By Paul Nicolaus
August 9, 2021 | As the coronavirus pandemic continues, new initiatives are emerging to help fend off future pandemics.
The University of Oxford has announced the launch of a new center of global research collaboration and excellence dubbed the Pandemic Sciences Centre. It plans to build upon the partnerships that have formed between academia, industry, and public health in the face of the current global health crisis.
The Centre’s mission is to ensure the world is better equipped to prepare for, identify, and address future pandemic threats. Its focus is geared toward three core themes: speeding understanding and insights; translating research into real-world solutions; and improving confidence, trust, and impact.
“The COVID-19 pandemic has shown us that spectacular advances are possible through an alliance of science, the public sector and industry—creating digital disease control tools, diagnostic tests, and life-saving treatments and vaccines at unprecedented speed,” said Peter Horby, a professor of emerging infectious diseases at the University of Oxford. He has been named the Centre’s inaugural director.
“But it should not take a pandemic to make this happen,” he added. “This level of innovation and multi-sectoral collaboration must be applied, day in and day out, to prevent another catastrophe like COVID-19.” The Centre is supported in part through a $7 million contribution from AstraZeneca, and there will be efforts to secure additional support from philanthropists, corporations, and governments.
Another example of a new endeavor looking to fend off future pandemics can be found in the Centers for Research in Emerging Infectious Diseases (CREID), a global network investigating how and where viruses and other pathogens emerge from wildlife settings to cause human disease.
Formed a year ago by the National Institutes of Health (NIH) and its National Institute of Allergy and Infectious Diseases (NIAID), the network is designed to enable early warnings of emerging diseases wherever they might occur. The knowledge gleaned from the research is meant to help enhance preparedness for future outbreaks.
The CREID network consists of 10 Research Centers as well as a Coordinating Center. Every Center collaborates with institutions in the United States and other countries across the globe. Research projects encompass an array of surveillance studies, and investigators intend to develop reagents and diagnostic assays to improve the detection of emerging pathogens and to study human immune responses.
RTI International, along with Duke University’s Human Vaccine Institute, runs the CREID Coordinating Center that serves as the operational hub and supports aspects such as data management, research response, and quality control.
The network’s overall objectives are to improve the knowledge of emerging and re-emerging infectious diseases through research to better understand transmission dynamics occurring in regions where pathogens are endemic or most likely to emerge, CREID Research Centers program officer Sara Woodson told Diagnostics World.
There’s a translational component, too, built around the development of reagents and diagnostic tests or tools that are designed to detect emerging pathogens and their vectors. Yet another aim is “increasing outbreak research response, flexibility, and capacity,” she said, as well as contributing to training the next generation of EID investigators and leaders.
Diagnostic Efforts of CREID
There’s been plenty of progress made over the course of the first year, Woodson explained, but so far it has been largely centered around startup activities. All the research centers have worked to get their international partners on board and obtain the ethical approvals needed to execute research in these different locations.
Then there’s the overall development involved with this type of large, complex network through the establishment of governance and guidance documents. Specific working groups and committees have been developed as well to better understand capabilities of the network at large and the challenges that these working groups could address via research currently underway and in the event of a future outbreak.
“We’re in this transitional phase from that startup activity into really launching into a lot more of the scientific research and progress,” Woodson said.
Diagnostic efforts include target platform development and the use of those platforms to carry out prototype development toward specific emerging or re-emerging pathogens. Researchers are attempting to leverage diagnostic technologies that could be launched in lower or middle-income countries, she explained.
“Diagnostics are absolutely important for outbreak responsiveness—especially when it comes to preparing for future pandemics—because we can only prepare for things that we know are there or that are brewing in wildlife reservoirs or things like that,” she pointed out. The development of diagnostic tests and tools sets the stage for better understanding what is out there.
Developing prototypes pre-positions them so that when an outbreak of concern arises, there is an ability to push the diagnostics further along in their development. Some of that development may not be supported by CREID specifically, but it could potentially be backed by other NIAID or NIH resources.
Studying Pathogens Across the Globe
Each of the 10 CREID Research Centers is focused on one or more global regions.
In East and Central Africa, pathogens studied include the Rift Valley fever virus and the coronavirus that causes Middle East respiratory syndrome. In West Africa, projects are geared toward the Ebola virus, Lassa virus, and arboviruses. Investigators will research coronaviruses and arboviruses in Asia and Southeast Asia. In Central and South America, meanwhile, studies will examine arboviruses, including those that cause Zika, chikungunya, and dengue.
The United World Antiviral Research Network (UWARN) is one of the 10 Centers bringing researchers together from various countries. Formed last year and funded by a NIAID grant, the network includes collaborators from the University of Washington, Fred Hutchinson Cancer Research Center in Seattle, Rockefeller University in New York City, FIOCRUZ in Brazil, IRESSEF in Senegal, KRISP in South Africa, Aga Khan University in Pakistan, and Chang Gung University in Taiwan.
