For millennia, as Yuval Noah Hariri writes in “Homo Deus,” “famine, plagues and war” have bedeviled humanity. Over the past century, famine has been largely contained; and so far, nuclear weapons have meant no major power wars. Viral outbreaks, not so much. COVID-19, following SARS and MERS, is but the latest in this young century. But what if the next pandemic could be eradicated with a universal vaccine?
Tenacious current research efforts reflect a world always struggling to get ahead of viral threats like COVID-19. On May 4th, at a G-20 virtual event in Brussels, co-chaired by Saudi Arabia, Germany and France, world leaders pledged $8 billion in cooperative efforts to pool resources to develop a vaccine, treatments and diagnostics for COVID-19. The U.S., which declined to attend, has launched “Operation Warp Speed,” a national effort to have a COVID-19 vaccine available by the end of the year.
Coordinated or not, the surfeit of public and private efforts to find vaccines and therapies for COVID-19 – and initial trial results – suggest it is likely a question of when, not if, COVID-19 is subdued. But unlike other recent epidemics, the global scope and devastating health and economic impact of COVID-19 has reinforced grave fears driving public health professionals and risk analysts about what other of the million or more microbes out there may morph into future pandemics.
One problem is that viruses rapidly mutate. This is why annual flu shots so frequently change or are less effective than hoped. SARS, MERS and COVID-19 are all variations of coronaviruses. On top of the legions of microbes, there are hundreds of bat species to spread them to other animals and to us.
As a thought experiment, consider what the world might have looked like today if after the 2003 SARS outbreak a universal vaccine had been developed, a kind of biological Swiss army knife. Many lives would have been saved and today’s economic crisis avoided.
With our cumulative knowledge of infectious diseases, plus enhanced technological tools such as gene sequencing and synthetic DNA, a universal vaccine should be possible. Then, when a new viral strain is detected, adapt the vaccine. As Dr. Anthony Fauci has explained, “all you would need to do is insert the gene of the protein you want to express and make a gazillion doses and send it out.”
This is hardly as easy as it sounds. Typically, only about 6 percent drugs developed and tested make it to market. Even as the technology revolution enables researchers to accelerate the process, the complexity of the problem makes designing a safe, effective vaccine that can be adapted to future variations not unlike learning to split the atom. There are, for example, still unknowns about some of the effects of COVID-19 on different parts of the body.
Dr. Fauci is hardly alone in his support. The medical community has been using foresight to peer over the horizon and anticipate future threats. Researchers have embraced the concept of a universal vaccine and therapies, and initial efforts are already underway. The National Institutes of Health (NIH) has distributed $29 million to a network of labs, while the Bill and Melinda Gates Foundation has put up $12 million. It will require a whole new scheme to assemble and scale an initiative to make a vaccine, which many researchers think may take 10-15 years. But, given the health and economic disaster from COVID-19, it warrants a major global initiative.
It took nervous physicists concerned that Hitler was trying to build a bomb to persuade Albert Einstein to write a letter to FDR that resulted in the Manhattan Project. It was perhaps the most successful Big Science project ever, taking almost four years, $2 billion ($23 billion in 2020 dollars) and a network of labs and facilities at its height employing 130,000 people.
Some medical researchers think starting a global version of a Manhattan Project, pooling the best minds, resources and risks, offers the best chance of defeating the next pandemic. To begin, a 3-4-year project with funding in the $5 billion range, in partnership with the private sector, could accelerate the prospects for discovering and producing a universal vaccine.
With cooperative efforts of the major players – such as the U.S., Europe, Japan, South Korea, India and China – the costs would be manageable. It could include a sunset provision, to be reviewed after a set time period and either terminated or revised. Consider that the Trump administration is spending $483 million on two private firms’ efforts to find and produce millions of doses of a COVID-19 vaccine.
The tenor of the times is not encouraging. The largely nationalist responses to COVID-19 point to a leadership deficit. Neither the U.S. nor China, in a downward spiral of mutual vilification, offered any contributions during the recent Brussels event.
Unfortunately, viruses are globalized — an epidemic anywhere is a threat everywhere. The U.S. has led such global health coalitions in the past — President George W. Bush on HIV/AIDS and SARS; President Obama to contain Ebola and MERS. Competing national efforts only make finding a solution more problematic and are contrary to the practice of collaboration in science, which is key to innovation.
Yet as Big Science projects go, a global Manhattan Project would be relatively modest. For example, the International Thermonuclear Experimental Reactor (ITER), a multinational effort to harness fusion, an endless source of energy, has a $15 billion price tag shared by the U.S., Euratom, Russia, India, China and South Korea. In light of the damage being done by COVID-19, which is still spreading in much of the world, it seems prudent to prepare now for the next pandemic, with the burdens, risks and benefits equally shared.
Mathew Burrows is director of the Atlantic Council’s Foresight, Strategy and Risks Initiative. Robert A. Manning is senior fellow at the Atlantic Council.