Having systematically screwed up the hydoxychloroquine (HCQ) trials for the treatment of the Covid virus and otherwise prevented its general use, all of which likely ended up in countless unnecessary deaths (see Dr Meryl Nass's despairing assessment) the WHO are now turning their attention to the first crop of vaccines, created at reckless speed with new technologies. The WHO's chief scientist told Reuters on Friday:
GENEVA (Reuters) - AstraZeneca's <AZN.L> experimental COVID-19 vaccine is probably the world's leading candidate and most advanced in terms of development, the World Health Organization's (WHO) chief scientist said on Friday.
The British drugmaker has already begun large-scale, mid-stage human trials of the vaccine, which was developed by researchers at University of Oxford.
This week, AstraZeneca signed its tenth supply-and-manufacturing deal.
"Certainly in terms of how advanced they are, the stage at which they are, they are I think probably the leading candidate," WHO chief scientist Soumya Swaminathan told a news conference.
The Oxford vaccine has a shaky history, funded to the tune of £90m million by the British government and taxpayer, and already in manufacture in billions of doses, the human trials began in April amid false reports that the animal trials had been successful: the product is arguably commercially too big to be allowed to fail. It also has the advantage that its lead developer Andrew Pollard heads the committee that will advise the British government on its use. Admittedly, last week he was in an apparently non-committal mood in conversation with Prince William:
Prof Pollard highlighted HIV, a virus for which no vaccine has been found because it mutates, saying scientists' great fear was that coronavirus could be the same. In that case, he said 'there is nothing we could do apart from social distancing forever' - a prospect William described as 'frightening'.
Given his position as chair of the Joint Committee on Vaccination and Immunisation it may be getting ahead of himself to show too much enthusiasm at this stage, but the world deserves better than this false alternative. Nor would anyone be very surprised if he gives the product the go-ahead when the time comes. As if to make the point director of NIAID Anthony Fauci was reported as saying on CNN yesterday he would settle for a vaccine which gave 70 or 75% immunity.
Swaminathan also has her eye on the Moderna vaccine which goes ahead despite the fact that it passed over animal trials altogether and had a 20% serious adverse rate in its initial human trial, as reported by Robert F Kennedy,Jr. Unlike HCQ it is impossible to see how there could be any true assessment of safety and effectiveness of these products for years to come. And it is hard to see that the WHO is at all interested providing their corporate sponsors are pleased. Both Moderna and the Oxford consortium have the backing of the Bill and Melinda Gates foundation among others.
Back in December Swaminathan came to attention because of her contradictory fronts at the WHO vaccine safety summit where she had one message for the public:
"Vaccines are very safe. If someone gets sick after vaccination it is usually either a coincidence, an error in administering the vaccines, or very rarely a problem with the vaccine itself.That's why we have vaccine safety systems - robust vaccine safety systems allow health workers and experts to react immediately to any problems that may arise. They can examine the problem rigorously and scientifically look at the data and then promptly address the problem.
"WHO works closely with countries to make sure that vaccines do what can do best to prevent disease without risks. New vaccines against malaria, meningitis and encephalitis in Asia and Africa are now being thoroughly monitored with support from WHO. Vaccines are one of the safest tools we have to prevent disease and ensure a healthy future for all children."
And a rather more candid one for the conference:
"I think we cannot over-emphasise the fact that we really don't have very good safety monitoring systems in many countries and this adds to the miscommunication and the misapprehensions because we're not able to give clear cut answers when people ask questions about the deaths which have occurred to particular vaccines and this always gets blown up in the media - one should be able to give a very factual account to what exactly has happened and what the causes of deaths are but in most cases there is some obfuscation at that level and therefore there is less and less trust then in the system...
Putting in place the mechanisms, whether they are cohort studies or whether they are sentinel surveillance sites to be able to monitor what is going on and report back and then for corrective action to be taken because unexpected things could arise after introduction and one always has to be prepared as we have seen. You know the history of many drugs you've heard about, I mean learnt about adverse events only after the drugs have been licensed and introduced into the population.So I think that the risk is always there and the population needs to understand that and feel confident that mechanisms are being put in place to understand some of those things."
Perhaps one might add that the monitoring systems in the developed world may be even more efficient at processing out serious events than undeveloped, AND WHAT WE ALL NEED NOW IS STRAIGHT TALKING.
ADDENDUM: It has just been drawn to my attention that Prof Andrew Pollard recused himself from an extraordinary meeting of the JCVI on 7 May (minutes published 18 June) to discuss the COVID crisis because of his conflict as developer of the Oxford vaccine: this may be viewed as a surprise since the Oxford Vaccine Group of which he is director was involved in research or development of manifold products that have been recommended to the schedule by the JCVI, notably in his second meeting as chair in 2014 recomending the Bexsero Men B vaccine to the the infant schedule for which he himself was lead developer. It remains problematic that this situation was acceptable to successive Secretaries of State for Health and Social Care, and to be seen whether the process becomes any more credible as a result (or whether they are just covering their backs). His role has been taken by Prof Wei Shen Lim one of the directors of the controversial Oxford Recovery Trial which included the discontinued trial of HCQ. The website for the trial records.
This trial is supported by a grant to the University of Oxford from UK Research and Innovation/National Institute for Health Research (NIHR) and by core funding provided by NIHR Oxford Biomedical Research Centre, Wellcome, the Bill and Melinda Gates Foundation, the Department for International Development, Health Data Research UK, the Medical Research Council Population Health Research Unit, and NIHR Clinical Trials Unit Support Funding.