Global Bioheroes: clinical research and new vaccines for health security

ABSTRACT

In the pursuit of ‘global health security’, some governments advocate deployment of pharmaceuticals to combat deadly infectious diseases wherever they emerge. Following the Ebola outbreak in West Africa, attention has turned to other emerging diseases and future pharmaceutical solutions. There is growing support for enabling faster clinical research to make new vaccines available sooner. Research on experimental vaccines must ordinarily be consistent with ethical principles designed to protect human research participants. However, where a target disease is framed in security terms, it could be argued that an extraordinary response is required: exposing research participants to more risk in order to accelerate research and enable more lives to be saved pharmaceutically. This article assesses two scenarios of security-oriented research. The scenario envisaged by the Coalition for Epidemic Preparedness Innovations (CEPI) is the propelling of vaccine research through to the stage of human safety-testing before a natural outbreak of the relevant disease. Efficacy and effectiveness tests are then able to be conducted once an outbreak begins. In a hypothetical second scenario, pre-outbreak vaccine research undertaken for the sake of health security would also include efficacy-testing. This would involve the exposure to pathogenic microorganisms of healthy volunteers (‘global bioheroes’) from around the world.

KEYWORDS:

• Coalition for Epidemic Preparedness Innovations (CEPI)
• Ebola
• health security
• research ethics
• vaccines

Acknowledgements

This paper was originally presented at the 2018 International Studies Association convention in San Francisco, USA. For their helpful feedback, the author thanks Stefan Elbe, Steven Hoffman, Tim Vines, Isaac Weldon, the AJIA editors, and two anonymous reviewers.

Disclosure statement

No potential conflict of interest was reported by the author.

Notes on contributor

Christian Enemark is Professor of International Relations at the University of Southampton. He is the author of Disease and Security: Natural Plagues and Biological Weapons in East Asia (2007), Armed Drones and the Ethics of War: Military Virtue in a Post-Heroic Age (2014), and Biosecurity Dilemmas: Dreaded Diseases, Ethical Responses, and the Health of Nations (2017), and co-editor (with Michael J. Selgelid) of Ethics and Security Aspects of Infectious Disease Control: Interdisciplinary Perspectives (2012).

Notes

1 In this article, the noun ‘hero’ is gender-neutral. It replaces ‘heroine’ in the same way that the gender-neutral nouns ‘author’, ‘actor’ and ‘waiter’ now commonly replace ‘authoress’, ‘actress’ and ‘waitress’, respectively.