Kate Bingham, former UK vaccine manager: “All companies asked for immunity, it was the price for insuring vaccines”

“It just keeps people from dying.” That was the instruction that Kate Bingham received in May last year from British Prime Minister Boris Johnson when she was appointed head of the task force for the procurement of Covid-19 vaccines in the United Kingdom. From then on he began to put together a team with only one focus in mind: speed. It was necessary to ensure as soon as possible that the population had access to a vaccine. But in that minute there were about 200 investigations and no one knew if they would make it to port. Until then the record in the development and approval of a vaccine was held by the mumps that took four years. But in this case, the idea was to have one before the end of 2020.

On the same day his appointment was announced, Bingham received an email from his friend, the Chilean ambassador to London, David Gallagher. From then on, a cooperation began that would also be key for the process of purchasing vaccines by the Chilean government and that today has both countries in the top positions worldwide in terms of percentage of the vaccinated population. According to the information provided by the OurWorldinData site, in the United Kingdom 37% of the population has already received their first dose and in Chile 27%, which places them in second and fourth place respectively. “David is the one who has to receive the credit for what was done and identify that we could share our strategies and our contacts,” he says from London.

What was the help you gave Ambassador Gallagher?

What I did with David was show him what our strategy was. I told him about the diverse portfolio approach to choosing the most promising vaccines across different formats and told him that our focus was on speed and that was important.

Did it also help you contact the right people in the process?

I put him in touch with the companies he was talking to. Chile today has contracts with PfizerBionTech, with AstraZeneca, with Janssen, all companies that I think are developing very good vaccines.

Did you collaborate in any other stage of the process?

No, I was not involved in any negotiation or management, nothing of that kind, I just shared with him what we were doing.

And did you have contact with President Piñera with someone else from the government in Chile?

Yes, David asked me to speak to someone, I don’t remember well at the moment, but I spoke to someone in Chile once.

Could it have been Rodrigo Yáñez, the undersecretary of international economic relations?

Yes, Rodrigo, it could be (and after checking on his computer he confirms it) Yes, Rodrigo Alejandro Yáñez Benítez. I had a phone conversation with him and then introduced him to the person who was leading the issue in the international area of ​​our team. And he asked me questions about indemnity insurance and we talked about the UK damage scheme.

That imagination was an issue that particularly concerned vaccine companies. Did the companies ask for immunity clauses in the contracts?

All the companies asked for immunity. In the case of the United States, they even established protective statutes and passed a law called the US Prep Act that gives vaccine manufacturers a statute of immunity. We didn’t go that far, but we did offer them immunity. That was basically the price for insuring the vaccines. If we had not offered that we would not have insured the vaccines. All countries had to offer immunity.

In a first stage there was a real war for medical supplies, which anticipated that something similar could happen with vaccines. How did they cope with the risk that vaccines might not arrive? Afraid of an escalation in the vaccine war?

We were concerned then with the US Defense Act because it is a very powerful law and it gives the government of that country the power to seize any vaccine or other product from any US company. But having said that, this is a collaborative effort. globally, we depend on the Americans, the Americans will use the UK for their clinical data and we seek supplies from other parts of the world. For this reason, our work focused on supply sources, on the security of supplies, but it is not realistic to think that the United Kingdom is going to be the only supplier of everything, because you need tubes from some parts, syringes from another part. This is a global market.

Was negotiating jointly with the EU evaluated in a first stage or was this never considered?

Yes, of course because last year the UK was still part of the European Union. But the reason we didn’t do it was because the EU set criteria that were very restrictive. They said, they can participate, but they would negotiate for us and then they would tell us which vaccines they negotiated, under what conditions and what would be the delivery plan. And besides, we had to stop all separate conversations with the vaccine companies. We felt that this was very restrictive, that it would be more flexible if we continued alone.

And do you think that is the reason for the problems the EU has today with the supply of vaccines?

They just took another route to get the vaccines, which is the normal way governments negotiate to buy products: You identify the product and then you negotiate to get the lowest price, especially if you are dealing with a large customer. We choose a different strategic path, we focus on speed rather than price. I don’t think his path was wrong. But in this case it made it slower and I think that was not good for people living in the territory of the European Union.

In the case of Chile, did you recommend that David Gallagher or Rodrigo Yánez follow the same approach as the United Kingdom?

