Read the Conversation
EF: What are your current priorities, and what is on your agenda? What challenges or opportunities are you facing in the vaccine sector?
SQ: The vaccine sector is an exciting part of the pharmaceutical world. I have been working in this sector for more than 15 years, and I continue to enjoy exploring and tackling the never-ending challenges.
The pandemic was a challenge that we recently faced; however, it was also an opportunity to recall the importance of vaccines and vaccination. Vaccination has its cyclical ups and downs. One moment, we are in a public health crisis with a huge demand for vaccines, and once the threat is over, we enter an era of vaccine fatigue. This cycle continues to repeat itself, crisis after crisis, losing all investments that were made to protect people. The COVID-19 pandemic taught us what worked well and, what did not and what needs to be improved. It’s time to apply these lessons learned and leverage the investments made.
In terms of what worked well, we benefited from a strong research-based pharmaceutical industry that delivered innovative vaccines in record time. Vaccination saved the world from deeper societal and economic consequences. This was achieved thanks to strong collaboration among all the relevant stakeholders as well as all types of partnerships at the public and private levels, which are critical and important for the vaccine industry.
In terms of what needs to be improved, it is clear that we need to address the issue of equitable access to vaccines. Linked to equitable access, it is important to mention that while, during the pandemic, the EU managed to provide an equitable supply of COVID-19 vaccines to all 27 EU member states and at the same time, this was never seen before for any other types of vaccines included currently in National Immunisation Programmes. This is a serious issue because today, we do not benefit from the full potential of vaccination.
For instance, the pandemic highlighted the critical role that vaccines and vaccination play in contributing to the resilience of the healthcare system and society. The pandemic put pressure on doctors and hospitals and caused mental stress in the population. The vaccines provided relief for these issues and allowed the economy to bounce back. Vaccines for one infection contributed to the resilience of the healthcare system, society, communities, and economy.
In national immunization programs, about 27 infectious diseases can be routinely prevented by vaccines and vaccination in the EU. Nobody would like to imagine what the world would look like without those existing vaccines.
On the positive side, the pandemic also led to an increased interest in vaccines and vaccination. We moved from an era where people did not care that much or did not know that much about which vaccines they were receiving to an era where they were naming the COVID-19 vaccines they received.
We also saw an increase in interest in this field with new vaccine companies and biotechs and continuous investment toward innovative vaccines. This is an exciting time for the industry and public health as we can bring solutions to many of the challenges we are facing today and that lie ahead.
Vaccines Europe publishes annually a report that explores the vaccine pipeline of its members. Eighty percent of the vaccines under development are targeted toward the adult population, demonstrating a shift in who is most at risk from infectious diseases today as a result of an aging population. There is also an increasing number of vaccine candidates in the AMR targeting resistant pathogens. Linked to supporting vaccine confidence and pursuing the potential for personalized vaccines is a diverse array of technology platforms that we did not have before, giving a choice to patients and health providers.
Vaccines Europe is also in the process of refreshing its strategy to prepare for the next challenges and evolutions that are coming. Notably, these are related to the evolving health challenges brought about by climate change, geopolitical issues, mass population movement, and an aging population. Vaccines Europe will focus on fostering innovation and value recognition of life course immunization in Europe to protect people against these evolving health challenges. We need to ensure that everybody understands the value of immunization as part of how we contribute to resilience and protect people throughout all ages and stages of their lives. As part of our manifesto in the context of the next EU election in 2024, Regarding our priorities, they can be summarised in three blocks.
Our first priority is to ensure the attractiveness of our industry, including attractive conditions and incentives for investment in R&D and manufacturing. This is critical and can be seen in our report on the EU's attractiveness for the vaccine industry. Before the pandemic, Europe was known as a global leader in vaccines. During the pandemic, Europe delivered on its vaccine mandate. Today, Europe is losing ground to the United States. Compared to the US and the rest of the world, Europe has 56 percent less biotech, and vaccine R&D is also losing ground in clinical trials l. Before the pandemic, one in five global clinical trials was done in Europe. In the last two decades, 35 percent of those trials have gone to the US. We need to consider this data to formulate a strategy for the EU region to remain attractive for the vaccine industry and ensure that we have a streamlined and harmonized regulatory framework.
Our second priority is to ensure a healthy population. We need everybody to recognize the value of vaccines. We also need to ensure that there is timely access to vaccines for the population. Europe has an issue of equitable access. The median time for an innovative vaccine to get funding/reimbursement following marketing authorization is six years, meaning it takes six years to provide access to vaccines that prevent deadly ailments and contribute to healthcare systems and the economy. That is far too long. This is an issue that needs to be addressed as vaccines are the primary prevention tool in healthcare and the first line of protection for the population.
Our third priority is ensuring a prosperous Europe. We want to unlock the full benefit of vaccines and vaccination to ensure a prosperous society and economy and drive the resilience of health systems. This priority is about investment, as vaccines and immunization are an investment, not a cost. We need to unlock a budget dedicated to immunization. Further, it is not only about buying vaccines but about ensuring that you have the right infrastructure, properly trained healthcare providers, and the convenience of access by expanding the role of pharmacists and nurses. The digitalization of our data systems for timely registration of vaccination uptake is also imperative. It is also about how you boost vaccine confidence and ensure that people trust not only the product but the science, the industry, and their governments.
These are our key priorities. If you have an innovative industry delivering to health systems, you can ensure a healthier population, which in turn will deliver a more prosperous region that is more resilient against any external health threats.
EF: What measures can be taken to boost European vaccine production, and how important is it to localize the supply of vaccines?
