As the coronavirus pandemic unfolded, it quickly became apparent that the only way the world will really return to normal is if a vaccine is found. As a result, the level of innovation and mass collaboration between biopharmaceutical companies, academic centres, governments and regulators is like nothing we have witnessed before.
For example, one high-profile collaboration that is making good progress is that between the UK Government and the University of Oxford. They have now partnered with AstraZeneca, which would be responsible for the development, manufacturing and distribution of the vaccine.
Another example is the partnership between Moderna and the US National Institute of Health, where together they are developing what is potentially the leading vaccine candidate. The Biomedical Advanced Research and Development Authority has contributed funding support and recently an agreement with Lonza for manufacturing capacity up to one billion doses has been signed.
The next steps
While a vaccine is likely still some way off, the search for treatments that can alleviate symptoms and potentially reduce the severity of the illness – and save lives – is making progress.
In April, Gilead Sciences reported that the first robust controlled clinical trial for a treatment had produced positive results, and in May, the firm signed licensing agreements with five generic drug makers, which will allow the treatment to be made and sold in 127 countries.
This is a new human virus – and scientists are having to learn quickly
However, most of what we know about the novel coronavirus is related to models of different viruses. This does perhaps give a level of comfort, but this is a new human virus – and scientists are having to learn quickly.
As we have seen, this coronavirus is particularly well adapted to mass human infection, it has a tremendous capacity to replicate and can spread prior to symptoms appearing, allowing it to evade public health measures.
Locking down the spread
Public health responses have revolved around containment strategies and lockdowns, to limit person-to-person transmission of the virus. Although lockdowns are effective at reducing viral transmission and thereby the impact on intensive care units, they are not a long-term solution.
In the longer term we need testing, the ability to trace contact, treatments and ultimately a vaccine. Much work is being done by biopharmaceutical firms, in close collaboration with the Food and Drug Administration, (FDA) and other national regulators to develop new or repurpose existing therapeutics for the treatment of COVID-19 or to prevent the disease. It took only two days for the FDA to approve remdesivir, Gilead’s anti-viral drug, for emergency use after the top line positive data were announced. Just six days after that, it was approved in Japan. We expect more of these drugs in development to report clinical data results over the coming months.
While regulators rightly do not want to cut corners, it is possible for timelines for approval of treatments to be expedited, if they are shown to work. What is termed the ‘benefit/risk decision’ could be straightforward in terms of providing treatments to patients already ill with COVID-19.
Vaccines however are different – they would be given to millions of otherwise completely healthy people, which changes the benefit/risk decision. As such, we remain cautious on whether timelines could be shortened here, but we are of course hopeful that a vaccine will be successful.
Learning from the past
Much of the work currently being carried out on treatments and vaccines is leveraging what scientists have learnt from Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS), arguably both precursors to the present pandemic.
Many of the large traditional pharmaceutical companies are also moving into the early development sphere and new technologies are being used that could facilitate the process of creating a vaccine. There is precedent for the vaccine technology that is being used in some of the candidates – for example, the recombinant protein and adjuvant vaccine being developed in a partnership between Sanofi and GSK. Others are using novel vaccine technologies, such as those based on messenger RNA – where Moderna is, in our view, at the forefront of development – and DNA-based candidates where we see Inovio as furthest ahead.
In the past few years, biopharmaceutical firms have come under the spotlight because of their high headline drug prices, so it is good to see them as a potential partner and a solution to this pandemic. The rate and speed of innovation currently taking place is very encouraging – it is very positive for the sector, and its potential longer-term growth prospects.
Read more: COVID-19: The language of a crisis