MI2025 – Kiat Runxrungtham

Title:
Vaccine and Therapeutic RNA Development for Equity Access

Abstract:
Commercial-driven vaccine and therapeutic RNA development has primarily benefited high-income countries, leaving behind populations without health insurance and those in low- and middle-income countries (LMICs). The COVID-19 pandemic, like other recent pandemics that are now emerging in less than 10-year cycles, has clearly demonstrated how vaccine inequity can prolong and intensify global health and economic crises. Even today, several approved life-saving vaccines reach only 30–50% of the global population.

At the same time, many countries are facing the growing challenge of aging populations, which increases the burden of cancer and non-communicable diseases (NCDs). Several RNA-based therapies, such as siRNAs, have recently been approved to treat rare diseases and hyperlipidemia, but their costs remain prohibitively high—often exceeding half a million USD per year. Promising clinical data also suggest that therapeutic RNA could be used for in vivo CAR-T cell therapy and gene editing.

To enhance global access to these transformative technologies, public-good or hybrid models are increasingly being explored and implemented. Notable initiatives include Drew Weissman’s Global Access Project, the WHO/MPP Southeast Asia Vaccine R&D Consortium, the UK–SEA Vaccine Hub, and the Gates Foundation RNA Network. A critical lesson from these efforts is that building manufacturing capacity alone—without concurrent investment in R&D—risks long-term sustainability. Without a pipeline of innovation, manufacturing facilities will ultimately become underutilized. Strengthening R&D capacity is, therefore, essential.

ChulaVRC, in collaboration with Dr. Drew Weissman (2023 Nobel Laureate), began developing mRNA vaccine R&D capabilities in 2017. During the COVID-19 pandemic, ChulaVRC successfully developed both monovalent and bivalent SARS-CoV-2 mRNA vaccines, which showed non-inferiority to approved mRNA vaccines in Phase 1–2 clinical trials. Currently, ChulaVRC has developed or co-developed up to 10 vaccine candidates and is actively participating in the aforementioned global access networks. Two candidates—for avian influenza and therapeutic HPV—have received o`icial funding from Thailand’s National Vaccine Institute (NVI) for GMP clinical lot production and clinical development. We have also initiated therapeutic RNA R&D e`orts. Although still in early stages, these e`orts provide concrete evidence that a transformative public-good model for LMIC access is feasible. Key elements for the success of a “Global Access” mission include: 1). Dedicated and capable R&D centers in LMICs, 2). Committed and coordinated funding, ideally through joint investment by LMIC and HIC governments, international donors, foundations, and public fundraising; 3). Strong partnerships with like-minded biotech companies, global research institutions, and lower-cost, high-quality raw material suppliers, and 4). Community engagement to ensure trust and uptake. “Together, Global Access to Save Lives is Feasible”

Biography:
Prof. Kiat Ruxrungtham is a Professor of Medicine and serves as the Director of both the Chula School of Global Health (Chula SGH) and the Chula Vaccine Research Center (Chula VRC), Faculty of Medicine, Chulalongkorn University. He is the founder of Chula VRC and is dedicated to addressing global health disparities and promoting equitable access to healthcare and vaccines.

His current research focuses on the development of mRNA vaccines for both prevention and treatment, targeting diseases such as COVID-19, dengue fever, HPV, avian influenza, Mpox, leptospirosis, Acinetobacter baumannii infections, Plasmodium vivax malaria, and allergies. His work demonstrates a strong commitment to innovation and public health impact, particularly for low- and middle-income countries in Southeast Asia.

Prof. Kiat has published over 390 peer-reviewed articles and has received numerous accolades, including the 2022 Royal Award for Contributors to the Development of the Country’s Vaccines.