SQ: Europe is already doing very well in terms of its manufacturing footprint. We have a resilient pharmaceutical supply chain. A lot is happening on EU soil, and this has not changed before or after the pandemic. Europe remains a strong leader in vaccine manufacturing, and it aims to strengthen this leadership.
To help realize this goal, Europe is creating a network of facilities for manufacturing called the EU FAB under the leadership of the Health Emergency and Response Authority (HERA) and has contracted five companies to offer three types of vaccines: protein, vector-based, and mRNA. Ireland, New Zealand, and Spain are strongly represented, and out of the five companies, three come from Spain. All are vying for leadership in vaccine manufacturing. Vaccine manufacturing is one of the most complex processes. Good manufacturing principles are critical. The quality process that goes into the manufacturing of vaccines is far beyond that of any other pharmaceutical product, with seventy percent of the time spent on quality control.
Continuous investment is also important. However, it is important to mention that vaccines have a long manufacturing lead time of 12 to 24 months and beyond for the most complex vaccines. Consequently, it is critical for vaccine manufacturers to have the right demand signals to anticipate the required level of supply. Increasing vaccine manufacturing capacity requires significant capital, of an order of tens or hundreds of millions of euros, depending on what is needed and the type of vaccines to manufacture. This is why, as part of our report on the EU's attractiveness to the vaccine industry, we have called for incentives to support sustainable manufacturing in Europe. This is linked to having a visible and sustainable demand. COVID-19 highlighted the importance of this call. Everybody has been vying for vaccines everywhere, but that does not mean that just because you have the vaccines, they are going to be used. We need to work in a sustainable way when manufacturing vaccines and implementing vaccination programs.
The notion of value is also critical. How do you demonstrate the economic value of immunization? How does this contribute to the resilience of your healthcare systems and the economy? Pandemic preparedness is key. The value of broader prevention is also important, as people often think about vaccination in a narrow sense. They limit the use of vaccines for the flu when, in fact, we can go broader and theoretically prevent major illnesses like cancer, and we can contribute to the global threat of antimicrobial resistance.
To reach these goals, we have a lot of work to be done in Europe, some of which is already ongoing. The European Council's recommendation on AMR started in June 2023, recognizing the value of vaccines in curbing the spread of infection in the fight against AMR. We put forward a white paper about the role of vaccination in the fight against AMR, which highlights the potential of the complementarity of prevention and other tools, such as therapy, and where prevention can contribute to preserving the benefits and value of antimicrobials. This value component across the board is embedded throughout the three pillars of our 2024 strategy.
EF: How do you use this common space like the European Pharma Association to promote collaboration between the stakeholders and advance the industry's common goals?
SQ: HERA has a segment called the Joint Industrial Cooperation Forum, which is a forum dedicated to the industry. It is a multi-stakeholder platform that facilitates dialogue between the Commission, represented by HERA, and the industry, and this is where we collaborate.
HERA is a new player, and we welcomed it with open arms. We are building and working together to determine what needs to be done to be better prepared for the next pandemic. We have a dialogue built on transparency and the continuous exchange of information. This is a key partnership at the European and regional level for public-private partnership collaboration in the field of pandemic preparedness. All stakeholders still need to understand the full potential of vaccines and vaccination. It is our role to bring that to their attention and provide all institutions with evidence as to what is needed to develop the sector and enhance the public health response.
EF: Our project is called The Roadmap to Sustainable Healthcare. As Vaccines Europe, what are the three key pillars for a road map that will build a prosperous and more sustainable healthcare system in Europe?
SQ: Firstly, we need immediate funding. Funding is critical, and this is true for Europe and worldwide. The level of funding in Europe for prevention is low and needs to be higher. Only three percent of healthcare budgets are dedicated to the prevention and less than one percent to immunization. This is not enough to cater to the whole population. With this low budget, health authorities cannot strengthen the infrastructure required to inform and vaccinate the population across the life course, ensure adequate education for healthcare providers, or run a population-wide vaccination campaign across the year. These issues lead to challenges such as vaccine hesitancy, low uptake, and the risk of vaccine-preventable outbreaks.
There is an OECD report that explains the lessons learned from COVID-19. The report highlights under-investment in the health system as part of the issue. If we consider vaccines as a key pillar for the resilience of our healthcare system, we need to invest in them, considering them as an investment in health and not as a cost.
The second pillar is the digitalization of our healthcare system. This is important for immunization as we need to be able to determine the population's coverage rate quickly. That system currently does not exist. There is only one exceptional tool, the COVID-19 vaccine tracker, which was developed by the ECDC for COVID-19. This tool allowed us to determine not only the incidence of the disease everywhere in Europe but also the coverage rates of the COVID-19 vaccines for each EU member state. If you look at the recent ECDC report on influenza, there is less data because not every country reports it. Further, the most recent data that is available is old, with it being from 2021. The digitalization of our healthcare system will help solve some of these issues and ensure its interoperability, and electronic vaccination records are key components for its feasibility.
Finally, we need to combat fake news and boost vaccine confidence. We need to bring valuable information to people by any means that we can, whether it is digital or through the network of healthcare professionals and communities. We know that healthcare providers are the most trusted sources of information on this topic. They should all be equipped to talk to the population about vaccines and vaccination. We also need to raise the bar related to trust in science, and here again, our industry has an important role to play.
EF: Do you have any final messages for our readers?
SQ: We need to integrate prevention and vaccination as part of the overall narrative. We need to look at what we can deliver to our citizens, from prevention to care, and there should be an integrated, simple narrative for all stakeholders, decision-makers, and citizens.
