The scale of the disaster that has been Ebola in West Africa since March 2014, and the speed at which it spread, claiming – at the most recent count over 11,000 lives, was unprecedented. But as a rapidly-emerging threat to public health it is part of an increasingly familiar narrative.
Ebola – which is believed to originate in fruit bats – is a ‘zoonotic’ pathogen, one that can be transmitted from animals to humans. This places it in a lineage that encompasses influenza, tuberculosis and West Nile virus. All told more than 60% of the infectious diseases that affect humans originate in wild animals.
But that proportion is even higher in emerging diseases, like Avian and Swine Flu, SARS and MERS, the latter of which caused the closure of more than 700 schools in South Korea earlier this month. When it comes to diseases like these some 75% of them are zoonotic.
There is a further element at stake – the total cost to society of a disease increases exponentially once it has an impact on humans. Professor Adrian Hill, head of the Jenner Institute at Oxford University in the UK, said: “Often the shutting down and quarantining of areas due to a diseases outbreak is a more significant loss than the actual infection or animal destruction. Media reactions and economic slowdown are much more impactful than the disease itself.”
Working with a different universe is a unique opportunity – GSK Emannuel Hanon
One health
One of the ways that zoonotic diseases could be combated is through an approach known as ‘one health’, which acknowledges the increasingly amorphous boundaries between species and involves animal health and human health institutions and companies joining forces to tackle health challenges.
Earlier this year the third annual One Health Congress in Amsterdam showcased support for the concept with representatives from the likes of Zoetis, GlaxoSmithKline, Oxford University’s Jenner Institute and industry trade bodies arguing in favour of a more holistic approach to health research.
Alejandro Bernal, who is executive vice president and area president, Europe, Africa and Middle East Region for Zoetis and chair of animal health trade body IFAH Europe, told PME: “One Health is a concept we support very strongly.”
He explained: “It is the realisation that health in animals and humans is very closely interlinked and we should look for ways of more effectively preventing, diagnosing and treating a lot of the diseases that have an interconnection between humans and animals. [This process] could be much more effective if we start looking at these diseases much more closely together.”
Formerly operating as Pfizer’s animal health unit, Zoetis was spun-out from the pharma giant two years ago. As such Bernal’s company has an intimate understanding of working alongside human health as well as the priorities of an animal health business.
Another pharmaceutical firm exploring one health is GlaxoSmithKline. Emmanuel Hanon heads the company’s GSK Vaccines Research and Development organisation and is senior VP of research and development for GSK Belgium. He told PME: “GSK has been very clear in its commitment to public health. We have a sense of corporate responsibility for this – we believe that, whether it’s for pandemic flu or Ebola, if we might have the technological solution to a problem then we have to consider the case for trying to provide that solution.
“In the case of Ebola and the pandemic it was compelling – as one of the leading vaccines companies, there was a notion of duty for responding and using some of our resources against these emerging threats.”
For GSK there is also a compelling, albeit indirect, business case for participating in this research. Vaccines, of course, being an area of heightened interest for the company following its recent acquisition of the vast majority of Novartis’ vaccine business made the UK firm a global player in vaccines, with a much bigger presence in the US, for the first time.
Hanon said: “It’s science that makes new vaccines possible, whether these are ‘classical’ vaccines or vaccines that would be used against emerging biological threats. And you can make scientific progress by investing into, and understanding, the new technological platforms that allow you to make new vaccines.”
One health is the realisation that health in animals and humans is very closely interlinked – Zoetis’ Alejandro Bernal
So, by working on newer targets – like Ebola – allows the company to generate knowledge and find solutions to more classical targets. GSK’s work on a malaria vaccine is a good example of this. The company’s RTS,S vaccine, filed for regulatory approval in Europe last year, is designed to protect against Plasmodium falciparum, the most dangerous of the mosquito-borne malaria parasite species. It’s most commonly found in sub-Saharan Africa, where around 90% of malaria deaths occur, with children under five bearing the brunt of the disease. All told, the disease kills more than 600,000 people a year.
“One aspect of that vaccine uses an adjuvant platform, an additive that we put in the vaccine that really boosts the response that is induced by its active ingredient,” said Hanon. “All the knowledge and findings that were generated in this development, besides making possible a malaria vaccine, have also developed other products in the pipeline.
Collaborations needed
In the speeches given at Amsterdam’s RAI Convention Centre the need was clear for a more collaborative approach than that presently seen.
But, although the One Health Congress attracted around 1,000 people, with vets, healthcare professionals, health companies and policy makers all represented, mainstream pharma involvement, with the exception of GSK’s vaccine operation, was noticeably thin on the ground.
However, EFPIA’s director of science policy Magda Chlebus noted at the Congress that the two sectors have a lot to gain from working together. “Human, animal and environmental health face many common or related challenges. Success in addressing these will, more than ever, rely on our ability to integrate know-how, sciences and technologies from many sectors and companies. The threat of resistant bacteria is a challenge that requires such a collaboration and coordination.”
Moreover, further momentum appears to be gathering this year. A further company – also one with animal health interests – to throw its hat into the ring recently was Bayer, which held an online congress on Vector-Borne Diseases to advance a one health approach.
Regulators are moving on the area too. Consulting on the EU Medicines Agencies Network Strategy to 2020, the EMA said in a statement: “Europe faces the global threat represented by antimicrobial resistance to human and animal health, and needs to be prepared for emerging epidemics, as reminded by the outbreak of Ebola.”
One of the strategy’s aims is to make the most of the opportunities to benefit human and animal health and the Network behind it includes all national medicines regulatory authorities for both human and veterinary medicines from EU Member States and the European Economic Area (EEA).
Asked why pharma should consider a one health approach, GSK’s Hanon commented: “Pharmaceutical companies are challenged on the innovation side – we need to be very thoughtful about how we get and create the best ideas that will bring new vaccines, and working with a different universe – with which we were not necessarily working before – is a unique opportunity.”
