Coalition for Epidemic Preparedness Innovations

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LLM Summary:CEPI is an international vaccine development partnership founded in 2017 that addresses market failures in pandemic preparedness by funding vaccines for diseases with limited commercial viability. While achieving notable success during COVID-19, the organization faces ongoing criticism for weakening equitable access policies under pharmaceutical industry pressure and maintaining insufficient transparency in its agreements.

Quick Assessment

Aspect	Assessment
Type	International vaccine development partnership
Founded	2017 (conceived 2015)
Headquarters	Oslo, Norway
Mission	Accelerate vaccine development for epidemic/pandemic threats within 100 days
Funding Raised	$760 million+ (as of February 2020)
Key Achievement	Supported 8 authorized COVID-19 vaccines
Primary Focus	Priority pathogens (MERS, Lassa, Nipah, Ebola, Marburg, Zika) and Disease X
Major Challenge	Balancing pharmaceutical partnerships with equitable access commitments

Key Links

Source	Link
Official Website	cepi.net
Wikipedia	en.wikipedia.org
World Bank Trustee	fiftrustee.worldbank.org

Overview

The Coalition for Epidemic Preparedness Innovations (CEPI) is a global partnership established to finance and coordinate the development of vaccines against emerging infectious diseases with pandemic potential.¹ Launched in January 2017 at the World Economic Forum in Davos, the organization addresses a critical market failure: many dangerous pathogens offer insufficient economic incentives for pharmaceutical companies to develop vaccines, requiring public funding to ensure preparedness.²

CEPI’s work focuses on diseases that disproportionately affect low-income countries and lack commercial markets, including MERS-CoV, Lassa virus, Nipah virus, Ebola, Marburg fever, and Zika. The organization also develops rapid-response vaccine platforms for “Disease X”—unknown pathogens that could cause future pandemics.³ During the COVID-19 pandemic, CEPI became a key partner in COVAX alongside WHO, UNICEF, and Gavi, leveraging pre-pandemic investments to accelerate vaccine access for low- and middle-income countries.⁴

The organization’s current strategic priority is the 100 Days Mission: developing vaccines against unknown pathogens within 100 days of identification. This ambitious goal, endorsed by G7 and G20 leaders, relies on advancing platform technologies and building prototype vaccine libraries that can be rapidly adapted to emerging threats.⁵

History

Conception and Founding

CEPI was conceived in response to the 2014-2016 West African Ebola epidemic, which exposed critical gaps in global vaccine development infrastructure.⁶ The epidemic killed over 11,000 people and cost $53 billion, yet a 100% efficacious vaccine arrived too late to prevent the outbreak.⁷ Four independent expert reports on the Ebola response called for a new system to stimulate vaccine development against epidemic threats.⁸

The concept was formally outlined in July 2015 in The New England Journal of Medicine in a paper titled “Establishing a Global Vaccine-Development Fund,” co-authored by Jeremy Farrar (director of Wellcome Trust), Stanley A. Plotkin (co-discoverer of the Rubella vaccine), and Adel Mahmoud (developer of the HPV and rotavirus vaccines).⁹ Between February and June 2016, task teams convened to define sustainable solutions, comprising 200 thought leaders and experts from more than 80 organizations.¹⁰

CEPI was formally established in August 2016 as an international non-profit association under Norwegian law, founded by the governments of India and Norway, the Bill & Melinda Gates Foundation, the Wellcome Trust, and the World Economic Forum.¹¹ The organization launched publicly in January 2017 at the World Economic Forum in Davos with an initial investment of $460 million from the governments of Germany, Japan, and Norway, plus the Bill & Melinda Gates Foundation and the Wellcome Trust.¹²

Evolution and Expansion

The European Union joined CEPI as a funding partner in 2019, followed by the United Kingdom in 2020.¹³ By February 2020, CEPI had raised a total of $760 million and mobilized more than $750 million to support vaccine development against priority pathogens.¹⁴

