key: cord-024020-6opgzgcj
authors: Jia, Hongpeng; Wu, Min
title: Sustained research fund and dedicated research center for preparing next pandemic
date: 2020-04-11
journal: Precis Clin Med
DOI: 10.1093/pcmedi/pbaa012
sha: 
doc_id: 24020
cord_uid: 6opgzgcj

The current COVID-19 pandemic caused by the SARS-CoV-2 virus is imposing a great threat to human lives and international panic that is not seen since WWII, resulting in financial crisis, daily life disturbance, transportation shutdown, industry disruption, and countries/cities lockdown in every corner of the globe. The inability to effectively contain the virus indicates that our investment and attention in research, prevention, and treatment development for this type of deadly viruses is insufficient, considering it has been 17 years since the brother coronavirus, SARS-CoV outbreak. The biggest lesson learned from the acrimonious past experiences is that humans quickly lose memory and do not continue to support related research when a pandemic is gone. It is the very time for the government, industry, and private foundations to work together to respond to this wake-up call and to take extraordinary measures to sustain the research support and establish comprehensive research centers. Only this level response may give us a hope to prepare the future and adequately deal with the next potential pandemic caused by emerging devastating viral infections.

The new coronavirus (SARS-CoV-2) leads to severe lung infection and unique pneumonia disease, namely the COVID-19 that was found first in December 2019 and has quickly spread in the world, which has caused international concern for healthcare and interfered with the normal lives of a large portion of the human population due to extensive quarantine and separation. This catastrophic disturbance may serve as a wake-up call for governments, policymakers, philanthropic organizations, healthcare systems, and industries to the reality of extraordinarily dangerous infections caused by emerging pathogens, especially viruses. Admittedly, the government, healthcare institutes, and hospitals as well as medical professionals in China have swiftly taken extraordinary steps and implemented well-coordinated measures to contain the disease by locking down Wuhan city, sharing research results, supplying all emergent materials and sending medical aids to the hospitals at ground zero in Hubei province, particularly Wuhan city. Similar approaches have been applied in Italy, USA, Spain, UK, India, etc. However, the measures taken to control this rapidly spreading disease were insufficient in most of these countries, even with intense efforts, resulting in quick dissemination throughout the world. This is a testament that our awareness and preparation of these types of diseases, even in relatively well-prepared countries such as the USA, Italy, the U.K., Spain, Germany and China, are extremely insufficient.

Over the past few decades, humans have experienced continued attacks by various deadly infectious diseases caused by newly found or evolved viruses, including SARS, MERS, ZIKA, EBOLA, influenza illness, etc. Due to a lack of continued funding support and other intervention measures, human societies are entering into a miserable cycle. When one emergency occurs, we have a knee-jerk response and quickly allocate emerging funding to reduce the potential spread, alleviate the disease suffering, support research on the pathogenesis and develop vaccines and drugs for the new pathogen. However, the dramatic urgency to respond to the pandemic each time has imposed humongous costs, damaged our economy, and disrupted routine life, including study, work, business, sports, and music events.

However, in each instance, we tend to rather quickly forget the pain it caused once the disease is relieved. There is no sustained funding available for continued research into the disease pathogenesis and development of tools for diagnosis, prevention, and treatment. As a result, the number of researchers in the field quickly dwindles after the initial enthusiasm at the disease outburst due to funding shortages, and industries are reluctant to invest in the development of effective vaccines and drugs. As there is no way to predict when the next pandemic will occur accurately, hence financially, a weak business sector cannot help in keeping the profit-driven industries continuing the development of drugs and vaccines. Therefore, when a new infectious pathogen emerges, or an old pathogen evolves, such as the current SARS-CoV-2, we are not well prepared regarding the vaccines and drugs.

The lesson learned from the bitter past experiences is that as humans, we just drop the ball in the related research after each of the many recent pandemics, such as SARS, EBOLA, MERS, and ZIKA, the last two still biting us. Around 2007-2009, a series of clinical trials of vaccines against SARS showed somewhat efficacy, not convincing results but had to be abandoned because of a lack of continued funding. To avoid the sudden death of promising research towards diagnostics, vaccines, and treatments for pandemic causing bugs, we have to do a lot more with an extraordinary, unconventional response from all levels to sustain interest and funding from all sectors, such as government, industry, and philanthropy.

