Preparing for the 100 days mission: end-to-end transformation for emerging infectious disease preparedness

The ‘100 Days Mission’ aims to enable initial deployment of safe, effective vaccines within approximately 100 days of identifying a novel threat. Delivering that consistently requires more than faster science: it demands an end-to-end transformation spanning pre-Day 0 research, platform-level regulatory pathways, warm-base manufacturing, and flexible push–pull financing. We outline a practical continuum to get there: (1) sustained foundational R&D organized around prototype pathogens and standardized assays; (2) vaccine libraries advanced to Phase 1/2 with validated immune readouts and clear licensure paths; (3) regulatory convergence through platform master files, pre-approved master protocols, and global reliance/work-sharing; (4) distributed, warm-base manufacturing exercised via ‘drills’; and (5) financing that blends catalytic push funding with advance-purchase pull incentives and pooled procurement. Case studies from COVID-19, Mpox, and the 2022 Sudan ebolavirus outbreak illustrate both successes and failure modes. We argue that aligning these components turns extraordinary, crisis-only performance into routine capability, and makes 100-day vaccines a repeatable public-health standard rather than a one-off feat.

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