Although not originally designed as a public health emergency response organization, CEPI became an equal partner with WHO, UNICEF, and Gavi in forming COVAX during the COVID-19 pandemic. The organization leveraged its pre-pandemic vaccine development investments to accelerate COVID-19 vaccine access for low- and middle-income countries.¹⁵ CEPI’s COVID-19 portfolio ultimately supported the development of 8 authorized vaccines.¹⁶

In March 2021, CEPI launched a $3.5 billion five-year plan focused on preparing for future pandemics through three pillars: prepare, transform, and connect.¹⁷ This plan included a $200 million call for SARS-CoV-2 variant-specific vaccines, linking surveillance systems to vaccine development decisions.¹⁸

Mission and Approach

Core Strategy

CEPI’s mission is to accelerate the development of vaccines and other biologic countermeasures against epidemic and pandemic threats so they are accessible to all people in need.¹⁹ The organization addresses market failures by funding vaccines for diseases that offer little commercial return but pose significant public health risks. By ensuring that price is never a barrier to access, CEPI focuses particularly on diseases affecting low-income countries disproportionately.²⁰

The organization operates through two primary focus areas:

Vaccine Platform Innovations: Funding platforms for rapid Disease X response, building preclinical, chemistry/manufacturing/controls (CMC), clinical, and regulatory expertise for outbreak speed and accessibility.²¹
Priority Pathogen Candidates: Advancing vaccines for high-risk pathogens and viral families, including exemplar vaccines against prototype pathogens.²²

The 100 Days Mission

CEPI’s 2022-2026 strategic plan, known as CEPI 2.0, prioritizes the 100 Days Mission—developing vaccines against unknown pathogens within 100 days of identification.²³ This goal involves:

Building prototype vaccine libraries for viral families (e.g., Paramyxoviridae, Flaviviridae, Togaviridae, Filoviridae, Bunyaviridae, Arenaviridae, Picornaviridae) pre-tested in Phase 1 trials for rapid adaptation²⁴
Using AI for viral modeling and earlier immune response biomarkers²⁵
Establishing innovative trial networks and regulatory pathways²⁶

A 2025 cross-sectional survey of 85 vaccinology and public health experts (73.2% response rate) identified vaccine libraries, surveillance, and trial networks as key priorities for achieving this goal. However, experts from low- and middle-income countries were more confident in success than those from high-income countries, suggesting differing perspectives on implementation feasibility.²⁷

Partnership Structure

CEPI operates as a partnership of public, private, philanthropic, and civil organizations, bringing together governments, industry, academia, intergovernmental institutions like WHO, and civil society.²⁸ The organization coordinates research activities, pairs small R&D firms with manufacturers, streamlines regulatory approvals, and manages patent issues.²⁹

The organization’s scientific advisory committee includes executives from major pharmaceutical companies including Pfizer, Johnson & Johnson, and Takeda Pharmaceutical, advising on strategic partnerships and development pathways.³⁰

Key Achievements

COVID-19 Response

CEPI’s pre-pandemic platform investments enabled a rapid SARS-CoV-2 response. The organization invested $4.4 million in March 2020 to support Novavax and the University of Oxford, eventually scaling to over $100 million in COVID-19 projects.³¹ Notable partnerships included:

University of Oxford and AstraZeneca: Supporting the ChAdOx1 platform (previously used for MERS, Lassa, Nipah), with equitable access provisions including Joint Monitoring Committees (JMAGs), stage gates, public health licenses, and dispute resolution mechanisms.³²
Next-generation vaccine candidates: Supporting development of multi-variant vaccines and improved formulations.³³

CEPI was the only public funder systematically leveraging investments for equitable access, securing first right of refusal for COVAX to access hundreds of millions of doses amid global shortages.³⁴ COVAX achieved the fastest vaccine deployment ever, with modeling suggesting it averted an estimated 2.7 million deaths by end-2022.³⁵

