Expanding Global Research Capabilities to Prepare for Future Pandemics
R&D for new vaccines, tests and treatments: Despite the ever-increasing complexity of the pure science, political and community buy-in and ecosystem approaches to prevention remain equally critical.

From increasing disease surveillance and developing a pan-coronavirus vaccine to ‘eco-health’ and public trust, participants in the COVID-19 Global Research and Innovation Forum considered ways to globally prepare for future pandemics and end the current one.

The third such forum, hosted by the World Health Organization, brought together over 100 research scientists, experts, policy makers, and donors worldwide to discuss and strategize about the future of COVID-19 research 24-25 February. 

Along with the more technical aspects of disease tracking, diagnostics and new vaccines, speakers emphasized the need for research to go beyond the narrow confines of laboratories and clinical trials so as to strengthen health systems to use the science well – and build public confidence in its value.  

Wellcome Trust Director Jeremy Farrar

Ultimately it’s about preparedness, said Wellcome Trust Director Jeremy Farrar, in a Thursday keynote address, “what you have before a crisis hits will determine your ability to prevent it and respond early.”

Public trust in scientific solutions also needed to be rebuilt, he added, making indirect reference to the public protests seen in the last pandemic over issues like masks and vaccines.

“No amount of science will deliver vaccines, therapeutics, diagnostic tests, or anything else that we can intervene with, unless we have the trust of societies.  And all of us, myself included, have taken that trust for granted for too long.” 

To do that, as well as ensuring equitable access to tools and solutions, Farrar and others urged policymakers to ‘reinvent’ health systems, science, and research ensuring that they are anchored within the communities that are to be served. 

Increased access to data surveillance through WHO Pandemic and Epidemic Hub 

Dr Chikwe Ihekweazu

Getting down to the nitty-gritty, Chikwe Ihekwazu, the recently-named director of the new WHO Hub for Pandemic and Epidemic Intelligence, explained how increased global surveillance data, inclusive animal and environmental health, is critical to quickly identifying and tracking outbreaks. The new hub, a collaboration with the German government, is based in Berlin.  However, data alone is not enough. 

“Often we have the data but we are unable to use it, because we don’t have access to the analytics, both in terms of the tools, the human resources, and all the governance in place,” said Ihekwazu. 

“Our problem, our challenge, is not to ensure that [politicians] make the right decisions, we need to provide them [with] the best possible opportunity of making the right decisions for humanity.” 

What is needed for pandemic and epidemic intelligence.

The role of the WHO Hub, inaugurated last September, is to fill critical surveillance gaps, supporting national public health experts and policy-makers in acquring and developing the very tools needed to forecast, detect, and assess epidemic and pandemic risks through a ‘system of collaborative intelligence’.

‘Collaborative’ is the key word, noted Ihekwazu.

“This is not something we will do for the world. This is something we will do with the world.” 

Pan coronavirus vaccine is next step  

The technology to develop a pan-coronavirus vaccine is already in place.

Along with the continuous evolution of SARS-CoV2, there is a high likelihood that other coronavirus strains could emerge from the wild, and so the holy grail of vaccine R&D now should be the development of a pan-coronavirus vaccine, many researchers also agreed. 

They spoke just a day after the CEPI announced a major grant to India to develop such a jab.  Moderna and US-based Duke University also are working on pan-coronavirus technologies that would offer broader protection against both existing and future SARS-CoV2 variants, as well as all beta coronaviruses.   

“It’s not a sustainable strategy to continue to have to boost people as variants continue to rise, and at some point, this boosting may not adequately address future variants,” said Phil Krause, chairperson of the WHO COVID vaccines research expert group. 

“We wouldn’t have gotten to where we are today if there hadn’t been some work on previous pandemics or epidemics including MERS. [We need to keep] both speed and rigour in developing and evaluating vaccines.” 

Pandemic saw boom in vaccine R&D

As a silver lining in the cloud, the pandemic has accelerated know-how that makes development of a pan-coronavirus vaccine, as well as other types of new vaccines, more feasible, said Stanley Plotkin, of the US-based Johns Hopkins University.  

“Despite the death and destruction and disease that this SARS-CoV-2 has caused us, these last two years have been the best years in vaccinology since the polio days, because we now have multiple strategies for developing vaccines.  

“The advantage of this extends beyond coronavirus,” Plotkin added, noting that new and improved vaccine technologies can be applied to a range of deadly diseases with epidemic potential, including Zika virus, Nipah virus, and Ebola. 

Embedding the ‘one-health’ approach into prevention strategies  

Drivers of disease emergence over last 60 years

Beyond vaccines, broader “ecosystem” and one-health approaches are needed to address pandemic risks.  

That’s not only because prevention is better than cure – but because coronaviruses, as such, are not the only risk. The risk can be from a range of infectious respiratory, vector-borne or water-borne viruses that come into increased contact with people, as a result of urbanization, wilderness degradation and industrialised food production, and then adapt to infect humans.  

So looking at the drivers of disease emergence, are equally important, said William Karesh of the Canadian-based EcoHealth Alliance, as “many of which lead to pandemics and some of which do not.” 

Those include land use changes that bring wildlife and humans in closer contact, as well as certain patterns of intensive agriculture and meat production, which stimulate disease transmission between animals and between animals to humans.  

Karesh proposes a ‘society-wide approach’, echoing Farrar about the importance of engaging with communities to influence health, economic, and social wellbeing outcomes. 

This doesn’t mean that investments should shift away from the health sector, but investments in pandemic preparedness and prevention should be ‘diversified’ with other stakeholders.

“We need to expand the pie by engaging other sectors of society.”

Better planning of pig farms to prevent Nipah virus in Malaysia 

He and others described, for instance, how the better planning of pig farms had been used to help prevent the transmission of Nipah virus in Malaysia from bats to pigs and finally humans. 

Nipah virus was first identified in pigs and pig farmers in the country in 1998; however, the virus itself originates from fruit bats. The practice of planting fruit trees, which harbour bats, on land that is also used for livestock production is the most likely pathway of transmission to humans. 

With this in mind, farmers have been encouraged to separate their pig styes from areas where they are raising orchard trees. 

These “practical solutions that are at our disposal already” said Catherine Machalaba, also of the EcoHealth Alliance, saying: “[We need to build that] into how we plan our new developments and make prevention embedded into our other sectors.”

Image Credits: Afrigen , (Photo: Adobe Stock), WHO , WHO, Eco Health Alliance , EcoHealth Alliance .

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