Coronavirus: Push for Covid-19 vaccines has led to ‘deficit’ of effective treatments, experts warn

‘What we really need are drugs for all stages of the disease’ - even if a vaccine is approved, say Wellcome Trust and Unitaid

More must be done to develop effective treatments for Covid-19, experts have warned, amid mounting concern that the push for a vaccine has led to a global "deficit of high quality" medicines for the disease.

There are no specific treatments for the virus, although existing drugs such as Remdesivir and dexamethasone have shown to be effective in reducing the severity of the disease among critically ill patients.

Despite the "significant gains" made on this front, experts from Wellcome Trust and Unitaid have warned that "what we really need are drugs for all stages of the disease" — even if or when a vaccine is approved.

Dr Nick Cammack, head of the Wellcome Trust's Covid-19 Therapeutic Accelerator project into promising therapies, said the world needed “drugs that will stop people having to go to hospital in the first place, drugs that will, if you're in hospital, get you out quickly, or at the very least prevent you from progressing to critical care and intensive care units."

He added that there needs to be more "global funding and the engagement of large and small companies" in this space, highlighting that £1.5bn has been pumped into the race for a vaccine, while only £232m has been invested in the research and development of treatments.

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"Vaccines have received six times the amount of funding," Dr Cammack said during a media briefing held on Wednesday. "We're at risk - and I'm thinking about the whole world - of having a real deficit of high quality new treatments for Covid-19."

Focus has so far centred around "repurposing" existing drugs, Dr Cammack added. This has included corticosteroids, which treat inflammation within the body, and anti-infective treatments that are typically used against HIV or malaria, such as hydroxychloroquine.

The UK's Covid-19 Recovery trial, which involves tens of thousands of participants, was the first to demonstrate the effectiveness of dexamethasone, and also proved there is "no clinical benefit" from hydroxychloroquine. Other trials, led by the likes of the World Health Organisation, have conducted similar research into existing drugs.

There is also emerging hope that a form of medicine ‘designed’ from human antibodies could prove to be a game changer. "Monoclonal antibodies are among the most promising treatments for Covid-19 that are coming through," said Dr Lindsay Keir, an innovations partner at the Wellcome Trust.  

As they are based on our bodies' own antibodies, this means "they're safer than other medicines which are formulated from chemicals,” Dr Keir said.

Dr Cammack said there would be more data available on this type of treatment, which was given to US president Donald Trump following his diagnosis with Covid-19, in the coming months.

"These are really exciting because these are the first exquisitely specific drugs for the virus," he added.

Still, the experts warned that this type of treatment would not be enough. "What we do need are other options," Dr Cammack said. "The pipeline today is bare. There are a few companies who are evaluating specific antivirals, and one example is Merck.” He said the German pharmaceutical will have data on a drug in development by the end of the year.

"We've estimated that to provide treatments around the world, it will probably need $7bn (£5.4bn) - a huge number, I know, but compared with a probable $7 trillion (£5.4trn) economic hit, it's minuscule," Dr Cammack added.

Janet Ginnard, director of strategy at Unitaid, a global initiative that focuses on pandemics, said that medicines for treating Covid-19 would still be needed "even when we have a vaccine.”

"Treatments and vaccines are complementary. We need both tools,” she said. "We need a wide range of treatments. There’s not going to be one size fits all, sort of a single silver bullet. It is great that we have a treatment recommended for severe and critical care, so dexamethasone, but we do need medicines for treatment earlier in the disease, for moderate cases, for mild cases.”

The experts also said that the world "can't be complacent" over the new monoclonal antibodies treatment, warning that it comes with its "own challenges".

"Eighty-five per cent of world can't access existing monoclonal antibodies, despite the fact they save millions of lives," said Dr Keir. "Cost is a major barrier -  monoclonal antibodies are among the most expensive drugs in the world."

She said the average antibody treatment, which mimics our own body’s response to the coronavirus, costs between £11,600 and £155,000 per year in the US. "Most are designed for high-income markets like the US and Europe," Dr Keir added.

In the UK, NHS chiefs have acknowledged that, with the mass delivery of a vaccine still some way off, there is a need to “see better and more effective treatments for the virus as the pandemic continues and changes shape”.

Dr Layla McCay, director at the NHS Confederation, told The Independent: “There are already medications found to help manage patients with Covid-19, and healthcare providers are learning more about the behaviour of the virus and how to treat it over time.

“But as case numbers rise, and especially those requiring hospital care, new, specific treatments will be important to help to keep people out of hospital and to treat the virus at different stages. Staff are doing all they can, but the reality is that as well as seeking to prevent infection, we are also going to be faced with the need to treat people with Covid-10 for the foreseeable future. 

“We will need honesty and realism from political leaders about what can be delivered, as the NHS continues to resume services while managing the ongoing threat of the virus.”