Priority Pathogen Programs

CEPI has initiated significant vaccine development programs for diseases lacking commercial markets:

Lassa Fever: Funded multiple vaccine candidates with the first volunteer dosed in Oxford trials; West African Ministers of Health pledged joint commitment to advance Lassa fever vaccines on September 8, 2025.³⁶
Chikungunya: Supported development of the first authorized vaccine against Chikungunya.³⁷
Rift Valley Fever: Created the largest-ever reserve of investigational Rift Valley fever vaccine in partnership with Oxford and Serum Institute.³⁸
Pancoronavirus Vaccine: Invested approximately $65 million in GBP511 for protection against future coronavirus pandemics.³⁹
Multivalent Filovirus Vaccines: Backing new research for vaccines protecting against multiple deadly filoviruses.⁴⁰

Expanded Infrastructure

In 2024-2025, CEPI significantly expanded its global infrastructure:

The International Vaccine Institute (IVI) and Korea Disease Control and Prevention Agency (KDCA) joined CEPI’s Centralised Laboratory Network in 2025, marking the first Korean labs in a network of 20 across continents for standardized vaccine evaluation.⁴¹
Samsung Biologics joined the Vaccine Manufacturing and Filling Network (VMFN) to supply up to 50 million doses in a pandemic, strengthening outbreak-ready vaccine production capacity.⁴²
Partnership with the African Vaccine Regulatory Forum (AVAREF) to boost clinical trial application reviews in Africa.⁴³

Governance and Funding

Funding Sources

CEPI is funded by a diverse coalition of public and philanthropic sources. Initial founding partners contributed $460 million, with funding expanding to $760 million by February 2020.⁴⁴ Major funders include:

Governments: Australia, Belgium, Canada, Germany, Japan, Norway, United Kingdom, European Commission
Philanthropic Organizations: Bill & Melinda Gates Foundation, Wellcome Trust
Recent Commitments: Korea invested $18.9 million in CEPI; Germany provided $150 million for CEPI’s core portfolio and $430 million for its COVID-19 portfolio, with plans to provide an additional $40 million through 2026.⁴⁵

The organization launched a $3.5 billion five-year plan in March 2021 to address future pandemic threats.⁴⁶

Leadership

Richard Hatchett serves as CEPI’s Chief Executive Officer.⁴⁷ Dr. Kent Kester serves as Executive Director of Vaccine R&D.⁴⁸ The organization maintains a scientific advisory committee with representation from major pharmaceutical companies and academic institutions.

Criticisms and Controversies

Equitable Access Policy Weakening

CEPI faced significant criticism in 2018 over policy changes regarding intellectual property and equitable access. Originally, CEPI required vaccine developers to grant access to technology and waive substantial profits or proprietary rights for publicly funded research. After pharmaceutical companies including Johnson & Johnson, Pfizer, and Takeda objected, these provisions were removed once funding was secured.⁴⁹

Médecins Sans Frontières (MSF) strongly criticized this reversal for undermining transparency and equity, accusing CEPI of not following its own policies and removing board review of contracts.⁵⁰ The New York Times characterized CEPI’s initial push for pharma partnerships without profits or IP rights as a “failed effort,” with the organization replacing specific measures with vague commitments to affordability and availability.⁵¹

CEPI defended the policy revision by arguing the original approach was idealistic but not pragmatic for business realities, noting that some manufacturers refused to participate otherwise. The organization maintained it retained rights to repurpose IP or switch manufacturers with consent.⁵²

Transparency and Accountability

CEPI has been criticized for keeping the terms of its grant agreements with vaccine developers confidential, preventing public accountability.⁵³ Inger Berg Ørstavik, a law professor specializing in patent licensing, stated that “without more openness, neither CEPI nor the vaccine manufacturers the organisation funds can be held accountable” and expressed surprise at CEPI’s reliance on “individually negotiated secret agreements.”⁵⁴

