Transforming Wales post-COVID-19, the road to new collaborations

Early in 2020, a new disease emerged – firstly in countries on the other side of the world, but slowly, inevitably, it made its way here to Wales. COVID-19 has been severely impacting patients, the public, health systems and economies globally ever since.

As a new virus, researchers, healthcare professionals and the life sciences sector have had a relatively short time to learn how it works and consider ways to initially minimise its impact, and discover long lasting preventions and treatments. 

Amongst the first approaches for tackling COVID-19 was to repurpose existing treatments; including medicines already approved for treating viral infections, such as HIV, Ebola, and others.

A logical place to start perhaps, would be a relatively quick and simple add-on trial organised to demonstrate whether a medicine already available to patients could be effective against COVID-19.

However, add-on testing, and the regulatory process required to repurpose a medicine, is complicated and problematic.

An issue recognised as challenging long before this pandemic by all companies who discover, research and then manufacture innovative medicines who are used to conducting large-scale, and costly clinical trials to prove their treatments or medicines are safe.

But an issue brought to focus when the timeliness of a solution is so critical, and success potentially life-saving.  

Looking to address the complexities of repurposing is at the heart of STAMP, a project involving the European Federation of Pharmaceutical Industries and Associations (EFPIA), together with other trade associations, patient groups, regulators and the European Commission.

STAMP is considering better ways of bringing together key individuals, such as academic researchers, healthcare professionals and industry – and there is much to learn from how we’ve come together during this health emergency.

Whilst this work continues, the World Health Organisation has organised SOLIDARITY, a project that is looking at a number of existing treatments for conditions as diverse as multiple sclerosis, HIV, Ebola and malaria to see if any of them work against COVID-19.

Working collaboratively gives us the best hope of finding a treatment, which is why so many companies, universities, regulators, governments and NGO’s are working together on new vaccines and medicines; it is not a magic wand, but – as we know in Wales – we are stronger together. 

Despite the good work and intention of SOLIDARITY and STAMP, there is no guarantee that repurposing will uncover an effective medicine, let alone satisfy the global desire for a ‘golden bullet’.

However, we must harness the enthusiasm for collaboration that we have seen throughout the pandemic and ensure that it continues once the current health emergency is under control.  

Similarly, scientists from our member companies are working with regulators globally to shorten the timelines for starting and finishing clinical trials, without compromising safety.

The pandemic has demonstrated what is possible under the severest of pressures and the lessons learned from COVID-19 related discoveries should be long-remembered – none more so than the ‘learns’ gained in fast-tracking promising COVID-19 vaccines and therapeutics. 

Traditionally, vaccines are created by using a weakened form of a virus (an antigen) to pre-warn the body’s immune system to fight the actual virus if encountered.

Of the over 100 different vaccine projects underway across the globe by June, the vast majority were being led by the private sector. Amongst these are: 

• GSK and Sanofi, who have announced that they have joined forces, 
• Johnson & Johnson, who have announced a vaccine candidate for COVID-19 and are committed to supply one billion vaccines worldwide for emergency pandemic use, and 
• Pfizer, who have entered into partnership with BioNTech to jointly develop their mRNA-based vaccine candidate. 

Perhaps the trial for a vaccine which has received the most publicity is being developed by the University of Oxford alongside AstraZeneca. The Oxford team began working on an antigen as soon as the virus’ genome became available.

However, they cannot complete the research alone, and amongst the 10,000 subjects being recruited to test the vaccine, 500 participants in this stage of the trial (which focuses on staff working within health and care settings), are being drawn from Aneurin Bevan University Health Board. 

There are many other examples of industry work worldwide – some of which are highlighted on the ABPI website. Many of the companies collaborating on vaccines already have scientific knowledge gained from decades of experience with similar viruses, such as MERS, SARS, influenza, HIV and Hepatitis C.

This experience alongside pharmaceutical companies combined technological and manufacturing capability, will help us to take enormous steps forward and dramatically improves the likelihood of success in developing an effective vaccine or treatment. And, for those already suffering from the virus, it is a treatment that is vital. 

By the end of March, around 20 pharmaceutical companies had potential medicines in various stages of development and are collaborating like never before. 

• Fifteen global companies are central to The Gates Foundation’s Therapeutics Accelerator, a public-private initiative aimed at identifying potential treatments for COVID-19, accelerating their development, and preparing for the manufacture of millions of doses for use worldwide. 
• Fourteen pharmaceutical companies are submitting proposals to the EU’s COVID-19 Innovative Medicines Initiative (IMI) – with a total of 144 proposals from across Europe. 
• Six companies are working together to urgently investigate the development of a new blood plasma-derived therapy, sourced from patients who are in recovery, and with the potential to treat individuals with serious complications from COVID-19. 

Closer to home, our industry is using well-established, UK-wide channels which review, prioritise and resource clinical trials.

This work is coordinated for the whole of the UK through the Department of Health and Social Care (DHSC) Therapeutics Taskforce, which aims to ensure patients in the UK contribute to clinical knowledge and have access to safe and effective therapeutics as soon as possible. 

Studies such as the ACCORD Programme, PRINCIPLE, RECOVERY and REMAP-CAP are contributing tangible evidence to the scientific and research community.

Wales is fully involved in this work and this has shown how NHS Wales, academia, charities, Welsh Government and the pharmaceutical industry can deliver high quality research at pace and scale.

Several innovative and flexible approaches to conducting trials have emerged during the pandemic and must be adopted when clinical trials for wider condition resume.

The incredible progress and new thinking introduced over the last few months must not be lost if Wales wants to be at the forefront of future research opportunities. 

As May 2020 drew to a close the first anti-viral medicine to support recovery from COVID-19 in hospital was made available to UK patients thanks to the joined-up efforts of industry, UK governments, NHS and regulatory authorities. The ABPI is proud to be part of the global healthcare community, especially at times like these.

We support our members’ work with clinicians and patients at the cutting edge of science, to deliver the innovations needed to tackle global healthcare challenges, whilst continuing the safe and timely supply of medicines across all disease areas. 

In Wales, we hope that we’re beginning to see the end of the initial wave of what has proven itself to be a terribly destructive disease.

However, it is only through working collaboratively both now and in the future, that clinical researchers, healthcare professionals and the pharmaceutical industry can help society conquer whatever comes next. 

To learn more about the ABPI and their work on COVID-19, please visit the ABPI website.

All articles published on the welsh agenda are subject to IWA’s disclaimer.