
COVID-19 Pandemic At 5: Will Funding Cuts Hinder Our Future Preparedness?
www.forbes.com
The COVID-19 pandemic began five years ago, seemingly all at once. Treatments quickly became ... [+] available, primarily because of federally funded basic research. (Photo by John Paraskevas/Newsday RM vis Getty Images)Newsday via Getty ImagesFive years ago, the COVID-19 pandemic seemed to begin all at once. It officially started with a declaration by the World Health Organization on March 11, 2020. Within days, schools and restaurants closed. The death toll continued to rise. Hospitals were overwhelmed. Our world had changed.But medical advancements seemed to occur all at once, too. Just seven months after the pandemic declaration, an antiviral that helped reduce disease severity and death became available. Two months after that, highly effective and safe mRNA vaccines became available. These advancements, however, didnt actually occur all at once. Their rapid development was possible because of basic research, often federally funded, that had been ongoing for decades.With funding cuts proposed by President Trump, this basic research is in jeopardy. If another pandemic occurs, we may not be able to respond with warp speed.To more fully explore the importance of federally funded basic research, lets look at the remdesivir story. The FDA approved this antiviral compound for the treatment of COVID-19 on October 22, 2020. Dr. Mark Denison, Director of the Division of Pediatric Infectious Diseases at Vanderbilt University Medical Center, contributed to the development of remdesivir and another COVID-19 drug, molnupiravir. But he didnt start out with that goal in mind.Denison has been studying coronaviruses for four decades. In a recent conversation, he noted that his work on remdesivir began with a much different goal, investigating the role of the coronavirus ExoN protein. Described as weird by Dr. Denison, ExoN functions as a proofreading enzyme. It allows the virus to fix mistakes that occur during replication, a property not shared by many other viruses.Dr. Denison wanted to learn more about the how this enzyme contributed to coronavirus replication. Ive researched coronaviruses for 40 years. Im interested in how they work, he said. In retrospect, his approach seems straight-forward. We wanted to find a compound that inhibited this enzyme. Then we showed that this compound inhibited viral replication in cell culture and infection in animals. Finally, we showed that it was effective in humans. He noted that the same playbook was used during the development of molnupiravir.This work wasnt initiated in response to the COVID-19 pandemic. The studies were conducted primarily to investigate interesting questions about coronavirus biology. As Dr. Denison remarked, Finding antivirals wasnt my career choice.The development of the mRNA vaccines presents another example of the value of basic research. Drs. Katalin Karik and Drew Weissman received the 2023 Nobel Prize in Physiology or Medicine for their seminal work leading to the development of the Covid-19 vaccines. As noted in the official Nobel Prize press release, The vaccines have saved millions of livesallowing societies to open and return to normal conditions.The award, however, was not for the actual development of the vaccines. Karik and Weissman were recognized for basic research into our immunological response to mRNA and an atypical component of RNA called pseudouridine. They were recognized for work done over 15 years ago, long before the pandemic began. And the story certainly didnt start with them. Work by numerous researchers on topics like the synthesis of RNA and the delivery of RNA into cells preceded their work, thereby setting the stage.Science is an iterative process. And often, as shown by the work of Drs. Denison, Karik and Weissman, the end result isnt even a consideration when the work begins.The basic research that eventually led to the development of remdesivir, molnupiravir, the mRNA vaccines and other COVID-19 treatments largely was funded by the National Institutes of Health. With a budget of nearly $48 billion, the institutes support over 300,000 researchers at over 2,500 institutions, according to the NIH website.The results of this funding are remarkable. Over 170 scientists employed or funded by the NIH are Nobel Prize recipients, including Karik and Weissman. Countless other researchers use this federal funding to make small but important scientific advances. Most likely, many of them are motivated largely by curiosity. They investigate myriad biological systems because, as Dr. Denison noted, they are interested in how they work.Recent proposals to cut funding to the NIH could derail this basic research. In February, the Trump administration proposed a drastic cut in the indirect costs associated with its grants. These overhead costs help institutions maintain important services, like animal care facilities. The loss of these funds could be devastating and negatively impact the basic research occurring at universities and medical schools throughout the country.Today, over 7 million people globally and 1.2 million people in the United States have died as a result of the COVID-19 pandemic. Seventeen million adults in the U.S. may have long COVID, according to KFF. Yes, our world has fundamentally changed. But it could have been worse. Next time, it might be.
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