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Hello my name is Cal MacLennan I am the
Director of BactiVac and Professor
of vaccine immunology. I'm here together
with Professor Adam Cunningham
co-director
and Professor of
functional immunity.
We're here representing BactiVac, the
bacterial vaccinology network, and we're
going to talk today about vaccines as a
solution for antimicrobial resistance
and the role of the BactiVac Network.
Thanks Cal and I'm just going to give a
few slides just as a bit of a background on why
vaccines can play a role here. Well we
know how big a problem AMR is
likely going to be in the future we
know it's going to appear rapidly
we know that it's a problem in
high-income countries and low-income
countries and
in other fields such as in veterinary use
and so
when we look at why vaccines can or
what they can bring to the table that's
very different to antibiotics all we
need to do is just look at this timeline
on the x-axis here really shows just how
quickly antibiotic resistance or
resistance to antibiotics can can occur
basically within a few years of every
single antibiotic's introduction, there
is resistance. In contrast if we look at
the length of the lines here for
vaccines there's there's negligible
amounts of
resistance to a whole range of different
vaccines and vaccine types, but we still
do not have enough vaccines particularly
against bacterial infections.
So
vaccines democratise opportunity across
the life course and one of the reasons
for this is because there are many
different
limited options to treat active
infections
as the availability of the use
antimicrobials constricts then the
vaccines become more important.
So when we use a
vaccine the reason it's so successful
is because it works right at the
beginning of the infection when the
numbers of infecting bacteria are at
their lowest levels.
In contrast,
antibiotics are usually used when
bacterial numbers are at their
greatest and when people feel sick so
you use them and you start to feel
better and these are life-saving these
provide great opportunities for
everybody to have success
for the vaccines and for
antibiotics but we can see what success
looks like and a vaccinated infant may
never know that it's ever encountered
the pathogen that it's protected against
because of the vaccine. In contrast,
antibiotics save lives but they can do
because they're used mainly when
children if for instance are sick is
that they can be very devastating
impacts of the infection on these poor
child. And so up to a point this can
make selling vaccines a little bit more
difficult because we rarely know when
they provide their life-saving benefits
and so we really need to understand just
how powerful our vaccines are in
preventing infections.
So the key reason that vaccines prevent
disease is and that the
is that they prevent the
bacterial numbers getting high enough to
be able to transmit so you don't get a
transmission of resistance onto
other people and so the vaccinated
population never have this
problem developing at all and so now if
we just summarise how vaccines can
really help reduce antimicrobial - well
this can be direct and indirect but
mainly it's through preventing infection
and blocking transmission so the direct
benefits are that they can
reduce antibiotic use for mild
infections
They can reduce the development of
resistance and a couple of examples
given here
they can reduce the burden of infections
with existing AMR and probably the
greatest example of this is the use of
the HiB vaccine which is reduced by
nearly 99% the numbers of cases
they by introducing herd immunity you
you prevent the bacteria having
somewhere to hide and lastly is that
there's reduced opportunity to share
genetic material in bacteria by
bacteria in shared niches, i.e to
pass on those antimicrobial genes but
they can be indirect as well.
So they can uh vaccines can block
transmission so for instance targeting
similar infections and we can see
this in in examples of outer membrane
vesicles
against meningococcus and gonococcus it
can reduce the inappropriate use of
antibiotics we know that
antibiotic use follows the flu season
and we really need better diagnostics as
well
and so we can by even another carrying
on that example of reducing of flu is
that we can reduce secondary bacterial
infections and antibiotic use there and
also we can
further their use in farming and animal
husbandry.
And it's with a great pleasure that I
pass over to Cal who will introduce
BactiVac, thank you.
Thanks Adam. So
coming down to the BactiVac network,
this really was an effort of how we can
improve vaccine development and access
in this whole bacterial vaccine space. So as
there isn't a another bacterial vaccine
network this was a gap
in terms of what was available to bring
the community together that are dealing
with bacterial vaccines and this was
established with support from the UKRI
and
The
GCRF
back in the uk in 2017.
So what is our mission? It is very
straightforward; it's to accelerate the
development of vaccines against
bacterial infections with a special
emphasis on those affecting low and
middle-income countries, so very much
with the global health remit.
So to do this
primarily we wanted to create a
sustainable network for bacterial
vaccine
development
we have
provided funding for projects and
training so we call this catalyst
funding
we wanted to attract investment and
leverage further funding
for vaccine development in both the
LMICs, and within the UK, and have a voice
for
advocacy for bacterial vaccine
development. So in terms of that vaccine
development network, what we wanted to do
is to bring together the different
components that you see in this slide, so
academia and industry,
but also high income country and members
and those in lower-middle income
countries, and policy makers as well so
those in government those in
organisations such as WHO,
and in terms of the bacterial vaccine
pipeline that we want to help push
vaccines along we're interested in the
whole pipeline from start to finish from
exploratory to
launch and
licensure.