We hope we have now learned enough. People did not realize that the real costs to us for missing this much research are humongous and unmeasurable, just thinking about the rescue $ 2 trillion bills for this disaster approved by the U.S. Congress in March 2020. If we have only had a tiny fraction of this funding but sustainable, humans will have more weapons to combat this type of emerging diseases. SARS-CoV virus is a sister of the current SARS-CoV-2, meaning some drugs for SARS-CoV would be potentially effective for the SARS-CoV-2 and have been quickly used as compassionate treatments (1, 2). Due to the meager funding of research investment, many of the previous vaccines have been abandoned (3, 4) , and no effective vaccines for mass protection are available. Hence, after 18 years of the outbreak (2002), we are still crying for no countermeasures to this very horrible virus.

Furthermore, the current and future economic damage and human life disruption are enormous, and we all cannot travel and work. Companies are sacking employees. Even our staff who need to work on the research to combat this virus are not allowed to access to the laboratories due to some viral phobias/fear or restriction/shutdown/lockdown. Alarmingly, the trend of viral evolution, antibiotic resistance growing, social-political development, economic pattern transition, and human behavior change (much more frequent global travels, human interactions and intercontinental economy dependence than 20 years ago), this type of pandemic is highly likely to threaten and slaughter us sooner and/or more often.

To solve this problem, we recommend two major reformations: 1) invest heavily and continuously into the development of countermeasures to control emerging pathogens that cause massive population infections, and 2) build multiple international and state-level research centers to deal with next pandemics. The international communities thoroughly rethink their policies and allocate sufficient funds even after the initial outbreak to continue at least for 20 years (preferably non-stopping) and sustain the research on these emerging pathogens and their diagnosis, prevention and treatment to better control future infections and avoid pandemics. A large scale of infrastructure, resources, and the task force is desperately needed at state, national. Even international levels build many-dedicated research centers to develop diagnostic, vaccines, and drugs as well as basic research to understand the molecular and cellular pathogenesis and host-pathogen interactions.

The National Institutes of Health (NIH) set up the Office of Emergency Care Research (OECR) in 2012 to recognize the importance of emergency care. However, this office has no funding to support scientific research. It is not explicitly designed to control rapid and widely spreading infectious diseases. Through the Biodefense & Emerging Infectious Diseases Program, the National Institute of Allergy and Infectious Diseases (NIAID) has played a vital role in supporting research involving Emerging Infectious Diseases/Pathogens in recent years; however, the level of funding and extent of intention is far less than needed to combat these new pandemic diseases effectively. For example, the annual support for coronavirus researchthe brother of the current outbreak pathogen, in the U.S. is a meager $11 million last year, which is rather small compared to many other diseases such as cancer, heart diseases, diabetes, and even different types of infectious diseases, to name a few.

We suggest that the NIAID or OECR of the US NIH, the Natural Science Foundation (NSF), the NSF of China, European Molecular Biology Organization (EMBO), European Union (EU), etc. establish a funding branch termed "Sustained support for emerging infections" with multiple billion-dollar budgets yearly to continuously fund research into the emerging infections caused by viral diseases that have recently emerged to anticipate new outbursts. We need to vigorously encourage young and established scientists to join these research frames to strengthen the efforts to combat these horrifying diseases. In addition, the government should allocate some funds to set aside for industries that work on prevention and therapy. These approaches are advised to all governments worldwide.

We call for the unification of funding sources from governments, industries, private foundations and philanthropic sectors such as the Bill Melinda Foundation, Chan Zuckerberg Initiative, etc., to invest heavily in this emerging viral infection. This has to be a serious creative input and significant investment and has a specific office to devote their efforts to quickly develop tools and novel strategies to invent vaccines, drugs, and diagnostic devices and kits by nurturing creative ideas and innovative technologies.

We call for governments, the World Health Organization (WHO), and the United Nations to rethink this need as a concerted effort to maximally prevent and curb the future infectious pandemic. We need not only research funding but also infrastructure, hospitals, containments, and medical disposables. All should be prepared and manufactured rapidly to contain the colossal pandemic, including continued stocking in case an unexpected outbreak such as this one. The preparation also needs all governments to establish universal and standard regulations to reinforce our awareness and swift response mechanisms by the leaders at every government level, not just the countries leaders to any potential emerging epidemic or pandemic.

When an emerging epidemic or pandemic occurs, the international communities need to communicate timely and often, interact and take a consortium approach to tackle the shortage of prevention and treatment including beds and medical professionals to unify to combat the disease, which will be much more useful than each country acts alone without others' support and cooperation. Simple banning airlines, distance separation, social distancing, or geographic locking down are helpful and sometimes may be necessary but not the right approach and causing a substantial cost.

In summary, the critical lesson learned from past experiences and the new pandemic infection is that we cannot continue to do the same as we have done before. Instead, we genuinely need an urgent, radical, and fundamental change.

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