The Bill & Melinda Gates Foundation, along with the charitable group Wellcome and Mastercard, announced Tuesday that they were launching a $125 million effort to speed up the development of drugs to treat the novel coronavirus.
The initiative, known as the Covid-19 Therapeutics Accelerator, will not be enough to develop even a single new medicine by itself, but it can jumpstart the process. Trevor Mundel, the president of the Gates Foundation, said the funding could provide important funds to companies and academic researchers immediately, before government funding will be available. Mundel estimates that two dozen companies, evenly divided between large pharmaceutical firms and small biotechs, could be involved in the effort.
“You need some entity that can work between the private sector … and the public sector, both the governments and the World Health Organization, and is able to move fairly agilely between those entities,” Mundel said. That’s the gap that needed to be filled, Mundel said, if there are going to be new antiviral drugs or monoclonal antibodies, a type of biotechnology drug, available within the next year to 18 months to treat the disease known as Covid-19.
One of initiative’s first goals will be to test antiviral drugs that have already gone through preclinical development or have already been tested in humans. Mundel said that the effort will have access to experimental medicines from Johnson & Johnson, and more from Calibr, the drug research arm of the Scripps Institute, as well as from other large pharmaceutical companies. All told, there could be 20,000 to 30,000 potential medicines to test. The hope is that just a few of those will be worth testing in humans.
The plan is for the medicines to be screened against the coronavirus in a matter of five to six weeks. Mundel said the screening would likely be done by the Rega Institute in Belgium.
But some of the money could be used in other ways. It could, for instance, pay for beginning to scale up manufacturing. That said, Mundel acknowledged, the amount of money set aside for the effort could barely cover the cost of setting up manufacturing facilities for a single drug. (Before joining the Gates Foundation, Mundel held a top position at Novartis, the Basel, Switzerland-based drug giant.)
The effort is in some ways modeled on another project backed by Bill and Melinda Gates, the Coalition for Epidemic Preparedness Initiatives, which focuses on the development of vaccines.
The development of both medicines and vaccines can be time-consuming — and take several years. The fastest possible treatment on the horizon is Gilead’s drug, remdesivir, which is already in clinical trials and could see results as early as April. Mundel said he could imagine doses being available by the end of the year if all goes perfectly. But the drug, which must be given intravenously, might not be ideal for countries such as Africa.
“Our estimate is the devastation in those countries with poor health care infrastructure is going to be magnified dramatically,” Mundel said.
A repurposed new drug from the libraries the new effort plans to test could be available by the beginning or middle of next year, after both small and large studies are run to test its effectiveness and safety. Antibody medicines, which many biotech firms are working on, could take until the end of next year in a best-case scenario. If drugs need to be discovered from scratch, that could add years to the process. All of those timelines are much faster than normal drug development, and could slip. Treatments derived from blood plasma of those who had recovered could be available more quickly, but supplies will be limited.
With vaccines, Mundel worries that even if a vaccine is ready by the end of next year, the need to manufacture large numbers of doses could mean it would take several years to get it to hundreds of millions of people. He can imagine, he said, a period of as long as six years where therapeutics might be available, but not vaccines.
To fund any company’s work, the Gates Foundation requires that companies pledge to make their medicines broadly available around the world. This does not limit prices that could be charged in developed countries like the United States. But Mundel said that executives at pharmaceutical companies are “leery” of being seen as taking advantage of Covid-19.
“The companies that I’ve spoken to, including some of the big companies, one of their abiding fears is that anything they do in this area would be seen as some kind of price-gouging,” Mundel said. He added that he is optimistic drug companies would avoid such a scenario. The bigger worry is getting medicines that could be used to treat the sick or as a prophylactics that can prevent infection.
The Covid-19 Therapeutics Accelerator, Mundel said, is “a good starting point” for speeding up drug development. “We also realize that the real responsibility does lie with governments,” he added. “We do believe they’re going to step up. But it’s just going to be slow.”
The Gates Foundation will provide $50 million, part of the $100 million it has already committed to fighting Covid-19. Wellcome will commit another $50 million, and Mastercard $25 million.