Bill Gates Urges Investing in Faster Development for Life-Saving Drugs

The Covid-19 pandemic "would look very different if scientists had been able to develop a treatment sooner," writes Bill Gates, in a guest essay Friday in the New York Times. This ultimately would've reduced fatalities - "and it may have been harder for myths and misinformation to spread the way they did." But note that Gates said "treatment" - not vaccine. Gates believes most people in the public health community had expected an effective treatment would appear before vaccines became available.Unfortunately, that's not what happened. Safe, effective Covid vaccines were available within a year - a historic feat - but treatments that could keep large numbers of people out of the hospital were surprisingly slow out of the gate.... In late 2021, a few of their efforts paid off - not as soon as would have been ideal, but still in time to have a big impact. Merck and its partners developed an antiviral called molnupiravir, which was shown to significantly reduce the risk of hospitalization or death for people at high risk. Soon after, another oral antiviral, Paxlovid, made by Pfizer, also proved to be very effective, reducing the risk of severe illness or death by nearly 90 percent among high-risk, unvaccinated adults. These drugs are useful tools for combating the pandemic, but they arrived much later than they should have and, for many, they are still difficult to access.... It's a mistake to think of vaccines as the star of the show and therapeutics as the opening act you would just as soon skip. We're lucky that scientists made Covid vaccines as quickly as they did - if they hadn't, the death toll would be far worse. But in the event of another pandemic, even if the world is able to develop a vaccine for a new pathogen in 100 days, it will still take a long time to get the vaccine to most of the population.... With good therapeutics, the risk of severe illness and death could drop significantly, and countries could decide to loosen restrictions on schools and businesses, reducing the disruption to education and the economy. What's more, imagine how people's lives would change if we're able to take the next step by linking testing and treatment. Anyone with early symptoms that might indicate Covid (or any other viral disease) could walk into a pharmacy or clinic anywhere in the world, get tested and, if positive for the virus, walk out with antivirals to take at home.... In short, although therapeutics didn't rescue us from Covid, they hold a lot of promise for saving lives and preventing future outbreaks from crippling health systems. But to make the most of that promise, the world needs to invest in the research and systems we'll need to find treatments much faster. That's why my foundation has supported a therapeutics accelerator at Duke University, but broader initiatives will be necessary to make lasting change. This will require substantial investment to bring together academia, industry and the latest software tools. But if we succeed, the next time the world faces an outbreak, we'll save millions more lives. Gates offers several specific recommendations - including "investing in large libraries of drug compounds that researchers can quickly scan to see whether existing therapies work against new pathogens." And...With advances in artificial intelligence and machine learning, it's now possible to use computers to identify weak spots on pathogens that we already know about, and we'll be able to do the same when new pathogens arise. These technologies are also speeding up the search for new compounds that will attack those weak spots.With adequate funding, various groups could take the most promising new compounds through Phase 1 studies even before there's an epidemic, or at least have several leads that can be turned into a product quickly once we know what the target looks like.

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