*HomeU.S. Government Accountability Office*
Menu

      close


          
          
                          	
				
				
	
	
					Reports & Testimonies
									
																				
				
				
	
	
								Reports & Testimonies
													
																												
																						
							
																Recommendations Database
							
																												
																						
							
																Month in Review
							
																												
																						
							
																Order Copies
							
																												
																						
							
																Restricted Reports
							
																												
																						
							
																View Topics
							
																												
																						
							
																View Agencies
							
																												
																						
							
																Bid Protests & Appropriations Law
									
																				
				
				
	
	
								Bid Protests & Appropriations Law
													
																												
																						
							
																Bid Protests
							
																												
																						
							
																Appropriations Law
							
																												
																						
							
																Federal Vacancies Reform Act
							
																												
																						
							
																Other Legal
							
																												
																						
							
																About
									
																				
				
				
	
	
								About
													
																												
																						
							
																What GAO Does
							
																												
																						
							
																U.S. Comptroller General
							
																												
																						
							
																Careers
							
																												
																						
							
																Contact UsFor Congress
                                
                          
        
                Press Center
                                
                          
        
                Careers
                                
                          
        
                BlogSearch < WatchBlog: Following the Federal Dollar
    In the Next Pandemic Antiviral Drugs Could Be Key, But Are They Ready? Posted on October 04, 2023
                    Scientists say another pandemic is likely and have even identified several viruses that could be a threat. But there are currently few approved drugs or treatments for these potential threats, nor is there much in the pipeline.

When COVID-19 struck, a vaccine to combat it was created in record time. Even so, it wasn’t fast enough to save millions who died. Antiviral drugs could be available before a vaccine in a future pandemic. These drugs can work on multiple viruses, meaning they could be ready before there is a specific threat.

Today’s WatchBlog post looks at our new report that assesses the role antiviral drugs could play in the next pandemic and the status of technologies for antiviral drug development.

**How antiviral drugs fight viruses**

Image
              Graphic showing how antiviral drugs fight viruses.

**How could antivirals combat the next pandemic?**

Unlike vaccines, which prime a person’s immune system to fight a virus, antiviral drugs do the fighting after a person is already sick. For example, when one kind of antiviral drug enters an infected person, it interferes with the virus’s ability to reproduce. That gives the immune system more time to rally and finish off the virus.

So why weren’t antivirals used during the COVID-19 pandemic? They were, but initially only in small quantities, and those were difficult to administer to patients. There was (and still is) only one antiviral in pill form for use against the virus. It had to be developed from scratch and did not become available until almost 2 years into the pandemic. By then, vaccines were becoming available and served as the main weapon against COVID-19.

That delay in developing an antiviral likely also cost many peoples’ lives, and it could happen again in the next pandemic.

**No treatment for most high-risk viruses**

One study puts the odds of experiencing a severe pandemic like COVID-19 during one’s lifetime at about 38%. Seven viral families have a high potential to cause another pandemic, according to scientists in the federal government. But FDA-approved antiviral drugs only exist for two of these seven families. The graphic below shows the status of antiviral drug development for these seven viral families.

Image
              Graphic showing the status of antiviral drug efforts for the 7 viral families.

For our report, we interviewed experts about why more antiviral drugs haven’t been developed. They told us a key reason is the lack of a current market for these drugs. Pandemic antivirals represent what economists call a “market failure”—prices do not reflect the benefit these drugs offer to society. While the federal government purchased millions of doses of vaccines, those vaccines were developed based on a known virus (a known problem). Antivirals for a potential pandemic would be developed based on an educated guess on the cause of that pandemic. Put another way, it’s too risky for drug companies to invest in antivirals because those investments would only benefit people (and pay off for the companies) if there’s another pandemic, which we all hope would be decades from now at the earliest.

The free market is not going to fix this on its own, the experts told us.

