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Revolutionizing Pandemic Response: The Promise of Therapeutics


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The Covid-19 pandemic highlighted the critical role of vaccines in controlling viral outbreaks, yet a more balanced approach that includes therapeutics could have drastically reduced the death toll. Experts estimate that an equitable split in funding between vaccines and antivirals might have saved four million lives during the Covid-19 pandemic. Despite the significant public investment of £71 billion into vaccine development in 2021, only £3.6 billion was allocated to drugs like antivirals, revealing a glaring disparity that many believe needs addressing before the next pandemic strikes.

 

Professor Sharon Lewin, director of the Cumming Global Centre for Pandemic Therapeutics (CGCPT) in Melbourne, emphasized this point at the World Health Organization’s (WHO) 77th World Health Assembly (WHA) in Geneva. Lewin and her colleagues argue that therapeutics offer several advantages over vaccines, including immediate protection, easier storage and distribution, and targeted use only for those infected. Lewin suggests that if antivirals such as Paxlovid or Molnupiravir had been available by June 2020, "four million lives could have been saved."

 

The development of Covid-19 therapeutics was slow, and the drugs that eventually emerged were not highly effective. A study published in Nature Communications found that nine days after starting a course of Molnupiravir, 48% of patients had cleared the virus, compared to 56% who did not take antivirals. Prof. Michel Kazatchkine, special advisor to the WHO Regional Office for Europe, acknowledges the "disappointment" surrounding these drugs, noting their limited effectiveness against certain mutations, particularly when the Delta variant gave way to Omicron.

 

Looking forward, Lewin insists that "we really need to think about how we can make [therapeutics] better, [and] make them faster." While the rapid development of effective Covid-19 vaccines was remarkable, there are scenarios where vaccines may not be feasible or sufficiently effective. This underscores the necessity of robust therapeutic development. Lewin cites the example of HIV, which, despite the absence of a vaccine, has become a manageable condition thanks to antiviral drugs. Similarly, Hepatitis C has been controlled through antiviral treatments.

 

Kazatchkine concurs that both vaccines and therapeutics are crucial, although vaccines received priority during the Covid-19 pandemic due to the long-standing belief in their ability to eradicate diseases. The successful elimination of polio, smallpox, and (until recently) measles, reinforced the perception of vaccines as the primary solution to pandemics. However, while therapeutics can prevent morbidity and mortality, they alone cannot halt an epidemic.

 

Dr. Birkneh Tadesse, associate director general at the International Vaccine Institute in Seoul, emphasizes that "prevention is generally more cost-effective and more impactful than the treatment of a disease." He highlights that vaccines are vital for preventing the transmission of diseases, reducing antimicrobial resistance, and saving costs through herd immunity. However, the debate over whether vaccines or therapeutics are cheaper remains unresolved. What is clear is that reducing disease prevalence benefits public health and the economy.

 

To achieve parity in therapeutic and vaccine development, substantial funding is required. The CGCPT, for example, was established following a £130 million donation in 2022. Lewin notes that "the technologies that we use to develop therapeutics haven’t really evolved much," pointing to a lack of investment in innovative technologies that could accelerate the creation of effective treatments. Despite the challenges, there is optimism about the future capabilities of therapeutics. Lewin envisions a future where affordable, non-toxic antiviral drugs could be used preemptively, similar to anti-malarials, to block transmission. She also highlights the potential of mRNA therapeutics, which could be adapted for different diseases, marking a significant advance in pandemic preparedness.

 

Ensuring global access to these future treatments is crucial. During the Covid-19 pandemic, over 90% of people in some high-income countries received two vaccine doses by the end of 2021, compared to just 2% in low-income nations. This disparity likely caused over a million deaths. Lewin suggests that affordable drug pricing models, similar to those used for HIV and Hepatitis C treatments, should be implemented to ensure equitable access.

 

A proposed Pandemic Accord, championed by leaders including Boris Johnson in March 2021, aimed to secure a coordinated and equal global response to future pandemics. However, negotiations have stalled, with the UK reportedly refusing to sign the WHO’s document in early May. Kazatchkine notes that the WHA opened without the treaty in place, and it could take another year to finalize. Historically, WHO member countries have only co-signed one health treaty: the Framework Convention on Tobacco Control in 2003, which successfully regulated the tobacco industry and reduced smoking rates.

