Health and Healthcare Systems

After COVID-19, we must rethink how we find and produce new drugs

A researcher works inside a laboratory of Chulalongkorn University during the development of an mRNA type vaccine candidate for the coronavirus disease (COVID-19) in Bangkok, Thailand, May 25, 2020

What can the race for a treatment today teach us about preparing for tomorrow? Image: REUTERS/Athit Perawongmetha

André Loesekrug-Pietri
Chairman, Joint European Disruptive Initiative (JEDI)
Thomas Hermans
Programme Manager, JEDI Covid19 GrandChallenge, and Professor, University of Strasbourg
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COVID-19

  • How we produce and distribute any vaccine is an issue we need to address.
  • The nature of the vaccine manufacturing process promotes inequality in who benefits and when.
  • We must now be creative and experimental today to ensure we are prepared for the pandemics of the future.

As the race for a COVID-19 vaccine continues, the Billion Molecules Against COVID-19 Global GrandChallenge - organised by the Joint European Disruptive Initiative (JEDI) - kicked off on 4 May. At the same time, the European Union – in cooperation with France, Germany, the UK, Norway and Saudi Arabia – launched a massive fundraising marathon. Its purpose is twofold: firstly to accelerate the development and deployment of tests, treatments and vaccines, and secondly to ensure that as many players as possible undertake to make them accessible to all countries. And the EU is thinking big money, as always: it has raised no less than €7.5 billion ($8.3 billion) in initial funding.

Although the ambition of this EU fundraising is laudable, the issue of worldwide distribution of the vaccine still needs to be addressed. Pharma players capable of producing massive numbers of doses are rare. In recent weeks, partnerships have multiplied between large laboratories to increase their production capacities: Moderna and Lonza Group aim for a billion doses per year, while AstraZeneca and the University of Oxford hope to be able to supply 100 million doses before the end of the year. The American Inovio Pharmaceuticals and the German Richter-Helm Biologics have joined forces for the same purpose, as well as the arch-rivals Sanofi (French) and GlaxoSmithKline (English).

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More than just the question of when a vaccine will be discovered – and the German Minister of Health poured cold water on hopes this could happen anytime soon – the question of which laboratory will discover it, the quantity of doses that can be produced and their accessibility are eminently strategic and a major challenge for humanity. The challenge of vaccination is twofold: in addition to protecting citizens, it also offers the hope of returning economies to normal without fear of a 'second wave'.

However, if tests conducted by American laboratories prove conclusive, it is likely that the American population will be heavily prioritized. And what is already problematic for Europe is likely to prove disastrous for countries that have neither the infrastructure, the financial means, nor the manpower of Western countries. The vaccine-manufacturing process is slow and expensive, and as such it automatically promotes inequality.

Tackling this challenge requires collective action to ensure massive production and equitable distribution. Besides the question of financing, on which the Coalition for Epidemic Preparedness Innovations (CEPI) and the World Bank are actively working, transforming production processes to make them more efficient is also crucial. Process intensification is a possible approach; this would aim to minimize the equipment and space used, thus reducing both its costs and its risks and potentially enabling a vaccine to be produced anywhere in the world on a distributed basis.

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Several players have already taken this process intensification route, such as the Belgian company Univercells and the Dutch firm Batavia. So have pharmaceutical companies such as Janssen and Merck, as well as the technology and service provider Cytiva. But obstacles remain numerous, and it is a scientific and industrial frontier that we must address with energy and determination.

If the European Union wishes to live up to the challenge it has launched, funding the design and production of vaccines and treatments will not be not enough. Let us use this historic and planetary crisis to imagine solutions that are both scientifically robust and radically new. We can develop and produce solutions through distributed production, 3D printing. We need to bring together disciplines and new capabilities brought by high-performance computing, machine learning and molecular biology to screen billions of molecules like the JEDI COVID-19 GrandChallenge. We need to fast-track drug discovery by having even better-qualified compounds enter clinical trials, compounds that could be cross-correlated by teams from across the globe. We need to tap into collective intelligence, be creative, experimental, and willing to push the limits of science and technology - because it is as much the sovereignty of each nation, as well the equality of access to care throughout the world, which are at stake.

Indeed, with the coronavirus monopolizing our attention, it would be absurd not to prepare today for the epidemics of tomorrow. The number of pathogens with pandemic potential are many, and some have much higher mortality rates than the coronavirus. To get out of the current tragedy and not return to the same state of affairs when the next major disease strikes, we must take heed of the French poet and philosopher Paul Valéry’s call to Europeans: “Well, what are you going to do? What are you going to do today?”

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