Pharmaceutical industry: How can we improve our preparedness for new health threats?

The pharmaceutical industries are naturally at the forefront of scientific innovation and emergency treatments, rather than of long-term intelligence and monitoring activities. This is further evidenced by the very short period of time – less than a year – that elapsed between discovery of the first cases of an unknown disease in Wuhan and the roll-out of the large-scale vaccine campaign.

 The scope and complexity of prospective phenomena – over and above their scientific and logistical components – requires the pooling of intelligence and anticipation by combining a range of expertise and talent, and this cannot be left to the industrialists alone.

 Given the sums required for research and even more so for clinical development, and in light of the need to mobilise resources – particularly human resources – which are undoubtedly disproportionate to the stakeholders' own in-house capacities and the difficulty of assessing multi-factorial phenomena such as pandemic threats, the very principle of forward planning – a difficult and uncertain exercise – highlights the key role of the support provided by public players in efforts at the interface between several disciplines, involving many different types of expertise.

The challenge of climate change

It is therefore not surprising that the monitoring required on macro-societal aspects is the prerogative of public, national or even supranational organisations, foundations or think tanks that are independent of the industrial sector: World Health Organisation (WHO), Biomedical Advanced Research and Development Authority, Novo Nordisk Foundation, Gates Foundation, and the One Health Initiative, among others.

 To analyse the processes and influences of climate change on human health, for example, it becomes apparent that this overview reaches far beyond the narrow scope of responses in terms of therapeutic innovations, and in many respects concerns territorial, agricultural, environmental and health policies, geopolitical decisions and international cooperation – the prerogatives of leaders, public health stakeholders, associations and NGOs far more than private actors.

This is very much in keeping with the letter and spirit of schemes such as the One Health Initiative, whose fundamental principle has been known for more than a century: human and animal health are interdependent and linked to the health of the ecosystems in which the species coexist.

Through closer collaboration between practitioners, engineers, sociologists and scientists studying human and animal health, this operational statement reveals the need for a fundamental theory, concrete methods and practical examples. 

Since the late 1990s, One Health has become the archetypal unifying concept for many governmental and non-governmental organisations concerned about protecting human and animal health, wildlife conservation and environmental sustainability.

To counter the threat of new pandemics, the WHO, the Food and Agriculture Organization of the United Nations, and the World Organisation for Animal Health have joined forces in a tripartite, global commitment. One Health remains a leading initiative in terms of research, pandemic capacity building and multi-stakeholder consortia.

This interdisciplinary approach is the product of more than a decade of experiments, research and teamwork dedicated to providing a comprehensive (but still limited) overview of theory and best practices in fields encompassing human and animal health, social sciences, economics, environmental sciences, engineering and conservation.

These interdisciplinary approaches are proving useful to professionals and academics alike, as well as to technical authorities and governments, by presenting numerous best practices in disease control, community services, conservation and education.

These interdisciplinary contributions have endowed One Health with the means to become an incubator for health innovation, research and training, by bringing together numerous stakeholders in an ecosystemic approach, at the interface between multiple competencies and enabling fruitful cross-fertilisation of ideas between public and private stakeholders, digital and healthcare players, entrepreneurs and researchers, etc.

As one of the creators of this initiative rightly maintains, through informal meetings and exchanges, cross-fertilisation generates the spark required to build collective intelligence and a renewed “grammar” of forward planning.

 Combinatorial data generation

I believe that improving inter-sectoral solidarity and the multi-disciplinarity of teams is one of the challenges that needs to be met in order to improve the preparedness for new threats of manufacturers in the health sector. To this end, data can also be a precious ally.

Greater attention should therefore be paid to combining predictive models and analysing statistical data on links between climatic and health conditions and disease transmission on a regional or even global scale, with a view to implementing monitoring and anticipation tools that are essential to the analysis of future infectious disease scenarios in line with changes in climate conditions.

As we showed in a recent article, precise and prospective modelling of a set of parameters – a product of combinatorial health data and more general extrinsic data, often from the social sciences – would benefit governing bodies and public health actors, medical and hospital staff, which would be responsible for organising the architecture and promoting exchanges.

This could include providing access to health-crisis monitoring and anticipation data in order to foster therapeutic progress. While there are many reasons for the rapid development of vaccines by private operators, one cannot fail to be impressed by the incredible data collection and processing systematics made possible by the recently acquired power of big data and artificial intelligence in health.

Ever since the start of the epidemic, genomic engineering, clinical trials, production platforms, logistical optimisation, instruments for managing and monitoring vaccination campaigns, the early detection of contamination risks, and the therapeutic education of the population are all means, methods and metrics that have been informed by the collection and analysis of big data. 

However, while still complying with the mandatory confidentiality requirements, public players should give greater freedom of access to manufacturers that instigate therapeutic innovation, when required by the analysis of weak signals or the study of future scenarios.

In this respect, it is symptomatic and reassuring that a number of international initiatives – notably OneHealth  – include several major health data operators among their main partners.