August 05, 2022
Advocate for International Cooperation
- Randy Schekman, Nobel laureate, WLA Vice-Chairman

Let me start by saying, I wish to speak on behalf of a renewed commitment to international cooperation on the problems we face as a people and not merely as individual countries. We've not yet conquered the greatest health crisis of the past century and yet increasingly countries have erected barriers to meaningful cooperation to defeat COVID-19. Once this crisis is overcome, I urge that we plan ahead as pandemics of this sort will re-emerge if we're not prepared.

Aside from the many logistical errors we and others made in attempting to contain the spread of SARS-CoV 2, our greatest mistake may have been in not anticipating the emergence or yet another deadly Coronavirus. Beginning with SARS 18 years ago, and MERS eight years ago, we should have mounted an international public-private effort to attack the virus at its core. However these epidemics subsided too quickly to have justified an investment by the pharmaceutical industry in the discovery and marketing of drugs, an effort that consumes billions of dollars for each successful application. If all goes well, we'll have a reasonable SARS-CoV 2 vaccine sometime next year. But patients who recovered in SARS in 2008 retained immunity for only a season or two. Thus a vaccine may have to be delivered as regularly as the annual flu shot.

Natural evolution of the surface antigens on viruses such as HIV and flu makes it difficult to anticipate a vaccine candidate. Likewise, we have yet to produce a vaccine that works on a variety of Coronavirus variants. In contrast, the core machinery that a virus's genome encodes is less flexible to random mutation, and therefore more amenable to targeted chemical attack in the form of drugs that work to block functions essential for virus reproduction.

This is a difficult lesson, but triumph of our successful approach to HIV therapy and that example must now guide our efforts to master the present and future versions of the Coronavirus. This effort must be sustained with substantial support from governments around the world for a public-private effort, even if we have a successful vaccine for SARS-CoV 2.