The race for a Covid-19 vaccine appears to be in the home straight with the prize on offer for the winner certainly huge: billions of dollars, perhaps more. Unsurprisingly the competition is fierce with 159 vaccines in development and pharmaceutical companies straining every sinew to develop the medicine. But amid the headlong pursuit to be first, there are words of caution against being too optimistic. Professor Angus Dalgleish, a cancer specialist and epidemiologist in London, told <em>The National </em>that he attended a medical conference in Washington, DC, 36 years ago where a vaccine for HIV had been predicted in 18 months' time. Sadly, it remains elusive. Others suggest that if there is no vaccine by the autumn then the coronavirus will go around the world in two or three infection waves killing millions of people, but establishing herd immunity in the process. There are also growing suspicions over China’s role. Why is the country at the centre of the virus at the bottom of the major nations’ casualty list? What was going on in the strictly controlled lab in Wuhan where scientists had been researching and experimenting with Covid-19 for at least two years? What is without doubt is that governments in many countries are sinking at least $8 billion (Dh29m) into a “cure” that will not only stop deaths but prevent further haemorrhaging of their economies. The front-runners are Britain and China. The combination of the major pharmaceutical firm AstraZeneca and scientists at Oxford University appears to have the edge in terms of advanced vaccine technology. American scientists have referred to “those crazy guys in England” in a complimentary fashion as the Oxford scientists pioneer new methods. An AstraZeneca press release has promised to start delivering the Oxford vaccine in September, with the capacity to supply one billion doses by next year. The fight here appears to have moved on to where the vaccines are sent after the UK takes its share. AstraZeneca has promised a “fair allocation and distribution of the vaccine around the world. ”With an eye on the presidential election in November, Donald Trump has launched Operation Warp Speed to create a viable vaccine. The administration has pumped $1.2bn into AstraZeneca in US laboratories with the promise that the first of 300 million doses would arrive in October. Success would prove quite an election tonic for Mr Trump, who many argue has handled the pandemic poorly. Not to be outdone, the Chinese firm Sinovac Biotech announced last week that it was 99 per cent of the way to a successful vaccine. China’s advantage lies in having researched the Sars and Mers viruses for a number of years. Hamish de Bretton-Gordon, a respected biological security expert, believes that a workable vaccine was “probably” due by the end of the year. “This is a world effort and there is no limit to money involved and no doubt the first one will get all the gold,” he said. “I think that the Chinese will win as they’ve had a two-year advantage researching Covid. But AstraZeneca and Oxford seem well down the line, and they have done vaccine testing before on other Covid strains. I expect there are quite a few who are reasonably close and there will be a winner.” Troubling for all the contenders is in what country to conduct an efficacy trial where the disease is still spreading virulently. India, Russia and Brazil are all experiencing high infection rates but within a month only one country might be left for full human trials. And trials are vital. If the prize for success is high, then failure, through a drug that causes unseen after-effects, would be catastrophic. Hopefully, the rush to success will not blind scientists and politicians to historic blunders such as the 1955 manufacturing accident of a polio vaccine that paralysed hundreds of children. To some, such as Professor Julian Peto, of the London School of Hygiene and Tropical Medicine, a vaccine will probably come too late. “It’s right to be pursuing a vaccine as hard as you can but you should also be pursuing other lines as well, such as mass-testing, because a vaccine might become irrelevant,” said Professor Peto. “If it takes two years or more, coronavirus could well have crept around the world and caused herd immunity but with deaths running into the millions.” Prof Dalgleish does not believe that antibodies produced by the current vaccine candidates would be capable of entirely neutralising Covid-19. He thinks, however, that if the right adjuvant – the substance that works alongside the antigen to give an extra boost to the immune response – is used then the resulting vaccine could be successful. “The secret of vaccines is to choose the right adjuvant and we don’t think others have done so. If we are right then Oxford, Imperial College and other vaccines are extremely unlikely to work.” He has developed the mycobacterial product IMM-101, used to help cancer patients whose immunity drops after treatment. “The effect is to prevent you getting ill even if you do get infected when you go through the respiratory phase," Prof Dalgleish said. "We could produce this very quickly as the trials are done.” Whatever the outcome, both politics and science will create winners and losers in the race for a vaccine.