This network plans to provide surveillance for emerging viruses, develop diagnostics and therapeutics, and build upon the current understanding of viral immune responses. The research will formulate diagnostic reagents, such as proteins that emit light when antibodies are present in blood. The work will also include LOCKR technology—an artificial protein “switch” that can work inside living cells to modify internal mechanisms, sense and respond to cues, and perform other tasks.
Another grant awarded by NIAID led to the creation of WARN-ID, or the West African Emerging Infectious Disease Research Center. This Center combines the efforts of epidemiologists, bioinformaticians, biologists, and clinicians in the United States, Sierra Leone, Nigeria, Liberia, and Senegal. Together, the group is looking to create a scalable response network capable of quickly addressing outbreaks.
The research group is focused on pathogens that pose the most significant risk to national security and public health, including Ebola and Lassa viruses and the SARS-CoV-2 virus responsible for the coronavirus pandemic. Efforts include surveillance, the study of transmission and evolution, and the examination of disease development and immune responses.
According to Woodson, some of the main challenges faced by the entire CREID network are the same ones that have always presented challenges for diagnostic developments at large. Gaining access to well-characterized samples for prototype development is one key hurdle, for example. So is optimizing or validating the different assays.
COVID-19 has revealed some of the difficulties involved with supporting or managing logistical and supply chain issues for tests needed wide-scale. “We’ve seen a big challenge in being able to just access simple PCR reagents worldwide for testing for SARS,” she explained. There is a need to figure out how to support that pipeline better so that it’s not inhibited in the event of another major outbreak.
Another dilemma is figuring out how to effectively integrate novel diagnostic assay development activities into outbreak response plans in international locations that extend beyond the United States. Some of the CREID investigators are more academically focused and don’t know the ins and outs of pushing a product further along the development pipeline, Woodson added, “so just navigating that pathway as a network, I think, is going to be a little bit challenging.”
Can Preparedness Efforts Remain Strong for Long?
The unique circumstances presented by the coronavirus pandemic have revealed what the scientific community is capable of when industry, academia, government, and other stakeholders are hyper-focused on tackling the same issue at the same point in time. In some ways, this may help lead to an improved response to different crises further down the road.
The regulatory bodies that approve tests and vaccines are now better equipped to quickly authorize treatments and tests using lessons learned from the pandemic, according to Priya Nanavati, managing director of production and R&D at Empowered Diagnostics, a Florida-based manufacturer of diagnostic solutions.
These takeaways are a crucial part of preparing us for the next health crisis and worldwide pandemic, she told Diagnostics World. It is also important to recognize that COVID-19 is not going away permanently, Nanavati added.
The past year has been an exciting time for diagnostics, added Lorraine Lillis, scientific program officer in the diagnostics program at PATH, a nonprofit global health organization. Innovation has been strong, and there has been development and commercialization of more contemporary technologies in place of more traditional methods.
Access to additional funding was a crucial part of all this development, she told Diagnostics World, especially through programs like the Rapid Acceleration of Diagnostics (RADx) initiative, which NIH launched to accelerate innovation in the development, commercialization, and use of COVID-19 testing technologies.
Many of these types of initiatives provided greater levels of funding compared with more traditional calls, offering added flexibility to help meet the financial demands of rapid diagnostic development. They also sought to provide timely feedback on proposal submissions and faster access to funds. This helped reduce downtime in development between funding gaps, she explained, which is more common when it comes to more traditional funding mechanisms.
Of course, industry, academia, and government cannot all remain hyper-focused on the same specific issue indefinitely. Much of what has been achieved this past year came about because so many stopped other workstreams and dedicated their time and attention solely to COVID research, Lillis pointed out, and “funders and developers do not have the finances or the bandwidth to continue this approach.”
Still, NIAID’s Woodson predicts the field will be invigorated for the next several years to continue supporting pandemic-related research and believes investigators will be interested in maintaining many of the newly formed collaborations. At this point in time, the CREID network is seen as “a long-term network with future iterations.”
Some of the goals or objectives could shift and evolve, but there needs to be a sustained effort to study the global diversity of pathogens—particularly their transmission dynamics—and how they emerge from remote places, as well as their overall risk and potential for causing future outbreaks or pandemics. Continued investment is needed to determine how to de-risk, mitigate, and establish infrastructure in places where outbreaks are most likely to emerge.
“I don’t think, for the foreseeable future, that anyone’s going to forget about SARS-CoV-2 and COVID-19,” she added. “And I think we’ll just continue to see investment in this area. The scale may change over time, but I think there will be a lot more to come from so many different sectors of science to continue to support these efforts for pandemic preparedness.”
Paul Nicolaus is a freelance writer specializing in science, nature, and health. Learn more at www.nicolauswriting.com.