Structural Limitations in Leverage

Despite holding significant contractual rights, CEPI experienced substantial limitations in exercising leverage against vaccine manufacturers during the COVID-19 pandemic.⁵⁵ The organization could not effectively coerce companies to make meaningful concessions on pricing and equitable access commitments, particularly during early development stages when leverage was theoretically greatest.⁵⁶

CEPI’s structure separates research funding from price negotiations, with pricing addressed downstream by partners like Gavi rather than during early-stage development. Critics argue this creates a fundamental flaw, as one expert noted: “in a pandemic situation, where high-income countries are not particularly price sensitive and are willing to pay pretty much anything just to get access to these vaccines, Gavi has very little power to negotiate with companies.”⁵⁷

COVAX Shortcomings

While CEPI itself was not solely responsible, the broader COVAX vaccine allocation system faced significant structural weaknesses. COVAX aimed to distribute 2 billion doses by end-2021 but shipped only 1.1 billion by January 15, 2022, and 1.72 billion by September 15, 2022.⁵⁸ Key issues included:

Few wealthy governments procuring through COVAX; self-financing governments bypassed it, redirecting billions of doses
Approximately 85% of administered doses went to high-income and upper-middle-income countries⁵⁹
CEPI’s agreements had “rights of first refusal” for epidemics, but leverage over national governments was limited⁶⁰

CEPI’s governance and funding decisions have been criticized for prioritizing high-income country interests over equitable global manufacturing.⁶¹ The organization did little to support vaccine manufacturing capacity in low- and middle-income countries, instead supporting the status quo that concentrates production in wealthy nations.⁶² Additionally, CEPI failed to leverage its influence to ensure technology transfer—for example, it did not require CureVac to share its mRNA technology despite supporting the mRNA Hub’s equitable access goals.⁶³

CEPI also did not require vaccine developers to publish results in open-access journals or participate in comparative analyses of their products, limiting the broader scientific community’s ability to benefit from publicly funded research.⁶⁴

Recent Developments

2024-2025 Initiatives

CEPI has launched several major initiatives:

Biosecurity Policy: Published its first Biosecurity Policy for oversight of safe research practices.⁶⁵
Prototype Pathogen Research: CEPI and WHO promoted using prototype pathogens as “pathfinders” to build knowledge for entire pathogen families at the Global Pandemic Preparedness Summit 2024 in Rio de Janeiro, coordinating research through Collaborative Open Research Consortium (CORC) hubs.⁶⁶
Analytical Technologies Funding: Announced funding for innovative analytical technologies to reduce vaccine development times and costs while improving equity in low- and middle-income countries.⁶⁷
AI Integration: Launched a global AI platform for pandemic preparedness, creating a new collaboration using AI and expert networks for pandemic spotting.⁶⁸

Recent Vaccine Progress

Mpox: New vaccine study launching in outbreak-affected Democratic Republic of Congo with focus on equitable access.⁶⁹
Zaire Ebolavirus: Backing updated vaccine for improved affordability and accessibility.⁷⁰
Pandemic Agreement: Adoption of a pandemic agreement following three years of negotiations (finalized around late 2024/early 2025), addressing COVID-19 inequities with next steps on Pathogen Access and Benefit-Sharing (PABS) system.⁷¹

Key Uncertainties

Key Questions (5)

Can the 100 Days Mission be achieved given current technological and regulatory constraints, or are expert projections overly optimistic?
How can CEPI balance the need for pharmaceutical company participation with meaningful equitable access commitments that preserve public value?
Will prototype vaccine libraries prove effective for rapid adaptation to novel pathogens, or will each new threat require substantial additional development time?
Can CEPI effectively address manufacturing capacity gaps in low- and middle-income countries given funding constraints and geopolitical pressures favoring high-income country production?
What governance reforms would enable CEPI to exercise greater leverage over vaccine manufacturers while maintaining industry participation?