How badly does the developing world need cheap, effective, easily-available vaccines against deadly viruses? As rhetorical questions go, that one’s a whopper. In March 2014 an outbreak of the Ebola virus spread across much of West Africa, with a fatality rate of around 50%. By 2015 it was headline news. As with many other disasters, the established media caravan has now moved on and the Ebola panic is over – until the next time.
Ebola, Zika – the story trajectory is similar. We panic and wring our hands at the horrific deaths of thousands; the world seems to mobilise, spending millions on tackling the problem; then media fatigue sets in; the problems remain, barely noticed outside specialist agencies. While anything that promises a treatment for malaria grabs headlines, Chikungunya – a mosquito-borne viral disease that causes intense joint pain and is incurable though not usually fatal – is for many just a name; not for those across Asia, Africa and elsewhere, where it signifies a crippling disease. Yet the impact on the lives of millions infected by Chikungunya is scarcely heard of. So too with Dengue Fever, which can be fatal; it affects an estimated 390 million every year in Africa and south-east Asia.
One of the latest member companies of the Social Stock Exchange is also one of the companies that might improve the lives of countless people across the world. That’s a big statement, but Emergex justifies it. Yet it’s almost unknown. Not for long, I suspect, if its innovative technologies prove successful out in the field. Emergex has a very clear mission. To quote its Impact Report: “we think we have the best and most-effective solution for the Zika crisis and for other viral and bacterial pathogens” including Ebola, Dengue, Chikungunya and others. Its CEO is professor Thomas Rademacher, who has a lengthy and impressive professional background in biotech. Emergex is currently funded by a combination of private high-net worth individuals and grant funding, with a recent £499,000 from Innovate UK.
I spoke to Laurens Rademacher, Scientific Operations Director with Emergex, to put the company under the microscope and hear more about its plans to assault high priority infectious diseases more cheaply and effectively. According to him, Emergex has several strategic technical advantages which – critically – translate into extremely powerful social impacts. “There are several elements to our technology. The first is that we are making a 100% synthetic vaccines as opposed to traditional vaccines technologies that use biological components such as live viruses or complex proteins. Although these technologies have seen some great success in the past, the smallpox vaccine for example was a weakened live virus vaccine, they do face a whole host of problems such as high production costs, need for refrigeration and safety concerns. The synthetic nature of our vaccines means we overcome many of these problems. The second is the viral peptides, the bits of the virus which your body recognises as an invasive virus. But again ours are different from those used in traditional vaccines; these peptides are from the internal part of the virus, which doesn’t mutate and is consistent. The third element of Emergex’s technology is using gold nanoparticles as a carrier for the viral peptides. By combining the viral peptides with the gold nanoparticle carrier we can make what we like to call a synthetic virus. We can use this synthetic virus to trick the immune system into thinking it has been exposed to the real virus and so generating immunity in a safe manner. The gold nanoparticle technology, which is licensed from (AIM-listed) Midatech, is the perfect structure on which to make our synthetic viruses. Gold is very inert, non-reactive, which means it’s very safe. Gold is also excreted very well, so it doesn’t build up in the body. It also allows us to make extremely small vaccine particles; our vaccines are about 5nm, that is around 1/36,000th the size of a human hair.”
Among the viruses in Emergex’s sights is Ebola. Following the recent outbreak, several companies are working on an Ebola vaccine, and these vaccines should in theory work. That might be thought a threat to the commercial success of Emergex, but Laurens Rademacher dismisses that. He says: “The problem is, because they use a live vaccine technology – using a genetically modified version of the Adenovirus with Ebola components added, a complicated and expensive process – it’s not practical for where the vaccine is most needed. Moreover they are much more expensive – the leading competitive Ebola vaccine, now in stage three trials, is going to cost up to $250 a pop for production costs alone.” According to Emergex a dose of one of its vaccines could cost as little as $0.1304 to manufacture.
Laurens Rademacher says the sheer size of the populations needing vaccination counteracts the likely success of conventional vaccines. “In the regions where Ebola is, most people exist on less than a dollar a day. To have effective herd immunity there you need to immunise some 70 million people. This becomes completely impractical. Then there are production bottlenecks – the companies making this conventional form of Ebola vaccine think they can only make 100,000 doses a month. With our synthetic process we can make millions of doses a week.”
The Emergex vaccines – being synthetic – also have a much greater shelf-life than more conventional ones. Another critical aspect of Emergex’s technology is its mode of delivery, which uses a microneedle patch to give the vaccine. That means no specialist skills are needed; an initial dose might be given by a local vaccine provider and any follow-up doses could be self-applied at home by the user.
A further novel aspect of Emergex’s strategic business aim is the development of a repository of experimental vaccines in readiness should further outbreaks occur. Emergex will offer its customers – governments NGOs and multi-lateral organisations pay-as-you go access to this repository. This will enable customers to be prepared for epidemics through keeping a reserved stock of readily available, effective vaccines and subscribing to on-demand vaccine production, allowing them to rapidly offer vaccination against the disease in question to affected populations. Creating such a repository would not be possible for traditional vaccines, but is viable for Emergex due to the fast and inexpensive development times and manufacture of its vaccines. This repository would therefore provide an on-demand emergency line of defence against the world’s most dangerous pathogens when no other solution exists, and provide vaccines which are ready for phase 2 and 3 trials as and when those outbreaks occur.
All the above suggests that Emergex, although only a couple of years old, is already on the path to both commercial success and widespread social impact. So why join the Social Stock Exchange? Laurens Rademacher considers: “We wanted to raise awareness as to what we are about. Often when we told people we were working on vaccines they assumed that we were the same as the general pharmaceutical industry who, let’s be honest, isn’t very popular. You hear stories of over-pricing, the vaccines not being very effective, and so on. When we set up we very much had in mind that we wanted to make vaccines that were practical, affordable, and for places where they are actually needed. We think that the Social Stock Exchange is probably one of the best ways to get that view across.”
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