By Asad Khan
There's a particular kind of energy at the World Vaccine Congress that's hard to describe unless you've been in it. Hundreds of scientists, executives, policymakers, pharma leaders, CRO teams, and site networks, all in one convention centre, all sitting with the same fundamental tension. We know how to make vaccines that save lives. So why does getting them to patients still take so long?
I spent three days in Washington this week as part of the Medable team. Washington in late March meant that the cherry blossoms were just past their peak but still stunning, and catching them along the Tidal Basin between sessions was one of those small, unexpected gifts that a busy conference week doesn't always make room for.
For the conference, I came in with a clear intention. I wanted to reconnect with partners I respect, listen more than I talk, and have honest conversations about where this industry is and where it needs to go. What I didn't fully anticipate was how much the week would reinforce something I already believed but needed reminding of.
The urgency is real and it's shared.
The mood in the room
The congress opened with a keynote from senior US government leadership on federal strategy for public health and pandemic preparedness. The fact that the speaker lineup was still being confirmed close to the event said something in itself. The policy ground under the vaccine industry is shifting, and nobody in that opening session pretended otherwise.
Nicole Lurie from CEPI was direct about it during the pandemic preparedness plenary. "We have a long way to go to rebuild trust, not just in the US but globally." That landed with weight in the room. Because the trust deficit isn't just about public perception of vaccines. It runs deeper, into data sharing, into international cooperation, into whether countries will report surveillance information when there are real social and economic consequences for doing so. No platform fixes that. It's a human problem before it's a technology problem.
What I kept noticing alongside all of that was a stubborn determination to keep going. Scientists presenting new data, site networks sharing what's working, regulatory specialists wrestling with AI governance frameworks in real time. Nobody was waiting for the policy environment to sort itself out. That resilience is one of the things I find most compelling about this community.
The AI conversation nobody's fully figured out yet
Thomas Waite, Deputy Chief Medical Officer at the UK Department of Health, said something that hasn't left me. "Maintaining public trust when deploying AI surveillance agents is challenging." He also raised the point that if you're training AI on datasets where certain populations are over or underrepresented, you risk making existing inequalities worse. It's not just about what AI can do. It's about how you do it and who it serves.
In almost every conversation I had at the congress, excitement about AI's potential existed right alongside genuine uncertainty about whether it can be trusted and governed responsibly. I think both of those things are true at the same time. The potential is real. So is the responsibility. The companies that'll matter in five years are the ones holding both of those thoughts without letting one crowd out the other.
The question the whole congress was really asking
Cristina Cassetti from CEPI and WHO framed something that stuck with me. "How do we weave all responsibilities into one unit? When there's an outbreak, it's always chaotic." The argument from the main stage was that you can't build rapid response infrastructure in the middle of a crisis. It has to already exist.
That felt directly relevant to everything I think about in my day job. The systems, processes, and partnerships that let trials move at the speed the science demands have to be in place before the pressure arrives. You can't retrofit speed into something built that is slow.
COVID proved that when urgency is real and barriers are genuinely removed, trials can move at a pace nobody thought possible. The question I came to Medable to work on is why that should require a global emergency to unlock. Every unnecessary delay in trial startup or enrollment or conduct is a delay in patient access to therapies that could genuinely change or save lives. That's not a commercial point. It's a human one.
What we shared over dinner
On Tuesday evening Medable hosted an intimate dinner at Ocean Prime for a group of vaccine development leaders. There were small tables, honest exchanges, no polished presentation competing with the actual conversation.
Our guests came from right across the clinical trial ecosystem, pharma, biotech, site networks, and CROs. Chief executives, chief medical officers, regulatory leaders, portfolio directors, and clinical operations specialists. People who design trials and people who run them at scale and people who are responsible for the vaccines themselves. The whole ecosystem around one table.
I shared Medable's 1:1:1 vision, one day to start a study, one day to open enrollment, one year to complete study conduct. Not as a pitch. As an honest articulation of what we're genuinely building toward and why it matters.
What surprised me was how it landed. The response wasn't just polite interest. It was recognition. Immediate and consistent, regardless of where people sat in the ecosystem. Every person in that room had felt that friction from their own angle.
My colleague Toai then gave a live demonstration of some of the technology behind that vision. Watching the room engage with it, the questions people asked, the connections they drew to their own programmes, reminded me why showing something real matters so much more than describing it. One result I shared made that concrete in a way no slide ever could. A recent vaccine megatrial we supported delivered 100% cohort enrollment within five days, at a scale where weeks or months would've been completely normal. That study became a blueprint, that blueprint became a programme, and three additional vaccine trials launched immediately after. Nobody needed me to explain what that meant. They'd all lived the alternative.
The conversation that mattered most
However, the most memorable part of the evening came up naturally around the table and it's stayed with me more than anything else from the week.
The people in that room care deeply about what they do. They're genuinely invested in vaccine development, they live the science,and they want to get safe and effective vaccines to the people who need them. That passion was unmistakable.
Yet, almost every person there described being held back by the same things. Manual processes. Paper. Operational friction that really shouldn't exist in 2026. Systems designed around how trials used to run rather than how they need to run now.
What came through just as strongly was a real fatigue with vendors. Not with technology. With a particular kind of vendor relationship where someone sells you a solution without ever truly understanding your problem, where the pitch is confident but the partnership is thin. Where you end up feeling like a number rather than a partner.
That hit me hard, because I think it's the most honest thing the industry is trying to communicate to technology companies right now. Better tools aren't enough on their own. Real partnership combined with the right technology is what'll actually shift the status quo. You can't have one without the other. It's also the standard I try to hold myself to, and a conversation like that one is a reminder of why it matters.
What I'm taking away
The policy environment is genuinely uncertain and the congress didn't try to dress that up. The questions around AI governance and trust are real and unresolved. But what I felt most strongly across the whole week was something much simpler. The people in this industry are committed to getting it right. The challenge isn't will or capability. It's the infrastructure and the processes and the weight of how things have always been done.
The work is urgent. The community doing it is serious. And what'll move it forward isn't technology on its own. It's technology in the hands of people who've taken the time to genuinely understand the problem they're there to solve.
That's why I do this. A week in Washington reminded me not to take it for granted.
