Rethinking the organisation of R&D

2020 will be remembered as the year of the COVID-19 pandemic, with all its catastrophic consequences for public health, and for social and economic life. This health crisis has highlighted the fragility of our system and of our preparedness in the face of an epidemic, notably the economic infrastructure supporting the research and development (R&D) that allows us to develop diagnostic and therapeutic tools rapidly in response to new illnesses. Despite everything, this year has been a time of innovation and scientific collaboration without precedent that has enabled us to develop new analytical tools and new treatments in record time, and to create safe and effective vaccines against SARS-CoV-2. American academic researchers have recently evaluated the efficiency of R&D during the COVID-19 crisis, to highlight progress, but also to point out those aspects that did not function well, so that we might be better prepared for future pandemics.

The idea of biomedical R&D taking place within a closed economic infrastructure, with the aim of combining the talents and resources from the sectors of academic research (public laboratories) and industry was born about twenty years ago. Priority was initially given to already known, chronic and non-contagious illnesses. Even though the pandemics resulting from H1N1 flu in 2009 and then Ebola in 2014 were a reminder that research on emerging illnesses requires constant and regular investment, financing a market product which may never come to fruition is less enticing than investment into the field of chronic, known illnesses. Lessons were, however, learned from the Ebola epidemic: the World Health Organisation was able to develop different measures and plans of action concerning R&D with the aim of being better prepared for other epidemics.

Research organisations have started to develop vaccine technologies that could be applied to several different pathogens in the future. For example, a public-private research partnership was set up with the Moderna company to develop its mRNA candidate-vaccine against MERS (another coronavirus). This allowed the very quick development on the same basis of a candidate-vaccine against SARS-CoV-2. Some countries like the United States or Russia had sufficient financial resources and the necessary organisational capacity to support public and private R&D before the pandemic. In the United States, for instance, this recently allowed the development and production from start to finish of a safe vaccine against  COVID-19 (Moderna).

Other countries such as France, Germany or the United Kingdom, have good scientific expertise, solid infrastructures and the financial means, but lack the necessary R&D economic system to carry through the whole process of product development. Other member states of the UN are poorly coordinated and the organisation is under-financed. In response to the need for accelerated elaboration, production and distribution of anti-COVID-19 pharmaceutical products, especially in developing countries, initiatives have taken place, bringing together heads of government, institutions and industrialists. But such initiatives have not been followed through by all countries and promises of financing has remained ill-adapted. Intellectual rights and patents arising from public and private research initiatives can also be a hindrance to the availability of pharmaceutical products worldwide.

In conclusion, the economic infrastructure of R&D for the production and rapid distribution of pharmaceutical products in the face of the epidemic is only relatively efficient and adapted to the situation in a small number of countries. The kind of worldwide cooperation necessary to deal with a pandemic is lacking. In the future it will be necessary to put a reliable, responsible system of global financing in place as well as to organise better worldwide collaboration, to ensure that everybody has access to the medicines necessary to confront the next pandemic.