Game-changing moment as middle-income nations push to invent mRNA vaccine : Goats and Soda How Sotiris Missailidis, head of R&D in Brazil's vaccine agency, used the COVID crisis to push through a game-changing effort for middle-income countries to invent their own mRNA vaccine.

A dire moment in the pandemic ... was the chance he'd been waiting for

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Never let a crisis go to waste. That's become the rallying cry of a group of scientists from middle-income countries. They say the COVID pandemic proved that wealthy countries cannot be counted on to share new vaccines, so they have come up with a game-changing plan. NPR's Nurith Aizenman caught up with them at an auditorium in Rio de Janeiro, Brazil.

FERNANDO LOBOS: So thank you very much. My name is...

NURITH AIZENMAN, BYLINE: This room is packed with some of the most central players in the cutting-edge world of mRNA vaccines. As they pass around a microphone to introduce themselves, there are experts from Latin America...

LOBOS: Argentina.

AIZENMAN: ...And from Africa.

CARYN FENNER: Hi, everybody. My name...

AIZENMAN: Specifically, South Africa.

FENNER: It was our turn to do the long journey around the world in two days.

AIZENMAN: But almost nobody here is from the United States or Europe, the wealthy countries of what's often called the Global North that, until now, have completely dominated the invention of new vaccines. This gathering is strictly a Global South effort, a coming together of middle-income nations that are determined to help each other finally invent new vaccines and manufacture them on their own terms.


SOTIRIS MISSAILIDIS: Thank you very much.

AIZENMAN: The fact that this is even conceivable is down to a major rethink of strategy that was largely pushed through by the man who's now taking the mic.

MISSAILIDIS: It's great pleasure to welcome you all here.

AIZENMAN: Sotiris Missailidis is a director at Brazil's premiere public agency for vaccine development and manufacturing. It's called the Bio-Manguinhos/Fiocruz Foundation, and it's the host of this gathering. Missailidis explains that before the pandemic, virtually every time his team has tried to create an original vaccine, they were undercut by the pharmaceutical companies in wealthy countries, often called Big Pharma.

MISSAILIDIS: When there is a specific need for a vaccine, our time to develop is more delayed than the Big Pharmas.

AIZENMAN: Institutes in middle-income countries like his don't have anywhere near the same funding. And governments like Brazil's understandably want to provide new vaccines to their citizens as quickly as possible. The upshot...

MISSAILIDIS: If there is an emergency and the Big Pharma has the vaccine, we are often obliged to interrupt our own development and accept a vaccine that is ready.

AIZENMAN: By doing what's called a technology transfer. Essentially, the middle-income country takes a vaccine invented in a wealthy country, learns how to produce it, and then starts pumping out its own supply. Brazil has gotten really good at this. The trouble - it still requires the permission of the inventor of the vaccine.

MISSAILIDIS: You'll always have access of what the others want to give you, at the price they want to give you, at the numbers they want to give you.

AIZENMAN: You'll always be dependent. When COVID hit, it looked like the old pattern was set to repeat itself. Some of the scientists Missailidis oversees had actually been working on mRNA technology. They proposed adapting it to create an original homegrown mRNA vaccine against COVID. But when Missailidis tried to get the funding, per usual, he was told, just drop it.

MISSAILIDIS: There were people that were pessimists. And they said, well, you'll never go anywhere, and we'll do a technology transfer anyway.

AIZENMAN: And on that last point, the naysayers were right. Missailidis helped Brazil reach a technology transfer deal with a Global North company, Europe-based Oxford/AstraZeneca. And in a few months, Brazil was making massive quantities of that COVID vaccine.

MISSAILIDIS: We managed to vaccinate 90% of Brazilian population.

AIZENMAN: But this time, Missailidis also insisted they still shouldn't give up on the homegrown effort, the one to invent Brazil's very own mRNA vaccine, even if it was going to take them years longer than Moderna and Pfizer to complete it.

MISSAILIDIS: If you don't bother, you will never change. You will always be at the mercy of Big Pharmas, at the mercy of richer countries. You need to have a moment where you change, you come out of that, and this was the moment.

AIZENMAN: It helped that mRNA vaccines aren't only useful against COVID. This is a totally new technology that could potentially be used to fight all manner of diseases. In other words...

MISSAILIDIS: Not stopping that effort made it possible to guarantee a better future for the next time.

AIZENMAN: But ironically, Missailidis probably got his biggest assist from Moderna and Pfizer, the only companies that had an mRNA vaccine. For months, their supply was limited, and they pretty much only sold it to rich countries. When Brazil proposed doing a tech transfer so it could produce some in-country, both companies refused. Missailidis gives a wry smile when he says...

MISSAILIDIS: That was a brilliant moment in some way. It gave us the push to continue so we have our own independence.

AIZENMAN: Moderna's and Pfizer's refusal to share their know-how also prompted the World Health Organization and some partners to launch an audacious plan of their own. They picked the Brazil team, paired with an Argentine company, along with a separate team in South Africa, to act as hubs that will not just figure out how to make mRNA vaccines against COVID, but then teach that knowledge to manufacturers from low- and middle-income countries around the world.

That's what this meeting is about. The lead scientist on Brazil's team, Patricia Neves, comes to the podium to propose a coffee break.

PATRICIA NEVES: The idea for this time now is to exchange information.

AIZENMAN: The scientists file out, including the head of South Africa's effort, Caryn Fenner.

FENNER: I think the holdup is...

AIZENMAN: She falls into conversation with one of the Argentines about lab equipment.

FENNER: So my recommendation would be, if you can, to get a benchtop system.

UNIDENTIFIED PERSON: Yes. These - like, you could scale out.


AIZENMAN: Fenner, who's with the company Afrigen Biologics and Vaccines, says there are lots of issues like this to work out still.

FENNER: Trading of ideas is really important because in terms of the mRNA platform, it's still fairly new. And so it's not a blanket thing that goes with all vaccines.

AIZENMAN: But just as valuable is the network of Global South scientists they are building in the process. Fenner says they've been trying to do this for years.

FENNER: You use a crisis to propel something, right? And we've used COVID as a springboard.

AIZENMAN: Brazil's Patricia Neves agrees as she surveys the room. She says seeing all these scientists from the Global South working together...

NEVES: That's the most exciting thing for me because we are not depending on others to do this.

AIZENMAN: Now, she says, we're making history.

Nurith Aizenman, NPR News.


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