Medical interventions against dangerous pathogensReducing risks through broad-spectrum vaccines and therapeutics

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This profile is tailored towards students studying biological sciences, engineering and law, however we expect there to be valuable open research questions that could be pursued by students in other disciplines.

Why is this a pressing problem?

Pandemic outbreaks can cause enormous loss of life. Global excess mortality due to COVID-19 was at least 17 million in 2020 and 2021, with more deaths continuing to this day, and pandemics can be far more deadly: the 1918 influenza pandemic, for example, killed between 1% and 5.4% of the global population. Smaller influenza pandemics, such as those in 1957 and 1968 which killed 1-4 million people worldwide, demonstrate that the emergence of new respiratory viruses is a routine event. Pandemics harm the quality of people’s lives in other ways; for example, the COVID-19 global recession is the deepest since the end of WWII according to the Brookings Institute. The Institute for Progress has estimated that COVID-19 cost the USA between 7 and 16 trillion dollars worth of health and economic damage, over and above the value of lives lost.

The next pandemic could be much deadlier and cause irrecoverable damage to global civilisation and humanity’s potential for flourishing in the future. A more deadly pandemic could emerge naturally, but as the necessary level of expertise and cost of creating dangerous novel pathogens continually decreases, anthropogenic pandemics are also becoming an increasing concern. There are multiple routes via which this could occur; there are many historical examples of dangerous viruses being accidentally released from research labs, or an anthropogenic pandemic could be started by the intentional release of pathogens, for example by a terrorist group or military during warfare. 

To address future pandemics, we need medical interventions against pathogens to be faster to produce, effective against a broad range of threats, and cheaper and easier to produce at scale. The development of therapeutics and vaccines typically takes many years, and prophylactics and treatments typically address only individual pathogens. Making medical interventions that are effective against a broad range of pathogens and can be quickly adapted to novel threats would drastically increase our resilience to natural and engineered pandemics.

Improving the speed with which prophylactics and therapeutics can be manufactured and distributed is also important. Medical interventions can be difficult to transport, store or administer – for example, the need for cold chains to transport COVID vaccines made vaccination efforts more challenging, particularly in low-income countries. Increasing the scalability of relevant biotechnologies via lowering costs and overcoming technical barriers is also needed. 

Medical countermeasures can have downside risks (for example, some vaccine platforms can increase how easy it is to synthesise dangerous viruses). If you’re interested in this area, apply for our coaching and we can connect you with experts in this area who can offer you advice on navigating these risks.

To learn more about an example of work in this area, see this talk from Alvea, an organisation formed in response to the COVID-19 pandemic to develop a scalable, shelf-stable vaccine that is easy to adapt to new COVID-19 variants and pathogens.

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If you’re interested in working on this research direction, below are some ideas that could be particularly valuable to explore further. If you want help refining your research ideas, apply for our coaching!

Biological sciences

This List of Concrete Biosecurity Project Ideas suggests some ideas that biologists could work on, for example:

  • Ingestible Bacteria for Vaccination: “Bacteria placed inside temperature-stable capsules, and engineered to produce antigens in a human host; can be self-administered in the event of a pandemic.” (From Technologies to Address Global Catastrophic Risk)
  • Vaccine Candidates for Prototype Pathogens: “Although scientists frequently discover new viral species that infect humans, the number of viral families that these species belong to has plateaued. Therefore, by investing in vaccines for at least one prototype pathogen in each of the 25 viral families known to infect humans, we could reduce the global burden of infectious disease while simultaneously preparing for the next unknown biological threat.” (From Apollo Program for Biodefense Technology Priorities)
  • Multi-Pathogen Therapeutic Drugs in Advance of Outbreaks: “Previous efforts to develop multi-pathogen therapeutics have largely targeted direct-acting small molecule antivirals. However, new modalities are emerging that may result in increased breadth and potency and which warrant extra investment, including host-directed antivirals and monoclonal antibodies targeting regions conserved across multiple viral species.” (From Apollo Program for Biodefense Technology Priorities)

You can also see the Open Philanthropy’s report for more details and other suggestions on how to help reduce risks from engineered pathogens.

Engineering

Vaccine distribution is made more challenging by factors such as the need to keep vaccines in cold storage and for trained health professionals to administer them. Improving methods of vaccination that can be self-administered or delivered by workers with minimal training, and developing vaccines that are more stable, could be useful. This List of Concrete Biosecurity Project Ideas suggests some ideas that engineers could work on, for example:

 

  • Microarray Patches for Vaccine Administration: “an emerging vaccine administration technology that has the potential to modernize the conduct of mass vaccination campaigns.” (From Technologies to Address Global Catastrophic Risk)
  • Needle-Free Methods of Drug and Vaccine Administration: “intranasal or inhalable drugs or vaccines may also enable self-administration… delivery is common for small molecule drugs [but] has seen limited use with biologic drugs and vaccines” (From Apollo Program for Biodefense Technology Priorities)

Law

  • “[Conduct an] overview of the legal landscape for knowledge transfer relating to vaccine and therapeutic development…how can we facilitate (or coerce) transfer of development and manufacturing knowledge between (private) entities? The question should potentially be broken down to look at “peacetime” and “during emergencies.”)” (Project Ideas in Biosecurity for EAs – David Manheim)
  • Conduct historical analysis into vaccine development and funding landscapes (ex. why / how did the NIH start funding early stage mRNA vaccine research in the 80s/90s and how can we make sure that visionary scientific progress like that keeps happening). (Proposed by Elika Somani)
  • Conduct research into developing law and policies around fast medical interventions and deployment (ex. how can the FDA create a rapid approval process that’s even faster than what happened with COVID-19 vaccines to equip us to best respond to future pandemics?) (Proposed by Elika Somani)

Further resources

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Podcasts

You could register interest for BlueDot Impact’s introductory course on the fundamentals of biosecurity. The Global Catastrophic Risk Institute suggests fellowships and other next steps here.

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Contributors

This profile was last updated 8/1/2023. Thanks to Elika Somani and Oliver Crook for helpful feedback on this profile. All errors remain our own. Learn more about how we create our profiles.

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