A new report from the National Academies of Sciences, Engineering and Medicine outlines findings from a workshop in December 2022 to explore how innovative approaches in research can enhance health systems preparedness and responses to emerging infectious diseases and dangerous pathogens.
The workshop was held by the National Academies Forum on Microbial Threats; Forum on Drug Discovery, Development, and Translation; and the Forum on Medical and Public Health Preparedness for Emergencies and Disasters.
Emerging and persistent infectious disease threats such as Ebola, chikungunya, Zika, Middle East respiratory syndrome, severe acute respiratory virus, antibiotic resistance, and, in recent years, COVID-19 and mpox demonstrate the global and unrelenting nature of infectious threats and the pervasive human, social, and economic consequences they carry.
The scale of the COVID-19 pandemic catalyzed unparalleled speed and cross-sector collaboration in the innovation of tools and technologies to address an emerging infectious disease outbreak. Continued innovation and cross-sector collaboration in rapid development and implementation of new vaccines, therapeutics, and diagnostics is central to future outbreak preparedness.
Although federal funding played a substantial role in facilitating vaccine development, lack of funding for other research areas was one factor contributing to shortfalls within the COVID-19 response. The resources and research funds available for vaccine development were insufficient to support the efforts needed to fully understand transmission and other aspects of viral pathogenesis.
Foundation of Research for Rapid Vaccine and Monoclonal Antibodies Development
Preexisting academic and public-private partnerships played an important role in pandemic response efforts. In 2017, the NIAID Vaccine Research Center (VRC) partnered with Moderna in response to growing awareness of the potency of mRNA vaccines and a failure to respond quickly enough to Zika.
Five years prior to the COVID-19 pandemic, VRC partnered with a consortium of academic groups on developing an improved MERS vaccine using structure-based design and mRNA.
This partnership included work with the University of Texas at Austin on structural biology, UNC on animal models and molecular biology, and Vanderbilt University on coronavirus biology, particularly in terms of viral replication and evolution. Other partners included Eli Lilly and Medigen Vaccines Biologics Corporation, a Taiwanese company that worked with VRC on making a subunit vaccine authorized for use in Taiwan. Extramural divisions of NIAID and the U.S. Department of Defense developed a coronavirus prevention program that enabled vaccine development to move from the lab into large-scale clinical trials with more than 200,000 enrolled volunteers within 6 months.
Within 65 days of the novel coronavirus (later called SARS-CoV-2) sequence publication, an mRNA vaccine entered clinical trials. Prior planning and research contributed to the speed of vaccine development. Most of the technologies applied to the coronavirus vaccines originated through four decades of HIV research. In addition, 8 years of research on coronavirus spike protein structure, the mapping of antigenic epitopes, and how neutralizing antibodies work had been conducted before the pandemic began.
The foundation of prior research and collaboration that enabled rapid vaccine development also applied to making monoclonal antibodies. For example, existing relationship between the National Institute of Allergy and Infectious Diseases (NIAID) and AbCellera Biologics facilitated creation of molecular probes and acquisition of convalescent peripheral blood mononuclear cells from COVID-19 survivors in the United States. This partnership involved 3 years of prior research on cross-reactive coronavirus antibodies that provided a system able to generate hundreds of sequences. Antibodies were then created and examined for neutralized activity. AbCellera and Eli Lilly arranged the clinical development program.
READ THE REPORT:
Applying Lessons Learned from COVID-19 Research and Development to Future Epidemics
– Proceedings of a Workshop. National Academies of Science, Engineering and Medicine, August 2023.