Shelley Lees said: “It's crucial to understand how different communities respond to vaccine programmes - for example, not all communities have positive relationships with national and international organisations that distribute vaccines, and these tensions can be made worse in an emergency situation. Drawing on stakeholder and community views we can study political, economic, and health system perceptions and dynamics to identify barriers and facilitators to the future deployment and administration of vaccines during epidemics. This will ensure that vaccine deployment strategies are acceptable to different communities.”
At University of Oxford, Dr Ben Cooper and his team will investigate how genetic information from infectious pathogens can be used to measure vaccine efficacy during an epidemic, as well as the merits of new methodologies for clinical trials in which interim results are used to change the trial during its delivery.
Dr Ben Cooper said: "We are developing innovative solutions to the problem of how to determine vaccine effectiveness in infectious disease emergencies, such as the Ebola epidemic of 2014-16. We aim to find how we can use genetic data from pathogens to better evaluate vaccine benefits, how we can run trials that tell us which vaccines and deployment strategies are most effective faster, and how new approaches to epidemic forecasting can help us evaluate vaccines in such emergencies. "
Professor Martin Maiden and colleagues, also in Oxford, will look at new laboratory techniques to distinguish between the three types of bacteria that cause meningitis, so the most appropriate vaccines can be deployed in an outbreak.
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