Chikungunya: Finding a route to introduction
Dr Sushant Sahastrabuddhe (International Vaccines Institute (IVI), South Korea) highlighted challenges in ensuring wider access to vaccines against chikungunya virus. First identified in Tanzania in the 1950s, chikungunya virus is in the same family of viruses as Zika and dengue viruses and causes similar symptoms (particularly fever and joint pain). It typically causes seasonal explosive outbreaks.
Two vaccines have been licensed but there is no clear pathway to their introduction in the Global South. Chikungunya is not a WHO priority pathogen, ruling out pathways based on WHO global access mechanisms and policy recommendations. Because of its epidemiology, classical efficacy studies are not feasible, so licensing has been based on immunological correlates of protection. Regulators in the Global South may not necessarily accept this approach. Funding will be an additional challenge, particularly in the absence of Gavi support. A global stockpile could be established, but it is unclear how this would be supported and what its governance mechanisms would be.
IVI is working with the London School of Hygiene and Tropical Medicine on a project to inform policy conversations. This includes further work on the global burden of chikungunya, development of a target product profile (TPP) for a global accessible chikungunya vaccine, and an analysis of stakeholder perceptions.
The European perspective
Dr Jan Paehler (European Commission) gave a high-level overview of European initiatives to enhance access to medical interventions in Africa, which was based on a strong commitment to strengthen the entire R&D ecosystem in the region, including R&D and local manufacturing.
The EU’s overall approach is guided by the EU Global Health Strategy, which includes sustainable clinical trial networks and surveillance as key priorities. As well as promoting a pipeline of interventions driven by African medical needs, this also requires strengthening of regulatory capacity at the national level.
Dr Paehler emphasised the importance of integrating European support mechanisms, such as the Innovative Medicines Initiative (a partnership with industry), Global Health EDCTP3, and Team Europe’s investment in biomanufacturing in Africa. This ensures an end-to-end perspective, with access integral from the beginning.
He also noted that the European Commission would soon be submitting its initial plans for the next Framework Programme, due to be launched in 2028.
Country ownership
Thi Hanh Cao (Drugs for Neglected Disease Initiative (DNDi), Switzerland) highlighted the importance of ensuring strong country ownership of access initiatives.
DNDi has a programme focused on leishmaniasis, a neglected tropical disease that particularly affects East Africa. It adopted a two-stage strategy – a long-term programme to develop simple oral drug treatments and a short-term programme to optimise and enhance existing treatments. It also established the LEAP platform, an international clinical trial network able to carry out treatment studies.
The LEAP platform includes ministry of health representatives from four East African countries and has evolved to consider access as well as clinical evaluation. This has helped to ensure strong political buy in, with the health ministers from six countries signing a commitment in May 2025 to eliminate visceral leishmaniasis, its most severe form.
Thi Hanh also highlighted the importance of securing a diversity of funding for different aspects of the project, as well as the global vision, strategic framework and targets provided by the WHO NTD Roadmap.
A platform for building communities of practice
Dr Christina Kitrima provided a brief overview of The Global Health Network, a digital platform that hosts numerous knowledge hubs and resources to help develop skills and build communities of practice.
It is designed to bring together different communities, across all stages of the R&D life cycle, promoting alignment around common goals and supporting communication across sectors, including with policymakers. It has strong links to EDCTP regional Networks of Excellence, as well as individual EDCTP project networks.
A panel discussion, with audience participation, highlighted several key issues. These included the potential of the mRNA vaccine platform as a flexible one that could lower development costs and support projects specifically targeting pathogens important to Africa. Dr Sahastrabuddhe noted that IVI was working on a mobile mRNA vaccine production facility that could be shipped to sites to respond rapidly to outbreaks.
It was also noted that different groups, such as clinicians and researchers, could come into conflict. The panellists argued that disagreements were highly likely, given different perspectives. Partnerships provided a forum through which different perspectives could be aired and partners could gain an understanding of the views of others. Ultimately, a more diverse team was likely to be more successful, given the complexity of the overall R&D ecosystem.
The key message was the need to consider access as early as possible in the development process – to understand potential access barriers so risks can be mitigated, to ensure that products are compatible with end-user needs and system constraints, to mobilise the support of key stakeholders, particularly at the country level, and to build in time for preparation activities for introduction.
Moreover, access is not a one-off event, and actions are needed to ensure the take up and use of new interventions once they become available in a country.
Challenges and opportunities to advance vaccine development against vector-borne diseases.
Sushant Sahastrabuddhe. International Vaccines Institute (IVI), South Korea.
EU initiatives to foster international partnerships and innovation to combat vector-borne diseases.
Kasia Jurczak, European Commission, Belgium.
Innovations in developing treatments for Leishmaniasis
Thi Hanh Cao, Drugs for Neglected Disease Initiative (DNDi), Switzerland
Transforming global health research into real-world impact through strong stakeholder partnerships
Christine Kirima, The Global Health Network, UK