I did not make any recommendations to Chile on the way forward, I simply described the approach we were taking and introduced David to some of the key people in different companies.

Returning to Europe, today several countries have decided to suspend the application of the AstraZeneca vaccine. Are you afraid that there is indeed a problem with the vaccine or do you think they are overreacting?

On the subject of AstraZeneca the concern is about a type of thrombosis in women in their 20s and 30s. They are very rare and generally underdiagnosed events in the population. My feeling is that there is no additional association with the vaccine. It all depends on how many people have been vaccinated. We are talking about 0.4 people per million here, so the reason we are not concerned about this is that it is very rare and what we have in the UK is very detailed and deep surveillance. We are able to detect any adverse event of any kind because we have all electronic records connected and we have a process to identify and monitor them. And the normal numbers that we see in this population with those cases are substantially higher than what we see among vaccinated people, so I don’t think there is any evidence that this is a thing of concern.

Think then that in the European Union they are overreacting.

Well, the EMA supported the use of the vaccine. Of course, as you get data, it will be necessary to see.

When you were commissioned to take on the vaccine procurement task force, little was known. What did you think then? What was your first goal?

We did several things in parallel, but the first challenge was to secure vaccines for the UK, the second was that successful vaccines were distributed internationally and the third was that the UK was better prepared and we could make plans for it. In terms of what I did, it was a combination of things, on the one hand to form a team that would lead in the different aspects of the work that we had to carry out; evaluate the environment, that is, evaluate the landscape of the different vaccines and start talking very quickly with those companies to understand where they were, all the data they had, what were their plans for clinical development and manufacturing, and understand what capabilities we had in United Kingdom to offer companies help to accelerate the development of their vaccines.

But there were hundreds of vaccine investigations, how did you decide which one to bet on?

We had a pretty clear set of criteria to consider. You’re right, I think there were 200 vaccine investigations. The first thing was to review mostly pre-clinical data and see if the data supported the possibility of generating a strong immune response. But probably the most important issue was whether they could start the clinical trial in 2020. There were a lot of companies that we thought would not be able to keep up with production. All our focus was speed. We started in May and by June we already had a long list of companies we wanted to work with.

Unlike Chile, which opted for Chinese vaccines, the United Kingdom chose none. Did you make that decision for any special reason?

Yes, we looked at Chinese companies, but again, the reason we did not prioritize them was because of speed issues and because they had to pass the regulations of the MHRA (the regulatory agency for drugs and medical devices). The MHRA needed to review their plants, be satisfied with their quality standards and we thought we would not be able to do that at the required speed.

Did you really think that the first vaccine could be approved in less than a year?

Yes, we knew it was possible. What was done was that the safety testing phase was not reduced in time, but the efficacy tests, phases 2 and 3, were greatly compressed. Now it is true that before starting in May, there was no vaccine for human coronavirus and when I spoke with the experts about what their estimates of the chances of success were, they told me that there was perhaps a 15% chance of success for a vaccine that already was in the clinical stage, but only 10% or less for vaccines that were not yet in the clinical stage. Against this, our view was that we had to support many vaccines to maximize the chances of getting one that was successful.

You did not have a special knowledge of the subject of vaccines, but of the pharmaceutical world. To what extent was that key?

I worked with that world for 30 years. We had the network in most of the companies – not in the case of Chinese companies, but in the rest – we had personal relationships in those companies or we had a way of reaching them and we understood what developing and producing implies in my case. pharmaceuticals, but it is similar with vaccines. And we understood all the manufacturing regulations. We spoke the same language, we came from the same industry. And the other aspect is that because our focus was on speed, we were able to create a process in government that was very fast in terms of decision-making.

And do you think the key to success was prioritizing speed?

The key was that we had the experience in the sector, we did not have to learn along the way. In the UK, less than 10% of civil service civil servants have academic degrees in science. And they have little experience in the sector.

He has had contact with Ambassador Gallagher in recent times, they have commented on the progress made in both countries.

Yes a bit. I’m seeing when the last email was (he says while checking his computer). He wrote to me asking for UK help in sequencing the virus to identify emerging variants. He asked for my help to speak with the group in charge of the Covid genome and is now in contact with them. They may do some sequencing for Chile.

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