Vaccination is our best hope for stopping the coronavirus pandemic in its tracks. But producing safe, effective and globally accessible vaccines within the next 12 to 18 months is not only a scientific challenge: new levels of collaboration and investment across industry and government will be essential.

This pandemic is the biggest public health threat that humankind has faced in a century. It is wreaking havoc on societies and economies and it is an acid test for public-private partnerships. We need to move fast to unleash the funding required to develop vaccines.

Delivering covid-19 vaccines for the world—at record speed—will take a collective effort. We must combine the resources and expertise of academia and the private sector with the ability only governments have to mobilise the political will and amass the large sums of money that will be required.

No therapies to prevent or treat covid-19 are available, but research is advancing at a breakneck pace. The private and public sectors must now collaborate to ensure the best and fairest use of new products—wherever they come from—when they arrive.

In the case of vaccines, this means pursuing multiple approaches across both established and new technologies rather than trying to pick one or two “winners” prematurely since many candidate vaccines will inevitably fall by the wayside.

Given the threat posed by covid-19 we must regard vaccines as a global good: a shared resource that is deployed for the good of all irrespective of a country’s ability to pay. Given the global threat posed by covid-19 and the universal, simultaneous need for a vaccine, the world must devise a globally fair allocation system to ensure that healthcare workers and the most vulnerable segments of the world’s population get priority access.

Today, exceptional science is being done around the world. Researchers have been working around the clock to produce vaccine candidates ever since the genome of the new virus was sequenced in January 2020. The good news is this has yielded a flood of more than 90 promising candidates. Now this effort must be buttressed by large-scale public-sector assistance to optimise clinical trial procedures and scale-up manufacturing capacity—something that involves risky upfront investments before any product is approved.

The Oslo-based Coalition for Epidemic Preparedness Innovations (CEPI) provides a platform to deliver just this kind of private-public co-operation. The coalition was  initially set up in 2017 after West Africa’s deadly Ebola epidemic to accelerate work on vaccines against emerging infectious diseases. 

CEPI—a partnership of governments, industry and philanthropies—has a clear roadmap to accelerate covid-19 vaccine development at an estimated cost of US$2bn over the next 12-18 months. Financial support from the UK, Germany, Norway, Denmark and Finland has brought in around US$660m. Closing the remaining financing gap is imperative if we are to stay on track.

Vaccine development is complex and expensive. Rates of attrition are high. We need multiple candidates to ensure that we can produce safe and effective vaccines. My organisation estimates that a large part of the US$2bn will be needed by the middle of this year to develop eight vaccine candidates through initial phase 1 testing, prepare for phase 2/3 trials and to invest in manufacturing processes for up to six candidates.

Assuming one or more of these candidates succeeds, there will then be a huge global demand requiring unparalleled efforts to harness manufacturing capacity and distribution networks.

Last month, G20 leaders pledged to support the global effort against covid-19, including contributing to this vital vaccine work. The message could not be clearer: now is the time for governments and industry to join forces to fight back against this deadly disease.

There has been a morbid fascination with the number of deaths associated with covid-19 and the extent to which countries are mishandling the crisis. But we are also facing a data crisis which distorts proper analysis of either. 

Scientists are tinkering with models on the expected number of deaths based on incomplete data as not all countries apply the same covid-19 testing rules and not all deaths are accurately recorded. At the same time countries are still deliberating about who they should test, be it asymptomatic cases, only those with symptoms, those presenting to healthcare systems or healthcare workers. 

Officials in the US have cast doubt on the numbers being reported by China, and not all countries have the resources to follow the WHO’s “test, test, test” advice. This is particularly true for economies with under-developed healthcare systems such as India, Africa and Latin America. 

So with that cautionary note, we have tried to work with the data at hand—incomplete as it is—to map the number of confirmed cases of covid-19 against deaths per 100,000 population over time. While the absolute numbers of deaths are important to note because each loss of life is painful to loved ones, we should also look at death rates across populations to better understand the virus and to keep abreast of potentially effective containment measures. In developing countries cause of death information is often hard to obtain, mostly because systems for recording these details are inadequate or non-existent.

The bubbles represent absolute deaths in an individual country. You can eliminate regions from the timeline to see, for example, how Europe is faring against North America, or zoom in on the trajectory for an individual country. As of April 20th, death rates appear to be highest in Europe with Belgium reaching around 50 deaths per 100,000 population.

While people are still focused on covid-19 deaths, be prepared for a new type of death associated with covid-19 over time. These are deaths and morbidity that will arise as healthcare systems direct more and more resources to covid-19 and less and less to common diseases such as stroke and cancer. For developing countries, the common diseases affected will be tuberculosis, malaria and AIDS. 

These “excess” deaths may also arise as people become more fearful of overloading healthcare systems or worried about catching the virus if they attend healthcare facilities including hospitals. There are also the deaths of older people living in residential care facilities or dying at home that are not being properly accounted for. If you have cancer and your treatment is delayed, that is a life and death situation for your overall prognosis. The same applies if treatment is delayed following the first signs of stroke. Patients living with chronic health conditions will see a significant change in the level of service and care received during this crisis, and the damage caused may take years to repair. 

So while scientists study the data around covid-19, expect new data to emerge on how other diseases have been affected by this pandemic.