But the sweet spot that we're
particularly targeting with BactiVac
is what we call the 'first valley of
death', which is the transition from
pre-clinical to clinical
and from this preclinical proof of
concept to clinical proof of concept and
that's where the baton often needs to pass
between
academic institutions and
similar
bodies across to manufacturers so you
have to have the capacity to develop the
product to be able to then go into that.
so that's the sweet spot for BactiVac
in relation to our catalyst pump
priming focus
and we also are interested in the whole
pipeline for
support with catalyst funding but also
for training funding too.
And then in terms of the network,
what we've seen over the past four years
in which the network's been in place has
been a gradual rise in members - we now
have over 1200 members spread across 76
different countries - and you can see the
pins in the map
on the slide here we have representation
throughout the globe but what's really
nice to see is the large number of
countries that are involved
with the Network
from the developing world and in fact 47%
of our membership are from low-middle
income countries. We've also very keen to
engage with industry obviously: the
end producers of vaccines; and we
have 13% membership from industry. Now
this reflects approximately 80 different
industrial entities so despite the
relatively low percentage in terms of
actual members
often individual manufacturers
or industry entities have only one or
two members in BactiVac so we
actually spread across a large number of
industrial bodies.
So a main focus of our work has been to
leverage funding for catalyst projects.
Now these are relatively small projects
where we seek to fund
new work between partners as
collaborations that will enable the
production of preliminary data that can
be used for substantive funding
applications
so far we've awarded funding to 50
different projects,
38 of these have completed
and over two and a half million pounds
of funding have been used for these
awards.
We insist that there's leveraged funding
to go with the funding that we award and
that has been
leveraged the tune of over 100% extra, but
what's been really important in relation
to the success of this catalyst project
program
has been the
follow-on funding that's been leveraged
from these projects and that has
amounted to an extra 13 million pounds
worth of funding
which equates to an extra 500%.
So bringing Adam back in and passing the
baton on to Adam with the summary.
Yeah so I'll just summarise the first
two parts is that
really our our options to control
bacteria interventions to control
bacterial infections are very limited.
Antibiotics are one, and vaccines are the
other, and we really really need
both arms to succeed to control
bacterial infections. But of these the
one that has been
possibly neglected the most are
vaccines.
The
widening the use of vaccination gives us
a fantastic opportunity to improve
human and animal health and address the
problem of AMR ß it really is a one health
opportunity and I think where this
really gives us the
element to consider most here is just
when and who will help. It will really
help in the youngest providing
people with the greatest opportunity to
live longer and fulfilling lives and so
essentially what we've had with that as
we've had the opportunity with funding
from the UKIR and GCRF in the UK to
support this networkÖ BactiVac, the
bacterial vaccinology network, we've been
able to grow this over the past four
years to the large membership that's
been shown in the slides already
bring disparate members who are involved
in different aspects of bacterial
vaccinology and related activities
to work on vaccine projects together
to
move forward with bacterial vaccines to
move them along the bacterial vaccine
pipeline
and to
it basically to gain further funding as
well in addition to what we've talked
about those projects we have funding for
training activities particularly focused
on members from low-middle income
countries and early stage researchers
and we also seek to be a voice for
advocacy as well so
both in the UK with UK governments and
bodies here but also internationally as
a voice for bacterial vaccinology
Thanks, Cal.
Cal iI think if we... one of the things I
think our network really gives is
opportunity
and opportunity for people who have
found it difficult to bring their ideas
to fruition and also to find funding
particularly in low-middle income
countries where there is so much talent
that needs to be
nurtured and to be supported, and I think
BactiVac has been really really
instrumental in helping that and
I'm sure you agree is that we really
look forward to seeing how the projects
we have funded come to fruition and
the opportunities that leads to for
people.
Is there anything you want to just
add about the successes we've seen in
the funded projects?
Yeah so we've had a number that have go on
to to get substantive funding from
bodies such as CARB-X, such as Wellcome,
such as the MRC, and
and this is allowing some projects to
move to the next stage of vaccine
development.
We have one vaccine for gonococcal
vaccine development we've got a number
of ones that have been moving now down
the vaccine pipeline we've been
targeting a range of different diseases
from typhoid
and shigella to gonococcus to
bacterial infections affecting
livestock as well
and so a whole range of different
diseases
and many of these are
diseases that we won't be so aware of
in high income countries unlike COVID
which has has affected everyone globally,
but these are diseases that
are affecting particularly
individuals impoverished in low-middle
income countries and cause a continual
rate of attrition, and as well as that
burden of disease we have the ongoing
threat of antimicrobial resistance which
threatens to make that all the worse and
as you
indicated at the start, vaccines
really are a major answer to the scourge
of antimicrobial resistance
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