Innovation and the Lessons of Covid-19
By: Global Coalition On Aging
Tags: Covid 19, Innovation, Policy, Health, Business

Now that Covid-19 vaccines are here and offer the real prospect we may soon turn the corner in addressing the devastating health, economic, and social impacts of the virus, it’s not too soon to identify critical lessons. How do we better prepare to defeat new public health threats, as well as rising challenges already on our doorstep — the growing-older age-related health-crisis explosion from Alzheimer’s to osteoporosis, antimicrobial resistance to vision loss that will, in the next two decades, be debilitating to an otherwise healthy aging, burdens on economic growth and even life-threatening to the 2 billion of us over 60 across the planet?

Lesson 1: The private-sector R&D model is the only one proven capable of delivering innovations to people at the speed and scale needed to respond to critical health crises. Yes, government and academic basic research is essential, but getting innovation outside the lab is what counts.

Less than 90 days after the first Covid-19 case was diagnosed in the U.S., FDA authorized the emergency use of Gilead Sciences’ drug remdesivir, the first therapy to treat the virus. Now, about nine months into the pandemic, we have two 95-percent-effective vaccines from a Pfizer-BioNTech partnership and Moderna. This is as stunning as it will be ephemeral if we do not understand how these miracles have come to be.

It’s true, this unprecedented mobilization of science, medicine, and manufacturing advanced at an extraordinary pace. But crediting only the speed of these breakthroughs misses the even more vital innovation infrastructure that makes rapid healthcare advances possible and will be even more needed as populations age.

This infrastructure rests on three pillars: Deep expertise and science-based intellectual capital built-up over decades, which allowed private companies to put treatments and vaccine candidates into clinical trials as soon as Covid-19 began spreading, rather than waiting months or years. Patient private capital and reinvested corporate profits that enable researchers to push innovations even without the prospect of success. And a public policy environment that encourages innovation, such as robust intellectual property protection.

We also saw this in other areas of innovation. The accelerated use of telehealth and telemedicine transformed healthcare for tens of millions of us around the planet as we shift from doctors’ offices, hospitals, and clinics to home-based healthcare delivery.

Lesson 2: Global health challenges require organizations that have the resources, capacity, skills, and decision-making culture to turn scientific insights into products that can treat patients on a global scale.

Academic labs and government-funded R&D efforts provide early scientific progress, but they cannot scale breakthroughs at the speed or size required to meet global health challenges. The ability to ramp up from producing small batches of a drug for testing in a lab to the mass manufacturing of billions of doses for a global population of patients requires the ability to pair Nobel-level science with General Motors-scale production, and Amazon-level distribution only far more complicated.

Gilead began stockpiling raw materials and building up a manufacturing capacity that spanned 40 companies across North America, Europe, and Asia before clinical trials began. By making this commitment, Gilead reduced a complex manufacturing process from one year to roughly six to eight months. Pfizer-BioNTech and Moderna began ramping up their vaccine manufacturing infrastructure — including building a dry ice factory to safely ship vaccine vials at ultra-low temperatures — in the coronavirus’s earliest days.

Cumulatively, billions were invested to manufacture treatments and vaccines before any of these companies knew their innovations would even work, let alone be approved by regulators.

Lesson 3: Smart public policy and solid public-private partnership is needed to support and pay for innovation to sustain the robust R&D- and technology-based healthcare infrastructure we need to treat viruses like Covid-19 and to address the challenges of a rapidly aging global society. Rewarding investment is central to the outcomes we want and need.

The drug approval process — from initial research to three phases of clinical trials to final approval — can take 12 to 15 years. Yet, the urgent response by pharmaceutical companies and the cooperation of leading public health authorities to fast-track treatments and vaccines for Covid-19 demonstrate that smart public policy can dramatically accelerate the innovation process.

Adaptive clinical trials, for example, provide the flexibility to observe patient outcomes, adjust goals, optimize drug dosage and duration levels, and shift more patients to the most effective treatments. This process encourages investment in existing lines of treatment, generating seemingly small alterations in a drug that can deliver meaningful advances.

Remdesivir, for example, did not result from the discovery of a new compound, but from continual investment in a drug first developed to treat other viruses. Or consider early melanoma or HIV innovation that initially promised limited life extension to patients — an advance some policymakers thought not worth the effort — but which launched an innovation process that has brought us to the point where diseases are no longer death sentences.

Having witnessed the power of innovation to address a global threat like Covid-19, it would be tragic for policymakers to ignore these lessons given the need for new innovations to tackle equally urgent public health threats. Even now, our antimicrobial resistance (AMR) crisis is set to kill 10 million of us because we have abandoned the policy support for continuous antibiotic innovation. AMR may not seem as acute as Covid-19, but history will teach a different lesson.

Whether in medicines or technology, achieving the 21st century innovations we need on the scale we need them will require we learn the right lessons of Covid-19. Public policy supporting and paying for innovation must be at the top of the list.