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Background:  The formation of the Coalition for Epidemic Preparedness Innovations (CEPI) sheds light on how conditions for global collaboration are created and sustained. This is a multi-stakeholder initiative whose objective is to be a global financing and coordination mechanism that supports the development of vaccines against epidemic infectious disease.    Methods:  The paper reports from an empirical study that documented and analysed CEPI’s formation from idea in mid-2015 to its formal launch in January 2017, using a qualitative approach and analytical perspectives from international relations and the governance of socio-technical systems to explain decisions and outcomes.    Results:  The accomplishment of forming CEPI in only 15 months was possible due to a substantial operational capacity among founding partners for groundwork and coordinating parallel processes, multiple individuals in leadership roles as well the flexibility offered by an interim phase. Findings also suggest that key alignments needed to be found between diverging positions on collective action for technology development, revealing the complexity and dynamics of interests among actors. The study further identifies key institutional conditions that interests clustered around, which CEPI needed manage in order to become operational.    Conclusions:  The study concludes that while successful in developing a new nexus between global public health, vaccine innovation and pandemic response, CEPI was in 2017 still in the process of defining the nature of its authority within that landscape. Finally, the CEPI formation process bears significance for the global coordinated response to the coronavirus (COVID-19) pandemic in 2020. As features of the CEPI formation represent persistent challenges in global health collaboration, the study offers both a backdrop and lessons learned.

The formation of the Coalition for Epidemic Preparedness Innovations (CEPI): An empirical study