Breakthroughs Blog: Medicines

Last week, the US Food and Drug Administration (FDA) approved Moderna’s flu vaccine for older adults, making it the first licensed mRNA flu shot. The approval follows objections raised by FDA earlier this year that put the future of the application in question. Compared to traditional influenza vaccines, mRNA vaccines can be produced much more quickly, allowing public health experts to wait longer before selecting strains to target for the upcoming flu season, increasing the likelihood that the vaccine will match the strains actually circulating. Beyond regular flu season, faster vaccine production and the approval of this seasonal shot could help speed up the development and approval of a pandemic flu vaccine. FDA specifically issued a standard approval for the vaccine for adults between 50 and 64 and an accelerated approval for adults 65 and older—Moderna has agreed to do a post-licensure trial to gather more data on effectiveness in this group. The company expects some doses will be available ahead of the upcoming flu season. The results of a Phase 3 clinical trial published in the New England Journal of Medicine last week showed that a once-weekly oral HIV treatment maintained viral suppression as effectively as a standard daily treatment regimen, pointing to a potential new treatment alternative for people living with HIV. This option could increase convenience for patients taking daily pills and doesn’t require the regular clinical visits associated with long-acting injectable options, especially for patients who experience stigma or have other health conditions requiring treatments to manage. The study regimen consisted of a once-weekly combination tablet containing islatravir and lenacapavir, which was evaluated in adults whose HIV had remained suppressed for at least six months through a daily regimen across 12 countries. The first participant has been dosed in a first-in-human trial of Moderna’s vaccine candidate against Bundibugyo, the strain of Ebola behind the deadly ongoing outbreak in the Democratic Republic of the Congo, which has now become the second-largest Ebola outbreak in history. There are currently no vaccines or treatments available for Bundibugyo Ebola. The vaccine candidate, mRNA 1469, uses Moderna’s mRNA platform, which is also used in the company’s COVID-19 vaccine. The Coalition for Epidemic Preparedness Innovations (CEPI)-supported trial is being conducted at three Canadian sites among healthy adult volunteers to assess the safety and tolerability of the candidate and evaluate immune response. If the vaccine candidate successfully advances to approval, Moderna has committed to working with CEPI to urgently make doses available to low- and middle-income countries at accessible prices.

Last week, the Merck-Wellcome joint venture Hilleman Laboratories announced that it will manufacture doses of a promising vaccine candidate for the Bundibugyo strain of Ebola, which is behind the worrying outbreak in the Democratic Republic of the Congo. There are no specific vaccines or treatments available for Bundibugyo, so global partners have worked rapidly to advance candidates into testing since the declaration of the outbreak. Hilleman Laboratories will manufacture doses of IAVI’s single-dose vaccine candidate, which uses the same vaccine platform as Merck’s approved vaccine for the more common Zaire strain of Ebola and has been identified by the World Health Organization as the most promising candidate currently in development. The lab expects to be able to produce tens of thousands of doses to be used in early-stage trials, potentially by the end of this year. Alveo Technologies is partnering with the University of Texas Medical Branch to develop a molecular point-of-care diagnostic test for Lassa fever, a hemorrhagic illness endemic in parts of West Africa for which access to laboratory testing is limited. Improving access to reliable, point-of-care testing could greatly improve Lassa control in endemic regions, as well as limit its potential to spread more widely—the virus has been designated as a dangerous pathogen with pandemic potential. The diagnostic test will be evaluated at clinical sites in Nigeria and Sierra Leone. The partners are also collaborating on field testing of Alveo’s diagnostic platform for avian influenza surveillance in Peru. The Global Antibiotic Research & Development Partnership (GARDP) announced last week that the Thai Food and Drug Administration has approved zoliflodacin, a first-in-class, single-dose, oral antibiotic for gonorrhea treatment, marking the drug’s second global approval. Zoliflodacin, developed as part of a public-private partnership between GARDP and Innoviva Specialty Therapeutics, was approved earlier this year by the US Food and Drug Administration. Beyond the potential of this innovative treatment to help address the rising global threat of antibiotic resistance, the rapid follow-up approval of the drug beyond the high-income market also represents an important step toward ensuring expedited global access to innovative new antibiotics.

