Canada welcomes antivirals as a new weapon to fight the COVID-19 pandemic and ease the overflow of our hospitals and intensive care units (ICUs). Health Canada’s approval of Paxlovid, Pfizer’s antiviral, sparked an enthusiastic response from many politicians, doctors and journalists. This support for the key role of antivirals is long overdue.
Posted at 12:00 p.m.
In its rush to buy vaccines quickly, Canada neglected to develop a strategy to develop antivirals at the same time. We have to make up for lost time.
There is an urgent need for the Government of Canada to establish a strong, stable organization dedicated to the production of more antivirals in order to meet its commitment to improve the global response to pandemics.
Antivirals are essential to ending the pandemic and getting Canada back on track to a new normal. A wider variety of antivirals will be needed to prevent SARS-CoV-2 from becoming drug resistant.
When AZT was approved in 1987 as a treatment for HIV, it was the only therapy available. Today, 35 years later, there are more than 30 drugs and their combined uses make it easier to manage symptoms and avoid drug resistance.
Treating infected people as soon as they are diagnosed can reduce viral load and decrease transmission to immediate contacts, which is a great benefit for public health. This has been demonstrated by triple therapy with HIV and Tamiflu for influenza. Antiviral therapy also lessens the severity of symptoms, providing relief to the patient, decreasing the length of hospital or ICU stay, and reducing healthcare costs.
We also need treatments for patients who suffer from the residual symptoms of long COVID, including chronic fatigue and fibromyalgia, cardiovascular sequelae, renal impairment, anxiety or depression.
What form should Canada’s antiviral initiative take?
The discovery and development of additional antivirals will require investments of a level comparable to that of the purchase of vaccines.
As a first initiative, Canada recently announced an investment of $18.5 million per year to establish the Center for Pandemic and Health Emergency Preparedness Research. The mission of this center is broad and while it includes developing and mobilizing research on expanded pandemic response, the Center will not be able to produce the antiviral therapies critical to an adequate pandemic response. of pandemic.
What other initiative should be taken then to achieve the objectives?
We believe that Canada should create a new, highly focused entity in the form of a global collaboration for the discovery and development of antivirals. This entity would have the mission to establish an avenue, not for profit, so that the discoveries of academics give rise to antiviral therapies applicable to patients.
We suggest that such an entity have two components: a focused research organization dedicated to antiviral development and integrated into a new “Network of Centers of Excellence” (NCE Canada) focused on antiviral discovery.
Canada should urgently issue a call for proposals for this new NCE to bring together academics with expertise in medicinal chemistry, structural biology, pharmacology and virology and capable of inventing new antivirals.
Participants in this new NCE would work in partnership with existing Canadian centers such as the National Microbiology Laboratory and its biosafety level 3 and 4 laboratories for preclinical testing and the new manufacturing facility of the National Research Council of Canada, in Montreal. Any collaborative arrangement between these organizations – or others – should be respectful of Open Science policies and practices.
Canadian institutions and scientists could thus truly participate in the efforts of the World Health Organization (WHO) through the ACT Accelerator with budgets running into billions of dollars. Such collaboration with low- and middle-income countries would support more adequate preparedness and a better global response in the event of a pandemic. An attempt to discover new treatments for COVID-19 has been dubbed “COVID Moonshot”. It is an international collaborative project launched on Twitter aimed at discovering therapeutic agents.
Although this project succeeded quickly in finding drug candidates, its promoters realized that they are now at a pivotal stage. There is an urgent need for access to the capital needed to complete many regulated trials, as well as to manufacture and distribute antivirals worldwide that will be subject to regulatory approvals.
The global community has assumed for too long that the pharmaceutical industry would take over the costly job and has resigned itself to paying the exorbitant prices that ensue. The experience of the “COVID Moonshot” group highlights the need to create a not-for-profit avenue for the development of treatments resulting from collaborations between academics.
With such a Canadian-led global collaboration for the discovery and development of antivirals, our country would be a pioneer.
* Jeremy Carver is Emeritus Professor at the University of Toronto Faculty of Medicine and Michel Chrétien is Emeritus Research Professor at the Clinical Research Institute of Montreal.