100 Days Mission Scorecard: Today's Data to Inform Tomorrow's Preparedness

Working with the International Pandemic Preparedness Secretariat, we have developed a Scorecard to critically assess available data to determine how well we are developing and deploying products to combat epidemic diseases.

This first 100DM Scorecard highlights areas of deficiency where urgent action is needed to ensure future, global preparedness. The COVID-19 pandemic has shown what is possible when political will backs the epidemic R&D ecosystem, building from these lessons with more targeted and intentional approaches to preparedness we can collectively move forward to meet the goals of the 100DM.

The Scorecard reveals:

• Therapeutics R&D lags behind with few approved products, clinical candidates and only one WHO TPP.
• There is a lack of unifying leadership to coordinate the sector in the way that CEPI and FIND champion vaccines and diagnostics.
• Funding for platform technologies to support “Disease X” has grown since 2019 and these are being used to develop products for eight priority pathogens. These should benefit R&D for other pathogens, but this is not yet routine.
• Pandemic product development predominately follows a traditional model of R&D but alternative approaches are needed to meet the 100 Days Mission, for example, greater use of the “animal rule” to support and accelerate licensure.
• COVID-19 is an outlier on every level. This reflects its bigger global impact, greater political will and a commercial market that is driving product development. It raises questions about how we right-size our response to pandemic threats.
• Funding for epidemic diseases is highly reactive, we have not yet adopted a preparedness approach for R&D.
• The R&D funding ecosystem is upheld by public funders, and dominated by the US government, making it less sustainable and vulnerable to political shifts.
• Medical countermeasures are unavailable for most R&D Blueprint Priority pathogens. COVID-19 and Zaire ebolavirus are the only two pathogens with a full complement of approved products; however, these are not always accessible.
• Pathogens which have had larger outbreaks and were perceived as a greater risk to national biosecurity have more mature pipelines. Aside from COVID-19 and Ebola, the clinical pipeline has few candidates, with the majority in early phases of testing. Vaccines R&D is the most advanced space in terms of funding, product R&D and has WHO Target Product Profiles (TPPs) for nearly all pathogens.