 

Reflecting on the need to improve pandemic responses beyond vaccines, Lewin asserts, "The conclusion has been that we need to do better." As we prepare for future pandemics, a balanced focus on both vaccines and therapeutics, backed by significant investment and global cooperation, is essential to save lives and control outbreaks more effectively.

 

Credit: Daily Telegraph 2024-06-01

 

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Posted (edited)
13 hours ago, Social Media said:

Dr. Birkneh Tadesse, associate director general at the International Vaccine Institute in Seoul, emphasizes that "prevention is generally more cost-effective and more impactful than the treatment of a disease."

 

There's a place in the pandemics world for both vaccine and therapeutic medications. But I agree with the sentiment expressed above:

 

In general, as the cited doctor recounts, it's better to prevent people from getting sick in the first place vs. trying to treat them after they've become sick.

 

That said, vaccines are not 100% effective in preventing illness, and therapeutics likewise (at least the two main ones for COVID, paxlovid and molnupiravir) also have been shown to have only partial effectiveness when used as recommended, and need to be taken very soon after an infection (timeliness of starting treatment has been an issue) to be effective.

 

As the OP report above recounts:

 

"The development of Covid-19 therapeutics was slow, and the drugs that eventually emerged were not highly effective. A study published in Nature Communications found that nine days after starting a course of Molnupiravir, 48% of patients had cleared the virus, compared to 56% who did not take antivirals."

 

So clearly, it's not an either-or proposition, but one of the medical world needing to deploy everything in its arsenal to first try to prevent people from getting sick in the first place, and then being able to effectively treat people who nonetheless end up getting sick despite vaccination or because of failing to get vaccinated or keep up-to-date with them.

 

Edited by TallGuyJohninBKK
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The trend toward increasing and emerging disease outbreaks is real, so the medicos hopefully will need to be on their toes with corresponding vaccines and medications to protect the global population:

 

Will climate change amplify epidemics and give rise to pandemics?

 

25 Aug 2023
 
 

"While the world recovers from the COVID-19 pandemic, another crisis continues to spiral at a much faster speed than was expected. Climate change is dominating our lives and causing a high level of distress. Countries all over the world are struggling to survive the damage caused by extreme events. They are trying to control wildfires, rebuild roads and houses damaged by floods, and learn to survive in a hotter and more dangerous world. However, there is also a new threat that is being overlooked—the interaction between climate change and infectious diseases. A comprehensive meta-analysis revealed that climate change could aggravate more than 50% of known human pathogens. Unfortunately, this is happening now.

 

Since the last big wave of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)—the omicron variant—less than 2 years ago, a range of pathogens have suddenly emerged. Some are not well-known, such as mpox and chikungunya virus; others have been known about for centuries, such as Vibrio cholerae (which causes cholera) and Plasmodia parasites (which cause malaria). There is even the prospect that pathogens frozen in the permafrost, for which no immunity currently exists, may be released as the climate continues to warm. Such a notion may be considered alarmist. And some people may think neither climate change nor epidemics are real or that both will pass. However, there is overwhelming evidence that climate change is fueling disease outbreaks and epidemics and that it is not a matter of if, but when, such events will precipitate another pandemic."

 

https://www.science.org/doi/10.1126/science.adk4500

 

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On 6/1/2024 at 7:28 PM, Robert Paulson said:

What the future holds: a world where everyone is mysteriously getting sick all the time, but do t you worry your little heads, we will have the medicines for you to regain your health 

Naah, we will have the 'promise' by Big Pharma that their products will help you regain your health.  

I' ll pass...

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Just take a pill and everything will be ok. We’ve been manipulated to think this way, for some (clear throat) odd reason. And it’s certainly worked. 
 

You know what we’re supposed to do when we get sick, not every ailment but many of them: start eating better. Change your lifestyle. Be more active. Get outdoors. He’ll get an outdoor active hobby. 
 

But no, take a pill, is what they’ll have you believe. It’s propaganda. 

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