HIC-Vac Network additional funding

英国在通过人体实验取得原创性科学发现方面处于全球领先地位。志愿者的人类感染挑战是有风险的，但这些风险需要与能够在实验中测试疫苗和治疗方法的巨大优势之间取得平衡，而不需要等待人们自然感染。尽管疫苗每年拯救了全球数百万人的生命，但仍有许多传染病导致大量人死亡，而接种疫苗仍无法预防这些疾病。在中低收入国家尤其如此，这些国家甚至无法获得基本的医院治疗，唯一现实的选择是通过寻找新的、经济上可行的疫苗来预防传染病。这一目标的核心是与这些LMIC的科学家密切合作，他们可以向监管机构、政策制定者和公众宣传这些研究的价值。开发一种新的疫苗过去需要20年时间，成本超过10亿GB。这种情况在COVID大流行期间发生了变化，但通过使用实验挑战，可以更快地获得确定的结果，表明疫苗有效或无效，只有少数志愿者--可能是10到100人--接种疫苗，而同样数量的人接受对照接种。以这种方式进行挑战研究可以在原则上证明疫苗的有效性。相比之下，证明疫苗有效所需的实地研究可能是巨大的，通常涉及数千人，费用是人类挑战研究的数倍。从伦理上讲，需要仔细权衡人类挑战的好处与可能对志愿者造成的伤害。这将可以测试的感染范围缩小到那些疾病相对轻微或可预测和自我限制的疾病，或者那些可以通过现有药物或支持性护理轻松可靠地治疗的疾病。英国正在进行的人类感染研究包括流感、呼吸道合胞病毒、鼻病毒、伤寒和副伤寒、疟疾、细菌性肺炎和百日咳。尽管有一些问题需要克服，但如果能够应对人类的挑战，针对寨卡病毒、登革热和MERS等新兴病毒的疫苗开发将大大加快。疫苗领域正处于一个非常令人兴奋的阶段，因为从早期研究中产生的许多免疫学概念现在可以应用于新的情况。目前，英国(伦敦、牛津、利物浦、约克、诺丁汉和南安普顿)和海外的HIC-Vac联盟的成员在开展这些研究时面临着许多道德和监管方面的挑战，他们热衷于分享他们的经验并提供相互支持。我们不仅在实验技术方面，而且在如何克服监管和安全工作做法的巨大但必要的负担方面，都有很多需要相互学习的地方。我们将通过共同努力来做到这一点：通过电话、面对面定期举行会议，并相互提供实际支持。HIC-VAC的主要优势是我们可以将资金分配给成员，从而使这项工作成为可能。除了加速疫苗开发，我们的网络还将合作解决有关人类感染的基本科学问题，这些问题只能从英国国内和全球(特别是LMIC地区)的挑战研究中获得。

The UK is a global leader in making original scientific discoveries by human experimentation. Human infection challenge of volunteers carries risks, but these need to be balanced against the great advantage of being able to test vaccines and treatments experimentally without waiting for people to be naturally infected. Although vaccines save millions of lives around the globe every year, there are many infectious diseases that still kill large numbers of people that are still not preventable by vaccination. This is especially true in low and middle income countries (LMIC) where even basic hospital treatment is unavailable and the only realistic option is to prevent infectious diseases by finding new and economically viable vaccines. Central to this aim is close collaboration with scientists in these LMICs, who can advocate for the value of these studies with regulators, policy makers and the public.Developing a new vaccine used to take 20 years and cost over £1bn. This situation has changed during the COVID pandemic but, by using experimental challenge, definitive results can be obtained much quicker showing that a vaccine works or does not work with only a few volunteers - perhaps 10 to 100 - being given the vaccine and a similar number being given control inoculation. Conducting challenge studies in this way allows proof in principle of vaccine efficacy. By contrast, the field studies that are needed to prove that a vaccine works can be vast, usually involving thousands of individuals and costing many times more than a human challenge study.Ethically, the benefits of human challenge need to be weighed carefully against the harm that may be caused to the volunteers. This narrows the range of infections that can be tested to those where the disease is relatively mild or predictable and self-limiting, or diseases that can be easily and reliably treated by existing drugs or supportive care. Examples of human infection studies that are on-going in the United Kingdom include Influenza, RSV, rhinovirus, typhoid and paratyphoid, malaria, bacterial pneumonia and whooping cough. Although there are problems to be overcome, vaccine development for emerging viruses such as Zika, dengue and MERS would be greatly accelerated if human challenge could be performed.The field of vaccines is in a very exciting stage in that many immunological concepts that have emerged from earlier studies can now been applied in fresh situations. At present the members of the HIC-Vac consortium in the UK (London, Oxford, Liverpool, York, Nottingham and Southampton) and overseas have faced many ethical and regulatory challenges to mounting these studies and are keen to share their experience and to provide mutual support. We have a great deal to learn from one another regarding not only experimental techniques but also how to overcome the large but necessary burden of regulation and safe working practices. We will do this by bringing our efforts together: holding regular meetings by phone, face to face and providing one another with practical support. HIC-Vac's main strength is that we can distribute funding to members, so enabling this work. In addition to accelerating vaccine development, our Network will collaborate in addressing fundamental scientific questions about human infection that can only be obtained from challenge studies both within the UK and globally (especially LMIC regions).