Rebecca Grais, director of research, Epicentre, Médecins Sans Frontières
« Having solid and engaging discussions is often the way that great progress can be made ».
What are the issues that you face in your research on vaccines?
One of the purposes of my job is to ensure that Research and Development activities address questions of access to vaccines for vulnerable populations. This is a question not only in terms of price but also concerning the supply and adaptability of the vaccines to these populations. We are asking ourselves whether there are vaccines which address diseases that affect vulnerable populations, whether the storage conditions are appropriate, whether these are the vaccines that these populations want and need and whether they are adapted for use in difficult contexts. These are questions that are important not only for the manufacturers, but also for populations and governmental, non-governmental and international organizations as well. We have found that access to these vaccines is actually hindered early on in the R&D process. There are fewer clinical trials in Sub-Saharan Africa sometimes for paternalistic reasons that participants may be exploited during trials. This is a real issue, but should not be a barrier as the result is that many vaccines are not tested within the populations that need them the most or they are excluded from trials, like malnourshised or HIV positive children or pregnant women. When the development of vaccines is not approached as an issue of public good, there are delays in the processes, and we are unable to provide tools that save lives.
What risks arise around innovation in the field of vaccines?
In terms of developing vaccines for lower income countries, innovation is far slower, not only because of technology but other issues as well. People that go into scientific fields to research and develop vaccines should be encouraged to study issues of vulnerable populations which would then help drive the research agenda. For example, oral vaccines have a very high efficacy in rich countries but only modest efficacy in low-income populations such as in sub-Saharan Africa and in parts of Asia, the very places where these could be life-saving interventions. This is an important area of research which has thus far not been answered.
How can open innovation be developed?
In principle, open innovation would come about anytime where results and knowledge are shared among scientists and researchers. However, when we define what “open innovation” really means, the problems arise. This applies not only to vaccine development but to all biomedical advancements. It involves a multipronged process, looking at how scientific studies are published, how data is shared and how intellectual property is dealt with. Not only that, but I believe this is also a generational concept. When you have people used to working in a system where sharing is not encouraged, you’re going to have difficulty encouraging innovation. Now that young people are starting to work more and more in this field, findings and publications are becoming more open. This is not to trivialize issues of intellectual property, but just to point out the entire system does not support sharing.
What are your expectations of the workshop and the plenary session dedicated to the vaccines of the future?
I expect and hope to listen to different perspectives. Having solid and engaging discussions is often the way that great progress can be made. It is all too rare to have scientists and researchers interact with business and civil society stakeholders. In fact when it does happen it is often in the context of exceptional circumstances such as during the Ebola epidemic, and it is a great pleasure to have this opportunity not in the context of a difficult or emergency circumstance.
Do you have personal vision for your time spent at BIOVISION?
I’ve been to a lot of meetings that end in creating a sort of “call for action,” and I hope that in this case it is not just a call to action but that there’s actual action involved afterwards.
* Interview by Nathaly Mermet and Claudia Quieros for the University of Lyon / Biovision 2016