**Economic incentives are a possible solution**

So what can be done? We worked with the experts we interviewed to identify three policy actions that might help the U.S. develop antivirals for the next pandemic:

**A national strategy** could assess the public health and economic impact of viruses most likely to cause a pandemic, then develop a portfolio of antiviral drug candidates to target those viruses.
	**A single government entity**could lead and coordinate efforts to develop antivirals, helping to ensure a more effective allocation of money and expertise.
	**Economic incentives**could encourage companies to develop more antivirals and could spur new drug development technologies. These incentives could include research grants or a government commitment to purchase the drugs for a national stockpile.Even if the nation takes all these steps, there is no guarantee they will produce antivirals that will blunt the next pandemic. Policymakers now face the unenviable task of deciding how best to prepare for another major outbreak, not knowing when or how it will strike. In our new report, we go in depth on these three policy options, on opportunities to bolster antiviral drug development to combat the next pandemic, and on some of the risks of not doing so. Check out our report to learn more.

GAO’s fact-based, nonpartisan information helps Congress and federal agencies improve government. The WatchBlog lets us contextualize GAO’s work a little more for the public. Check out more of our posts at GAO.gov/blog.
TopicsHealth Care
              Science and Technology
                        Pandemic
              Medical technology
              Coronavirus
              Pandemics
              Public health preparedness and response for bioterrorism program
              Public health
              Health care
                        Science, Technology Assessment, and Analytics
              Applied Research and Methods
GAO Contacts
    
      candice_wright_2023
      
              Candice N.  Wright
            
            Director
      
            wrightc@gao.gov
      
            (202) 512-6888
    Michael Hoffman
      
              Michael Hoffman
            
            Director
      
            hoffmanme@gao.gov
      
            (202) 512-2700
		
					Related Posts
		
			Photo showing a medical worker injecting a COVID vaccine into a woman's arm with others standing by awaiting vaccinations.
          Blog Post
              For World Health Day (April 7), We Look At U.S. Efforts to Promote Global Wellness
            Thursday, April 4, 2024
      
            When it comes to communicable diseases, it turns out, it is a small world after all. Serious...
          Stock image of a stack of credit cards.
          Blog Post
              American Credit Card Debt Hits a New Record—What’s Changed Post-Pandemic?
            Tuesday, October 31, 2023
      
            It’s Halloween! And while you may be thinking of goblins and ghosts, nothing can haunt you the way...
          $100 bills. Source: Harry HU/stock.adobe.com.
          Blog Post
              Protecting Emergency Assistance Funding from Payment Errors, Including Fraud
            Thursday, July 13, 2023
      
            Federal emergency assistance is a critical resource for helping communities, businesses, and...

Related Products
					Antiviral Drugs: Economic Incentives and Strategies for Pandemic Preparedness [Reissued with revisions on Sept. 29, 2023]Product Number
              GAO-23-105847

	Published:  Sep 29, 2023


	Publicly Released: Sep 29, 2023
About WatchblogGAO's mission is to provide Congress with fact-based, nonpartisan information that can help improve federal government performance and ensure accountability for the benefit of the American people. GAO launched its WatchBlog in January, 2014, as part of its continuing effort to reach its audiences—Congress and the American people—where they are currently looking for information.

The blog format allows GAO to provide a little more context about its work than it can offer on its other social media platforms. Posts will tie GAO work to current events and the news; show how GAO’s work is affecting agencies or legislation; highlight reports, testimonies, and issue areas where GAO does work; and provide information about GAO itself, among other things.

Please send any feedback on GAO's WatchBlog to blog@gao.gov.
 Receive GAO Updates
  Stay informed as we add new reports & testimonies.

    GAO Logo
      U.S. Government Accountability Office


                                   Column 1
                            Press Center
                              Contact Us
                              Inspector General
                              Restricted Reports
                              Column 2
                            Copyright & Terms of Use
                              Privacy Policy
                              Accessibility
                              Sitemap
                              Column 3
                            FOIA Requests
                              Scam Alerts
                              No FEAR Act Data
                              Health Care Advisory Committees