Interim study findings that will be presented at this week’s AIDS 2026 conference show that a new, once-weekly antiretroviral combination pill for HIV seems to be effective and well tolerated, with comparable results to currently available daily pills. The findings are from two ongoing large, multi-country Phase 3 trials comparing the new combination pill to current treatment options. The new combination treatment has the potential to greatly simplify HIV treatment for patients and health care providers by reducing treatment frequency—and potentially cost—which could help improve access and adherence. A new study in humans suggests that Merck’s Ervebo vaccine, which is licensed for the Zaire strain of ebolavirus, could offer some protection against the Bundibugyo strain of ebolavirus, fueling a growing number of calls to evaluate Ervebo in a clinical trial in the Democratic Republic of the Congo (DRC), the site of the rapidly expanding outbreak of Bundibugyo, for which there are no licensed vaccines. The World Health Organization has so far prioritized evaluation of Bundibugyo-specific vaccines, but the few in development are still months away from clinical trials in the DRC. A trial of Ervebo could provide some protection to people at risk in the outbreak sooner, since there is an international stockpile of Ervebo doses. The Africa Centres for Disease Control and Prevention is planning a trial that would test a two-dose vaccine regimen of Ervebo and an experimental vaccine targeting Sudan Ebola in health workers. Last week, IAVI and Biofabri announced that their Phase 2b clinical trial of tuberculosis (TB) vaccine candidate MTBVAC has reached full enrollment. The trial is evaluating the safety and efficacy of MTBVAC in preventing active TB disease in adolescents and adults with latent TB infection, as well as an additional cohort of participants who have never been exposed to TB infection, across 16 clinical research centers in South Africa, Kenya, and Tanzania. The current TB vaccine is more than 100 years old and provides incomplete protection in young children and does not prevent TB disease in adolescents and adults. MTBVAC, which is single-dose and well-suited for use in remote locations, could be a game-changer for TB control. 

Last week, the Serum Institute of India announced that it will manufacture a promising tuberculosis (TB) vaccine candidate in late-stage development under an agreement with the Gates Medical Research Institute (Gates MRI). The candidate, M72/AS01E, which is currently being evaluated in a late-stage clinical trial, was originally developed by GSK before being licensed to the Gates Foundation. It could become the first TB shot in more than 100 years if approved. The agreement aims to build up manufacturing capacity to ensure adequate supply of the vaccine for rapid, widespread scale-up in key communities, if it is eventually approved. The Gates MRI will transfer the technology and know-how to the Serum Institute, which will invest more than $100 million to scale up manufacturing capacity. A Phase 1 trial evaluating a potential fast-acting, single-dose malaria treatment found promising results, as the growing threat of resistance of the malaria parasite to first-line therapies has underscored the continuous need for new antimalarials. The trial, conducted by QIMR Berghofer in collaboration with UniSC Clinical Trials and sponsored by Medicines for Malaria Venture (MMV) and GSK, found that the novel drug MMV367/GSK3772701 rapidly killed malaria parasites and was generally well tolerated in infected volunteers, appearing to work by blocking two enzymes critical to the survival of the malaria parasite in red blood cells. The treatment candidate belongs to an entirely new class of antimalarials that work differently to existing treatments, making it less susceptible to resistance. It also has the potential to be administered as a single-dose therapy in the right combination with other anti-malaria compounds.A Phase 1 trial of a Bundibugyo ebolavirus vaccine candidate launched last week, making it the first vaccine candidate to enter clinical testing in the response to the ongoing outbreak in the Democratic Republic of Congo. The Coalition for Epidemic Preparedness Innovations (CEPI)-backed candidate was developed by University of Oxford scientists and uses the same viral vector platform as the Oxford/AstraZeneca COVID-19 vaccine. Since the early days of the outbreak, CEPI, the University of Oxford, and the Serum Institute have been working together to urgently advance the development of the investigational vaccine into clinical trials. The trial will be conducted in Oxford, United Kingdom among 50 healthy adults aged 18-55 years, evaluating the candidate’s safety and immune response. There are currently no approved vaccines or treatments for the virus.