Would a ‘viral Manhattan Project’ help overcome Covid-19?

The race to find vaccines, tests and treatments to overcome the coronavirus pandemic must become more globally coordinated, scientific experts have urged − although others have cautioned that an overly top-down approach could stifle innovation.

As universities, pharmaceutical companies and national laboratories scramble to find products to defeat the virus, there have been growing calls for the efforts to be aligned via a global organisation akin to the Manhattan Project − the US-led research and development initiative that created the world's first nuclear bomb − to coordinate, assess and, in some cases, fund the hundreds of research projects, including some 44 vaccine projects, that have emerged in recent weeks.

In an editorial in Science on 27 March, Seth Berkley, chief executive of Gavi, the Vaccine Alliance, said the “current piecemeal efforts are not enough”. A “big science” initiative, similar to the Human Genome Project or Cern (the European Organisation for Nuclear Research), was instead needed “not only [to] potentially save hundreds of thousands of lives, but [to] help the world be better prepared for the next pandemic”.

“A top-down approach is necessary,” said Annelies Wilder-Smith, professor of emergency infectious diseases at the London School of Hygiene and Tropical Medicine, who noted that this has been employed for vaccine research through the Oslo-based Coalition for Epidemic Preparedness (Cepi). The foundation, established in 2017, has funded Covid-19 vaccine projects at Imperial College London, the University of Oxford, the University of Queensland and the Pasteur Institute in Paris. Cepi recently called for an additional $2 billion (£1.6 billion) to advance vaccines, and last week the UK government announced £200 million in extra funding.

“We have this platform, which is funding a lot of outstanding work, but we must find ways of funding both the smallest groups in universities and the biggest companies,” Professor Wilder-Smith said, adding that “sometimes the most genius of ideas come from the most unlikely places”.

“Our best chance is probably modifying our existing platforms [such as Cepi and the World Health Organisation] rather than inventing entirely new ones,” she continued, saying it was crucial that “both top-down and bottom-up research” were supported in a speedy manner. “We need to put more investment in this than in anything else we’ve seen [in science] – there may be some duplication, but that doesn’t matter because, at the moment, we are being run over by this.”

Kenneth Kaitin, director of the Tufts Center for the Study of Drug Development at Tufts University, agreed that there was a “tremendous value” in adopting a more coordinated approach along the lines of Cepi to avoid “needless duplication”.

With so many potential vaccines and treatments being explored, however, some duplication was inevitable and, indeed, desirable given that a Covid-19 product might be used by millions of people, said Professor Kaitin.

“This will not be like testing a phone app, where you could test it with a dozen or so people,” he said. “You want duplication [of effort] to some degree because drugs that work well for one racial or demographic group might work differently in others,” he said.

Having a high-level oversight group to consider which vaccines or treatments were most likely to work would also be useful, said Professor Kaitin.

“It is very difficult for investigators to give up what they are doing when they have devoted a lot of time, energy and millions of dollars to a project,” he explained. “Having an oversight group that could say that, on the basis of all the evidence and in comparison to other groups, this isn’t going to work and your efforts should be deployed elsewhere, would have a lot of value.”

A new coordination body to help link industry and academia could also be beneficial, he added. “If you look at some of the recent breakthrough drugs, such as for Aids or Sars, it is typically done by a partnership,” Professor Kaitin said.

“Industry has reduced its investment in early-stage research as it is too far upstream and too risky to commit resources, while industry is equipped to do the later-stage development and large-scale trials, which is something academia has not done,” added Professor Kaitin, who explained that federal funders lacked the financial firepower to do so because just 10 per cent of drugs that enter development make it to market.

Having a clear set of targets or problems set by funders that researchers could address would also help to avoid duplication of smaller projects now being proposed by academics, added Nick Jennings, vice-provost for research and enterprise at Imperial. “My slight fear is that we have lots of enthusiasm from groups coming forward, who are, for instance, building apps or data science bases, but it is not clear what the actual problem is that we need to address,” he said.

“If researchers knew there were, say, five key things that we needed to progress, or someone saying: ‘Here is a product – if you can beat it, then we are interested’, then that would help,” Professor Jennings added.

However, Trisha Greenhalgh, professor of primary healthcare sciences at the University of Oxford, said that while globally coordinated efforts on medicine were desirable, an overly planned approach to research could potentially stifle some important studies, such as those arising from curiosity with academics’ local surroundings.

“When I am sending my 28-year-old son into a hospital where there are apparently junior doctors on respirators, I become really interested in this problem, and nuanced research questions are often better when they arrive bottom-up,” said Professor Greenhalgh. “If someone set up a top-down, hierarchical approach to Covid-19 research, it might be that some emergent research offering solutions might not happen.”

jack.grove@timeshighereducation.com