COVID-19 therapeutics

We’re turning over the pen (or, the keyboard in this case!) to Brad Wilken. Brad is a Deputy Director of Product Development Operations at the Bill & Melinda Gates Foundation. He is at the forefront of the foundation’s research and development (R&D) efforts for therapeutics focused on preventing or treating COVID-19, the disease caused by the coronavirus.

Here, Brad shares updates on the COVID-19 Therapeutics Accelerator — and why it’s critical to continue developing options for treatment, even when vaccine candidates are on the horizon.

As a donor to Gates Philanthropy Partners’ Combating COVID-19 Fund, you are part of accelerating this work alongside us. Your trust and partnership are making progress possible.

I’m excited to share what we are learning about therapeutics. While vaccines are rightfully getting much of the spotlight and headlines, we know that reducing infections requires a multi-pronged approach — including tests, treatments, and vaccines.

Some have questioned the need to continue prioritizing treatments when the world might have a successful vaccine soon. Simply put, people will still get sick while a vaccine is in development — and even after one is available. There are lots of caveats and complexities to that statement, but from what we know today, we need to anticipate that this virus will be with us for years to come. Finding multiple effective and affordable treatments for COVID-19 is imperative to preventing severe illness and deaths. And maybe even averting infections all together.

Our team at the Gates Foundation, in partnership with Wellcome, started thinking about treatments early in the pandemic.

Two fundamental questions drive our work:

• Are there existing drugs that can be repurposed for treatment of patients with COVID-19? If so, that saves the world time — and we get a leg up on understanding safety, dosages, and potential side effects.
• If a treatment is identified, can it be manufactured at scale and affordably for health systems (especially in the lowest-income countries) around the world?

Therapeutics Accelerator: Advancing Research on Existing Drugs

Early in the pandemic, we partnered with Wellcome and Mastercard Impact Fund to launch the Therapeutics Accelerator. The goal was to fast-track research on potential breakthrough treatments. Since March, 14 additional donors and partners have committed more than $300 million to accelerate the search for treatments. Donors’ incredible generosity and belief in the goal have enabled the Accelerator to invest $69.4 million so far in fast and flexible support for targeted research.

At its core, the Accelerator is supporting researchers to scan thousands of existing drug compounds and conduct clinical trials using available treatments to determine their efficacy against COVID-19. It’s a fascinating process and Scripps Research provides a helpful overview of how the research is done.

Supporting Clinical Trials

Funding from the Therapeutics Accelerator is supporting multiple clinical trials for different drugs with potential to prevent or treat COVID-19 in parallel. We’re diversifying investments across the drug development process to remove bottlenecks and increase the chances of finding and scaling an effective treatment sooner.

Some trials haven’t uncovered the effective treatment we hoped for. But we’ve quickly pivoted to determine which drug candidate to support next. More importantly, these efforts are building the research infrastructure needed to test promising treatments for future pandemics.

One exciting investment we’re making is in trials and manufacturing of monoclonal antibodies, an immunotherapy previously used for other treatments (e.g., cancer). Most antibody treatments require intravenous (IV) courses, which are incredibly difficult to administer in low resource settings. Our investments are geared towards looking at alternative administration techniques that can work anywhere in the world. The Journal of the American Medical Association (JAMA) is a great resource if you’d like to dive deeper.

Preparing for Manufacturing at Scale

Treatment discovery and development is not our only focus. We also have to prepare to manufacture –and quickly — the most promising candidates. As part of its investments, the Accelerator is reserving future manufacturing capacity for the best therapeutics that make it out of clinical trials.

To support this effort, we’re collaborating with partners such as Unitaid and the Global Fund to make sure that the processes are in place to procure and deliver the treatments we’ve supported in the world’s poorest countries. Mark Suzman, CEO of the Gates Foundation, recently wrote about the importance of global distribution of vaccines and treatments.

The support the Therapeutics Accelerator has received so far has helped advance the world’s search for effective treatments. It’s given the countless researchers and drug development experts around the world what they need to innovate and challenge COVID-19 from multiple angles. I’m lucky to witness this firsthand. And though our work hasn’t yielded the breakthrough yet, we’re on the right path.

R&D is a high-risk, high-reward venture. Not everything we invest in will work. That’s ok. We need to be able to accept some failure, because that enables the boldness and ingenuity we need to beat COVID-19 and be better prepared for the next pandemic.