The pandemic’s impacts on disease prevention, science, and innovation 

In this interview series from the Milken Institute Center for the Future of Aging and PBS' Next Avenue, experts from the Center's Advisory Board share their perspectives on the long-term impacts of the COVID-19 pandemic.

Milken Institute Center for the Future of Aging: As we await vaccines and treatments, where are we in the process, and what critical steps are ahead?

Nanette Cocero: Over the last few months, biopharmaceutical companies, along with others in academia and the broader scientific community, have achieved what usually takes years—driven by a shared mission to find a solution to this pandemic. We are all acutely aware of the responsibility that rests on our shoulders and the lives that are at stake. 

Around the globe, there are more than 1,500 clinical trials underway of treatments and vaccines to fight COVID-19. This is a stunning number, as is the number of vaccine candidates currently in clinical evaluation (more than 40). 

In terms of where we are in the process, we are moving at the speed of science. 

Several of the vaccine candidates I mentioned are now being studied in large-scale, late-stage trials, and some developers have expressed the hope that they may have the data necessary to seek regulatory review before the end of the year. 

The world recently reached the very sobering milestone of 1 million deaths from COVID-19. So, we feel the urgency, but we will in no way compromise safety for speed. 

A public pledge signed by nine biopharma leaders underscored this — a commitment to scientific integrity and rigor, above all else.

One point I’ll add, regarding this time period as we await a vaccine: Let’s not forget the importance of staying up to date on recommended vaccinations against diseases that currently are preventable. 

As winter approaches, it’s especially critical to help protect vulnerable individuals, including those over 65, against illnesses like flu and pneumococcal disease, which have the potential to be quite serious and even deadly. Doing so has the added benefit of helping to preserve health-care resources to focus on COVID-19 where needed.

COVID-19 has exposed ethical challenges around scarce resources. With multiple treatments and vaccines in the development pipeline, what are key considerations for use, distribution, and equity in access?

Equitable access to treatments and vaccines is absolutely vital. 

When it comes to a potential vaccine, announcements of supply agreements with governments are in the headlines almost daily—but this is just the first step in what is ultimately a complex process. 

Those of us developing vaccine candidates are working with governments to provide input and help ensure the doses we produce reach the people who need them. 

For now, global health guidelines have prioritized those who are at highest risk of contracting COVID-19 to receive a vaccine first—among them are frontline health-care workers, essential workers, immunocompromised individuals, and public safety officials.

Supranational and third-party organizations (such as Gavi, the Vaccine Alliance and the Bill & Melinda Gates Foundation) also have important roles to play. In the case of COVID-19, several of these organizations have set up a landmark collaboration known as COVAX that aims to provide governments, including those of lower-income countries, with early access to a large portfolio of candidate vaccines.

I’m hopeful about the potential of mechanisms like COVAX to make a substantial impact.

What do you predict will be the most significant long-term impacts of COVID-19 on infectious disease prevention and control, science and innovation, and related policies?

I really believe that the value of prevention in health care is better, and more widely understood, now than ever. It’s important that we build on this momentum to ensure that prevention becomes a higher priority for governments across the world. 

This means greater investment in vaccine innovation and a renewed focus on routine vaccination schedules. 

Older adults have been disproportionately impacted by COVID-19—by the disease itself, but also, the implications of country “lockdowns” and stay-at-home orders. This has shone a light on the need to establish effective health policies that focus specifically on the aging population.

The pandemic has also drawn focus to the need for greater racial and ethnic diversity in clinical trials. This is not a new issue—diverse communities have long been underrepresented in clinical research—but I’m encouraged by the progress being made. 

Vaccine makers have taken proactive measures to select trial sites in diverse communities and reduce barriers, like language, that prevent enrollment. As an industry, I hope we’ll continue to hold ourselves accountable in this area, so our clinical trials truly reflect the diversity of the world we live in.

Finally, across the global health community, I hope the partnerships and collaborations that have been mobilized so quickly in the face of this crisis will endure. 

This year, we have shown that we are stronger together. I can’t help but wonder what strides can be made in fighting other diseases if we sustain this high level of collaboration going forward.