Science after the pandemic – Bright side of the moonshots | Leaders – The Economist

Mar 27th 2021

THE FIRST virus to have its genome read was an obscure little creature called MS2; the 3,569 RNA letters it contained were published in 1976, the hard-won product of some ten years work in a well-staffed Belgian laboratory. The SARS-CoV-2 genome, almost nine times longer, was published just weeks after doctors in Wuhan first became concerned about a new pneumonia. That feat has since been repeated with getting on for 1m different samples of SARS-CoV-2 in the hunt for fearsome variants like the one ravaging Brazil. Within weeks of its publication, the original genome sequence became the basis for the vaccines that today are stymieing the virus wherever supplies, politics and public confidence allow.

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It is hardly remarkable that medical science has moved on since 1976. But the covid-19 pandemic has brought the sharp joy of seeing decades of cumulative scientific progress in sudden, concerted action. The spate of data, experiments and insights has had profound effects on the pandemicand, indeed, on the future of medicine. It is also an inspiration. Around the world, scientists have put aside their own work in order to do their bit against a common foe. Jealously guarded lab space has been devoted to the grunt work of processing tests. Covid-19 has led to some 350,000 bits of research, many of them on preprint servers that make findings available almost instantaneously.

The basis of all this is the application of genetics to medicine in a systematic and transformative waynot just in understanding the pathology of diseases but in tracking their spread and curing and preventing them. This approach could underpin what is becoming known as natural securitythe task of making societies resilient in the face of risks stemming from their connection to the living world, whether because of disease, food insecurity, biological warfare or environmental degradation.

The application of genetics to medicine partly reflects huge, rapid gains in efficiency. Reading the DNA in a human genome cost $10m in 2007, today it takes less than $1,000 and a fraction of the time. Coupled with ever-better ways of synthesising and editing genes, this has enabled cleverness little short of the miraculous. Before the pandemic, these trailblazing techniques were not much talked about beyond the laboratory. Having shown their mettle against a brand new disease, they have burst out into the open.

Take the vaccination technology rapidly developed by Moderna of America and BioNTech of Germany, building on years of patient and often unsung work on RNA, a store of genetic information. It is remarkable that you can simply instruct the bodys cells to make the viral protein you have designed to prime the immune system. The RNA vaccines are testament to the insight of Eddie Cantor, a comedian, that it takes 20 years to become an overnight success.

With this proof of concept, the investments of companies that have worked hard on RNA may now pay off. To some extent, RNA medicine divorces form from function. An RNA vaccine against any disease is a message written in genetic code: a vaccine against malaria, or some form of cancer, can be made in the same way and with the same equipment as a SARS-CoV-2 vaccine. If this provides a platform for getting cells to do all sorts of specific things and to desist from others, as it promises to, medicine will become both more powerful and more personal. Therapies tailored to rare, even one-off, genetic abnormalities should become routine.

The pandemic has also demonstrated the value of gene-sequencing technologies. Observing SARS-CoV-2 as it mutates is essential if the world is to understand and defend itself against dangerous variants. Should covid-19 become endemic, as is likely, sequencing will become the basis for developing regular booster shots. More broadly, routine sequencing is one of the best ways of knowing what is out there. Companies have done brilliantly in producing powerful sequencing systems for trained technicians. Now the world needs cheap, ubiquitous and reliable systems that can be used in the prison sick bay or the rural health centre, on the farm or at the town sewage works, to act as early-warning systems for the spread of pathogens.

Another area of work is where the pandemic has revealed a gap. Even todays progress has yet to produce small-molecule antivirals to combat SARS-CoV-2. A focus for natural security should be drugs aimed at the viral families most likely to cause trouble in the future. This is not something that the market will support on its own. New mechanisms that involve governments will be needed, such as funds for R&D and trials and to buy stockpiles of medicine. Similar approaches should also be used for the looming threat of antibiotic-resistant bacteria.

These innovations will have big consequences. General-purpose RNA medicine asks new things of firms and regulatorsas do other platforms, including some forms of gene therapy. Regulators will need to take advantage of the fact that, say, a malaria vaccine and a SARS-CoV-2 vaccine are both made on the same platform by streamlining approval for them, while continuing to ensure safety.

Drugs firms will have to adapt, as some chronic conditions may, in effect, be cured. Many are used to concentrating on the long-lasting afflictions that most trouble the rich world: heart disease, cancer, metabolic disorders, neurodegenerative conditions and the like. If drug development is more targeted on instructing cells what to do, rather than finding novel molecules against specific proteins, some of the know-how on which old-style pharma is based will be less relevant. Firms will need new pricing models and a new focus to their research.

Technology will not, in itself, thwart pandemics. That goal also requires systems and institutions which use technology broadly and wisely. Without good systems, great technology will often provide only mediocre results, as it has in many covid-19 test-and-trace programmes. But the pandemic has shown that biomedical science has the tools and the enthusiasm to improve the world. The world must now build on both.

Dig deeper

All our stories relating to the pandemic and the vaccines can be found on our coronavirus hub. You can also listen to The Jab, our new podcast on the race between injections and infections, and find trackers showing the global roll-out of vaccines, excess deaths by country and the viruss spread across Europe and America.

This article appeared in the Leaders section of the print edition under the headline "Science after the pandemic"

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Science after the pandemic - Bright side of the moonshots | Leaders - The Economist