Abstract
Background: The formation of the Coalition for Epidemic Preparedness Innovations (CEPI) sheds light on how conditions for global collaboration are created and sustained. This is a multi-stakeholder initiative whose objective is to be a global financing and coordination mechanism that supports the development of vaccines against epidemic infectious disease. Methods: The paper reports from an empirical study that documented and analysed CEPI’s formation from idea in mid-2015 to its formal launch in January 2017, using a qualitative approach and analytical perspectives from international relations and the governance of socio-technical systems to explain decisions and outcomes. Results: The accomplishment of forming CEPI in only 15 months was possible due to a substantial operational capacity among founding partners for groundwork and coordinating parallel processes, multiple individuals in leadership roles as well the flexibility offered by an interim phase. Findings also suggest that key alignments needed to be found between diverging positions on collective action for technology development, revealing the complexity and dynamics of interests among actors. The study further identifies key institutional conditions that interests clustered around, which CEPI needed manage in order to become operational. Conclusions: The study concludes that while successful in developing a new nexus between global public health, vaccine innovation and pandemic response, CEPI was in 2017 still in the process of defining the nature of its authority within that landscape. Finally, the CEPI formation process bears significance for the global coordinated response to the coronavirus (COVID-19) pandemic in 2020. As features of the CEPI formation represent persistent challenges in global health collaboration, the study offers both a backdrop and lessons learned.
Highlights
Infectious disease outbreaks that cross borders reveal gaps in global structures for collaboration
As the methods section will elaborate in further detail, data from this study suggested that interests and leadership as key independent variables clustered around four necessary conditions for Coalition for Epidemic Preparedness Innovations (CEPI)’s creation
Even as actors shared the trauma of the Ebola outbreak, agreed on the need for R&D funding and the urgency of a new solution, the change, or the commons - in this instance CEPI – was achieved through a political process where stakeholders worked hard to find agreement on rules and instruments, leaving some options behind
Summary
Infectious disease outbreaks that cross borders reveal gaps in global structures for collaboration. As the methods section will elaborate in further detail, data from this study suggested that interests and leadership as key independent variables clustered around four necessary conditions for CEPI’s creation Making sense of these conditions, or what stakeholders needed to agree about, led to a broadening of the analytical perspective to include emerging work on the governance of socio-technical systems. In this way, the combination of conceptual framework for the study evolved as part of an iterative process and pragmatic approach to understand a new kind of institution. The rules and instruments that come into play in the case of CEPI is an empirical question, and reflects the characteristics of the technology in focus
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