An inside look at the global fight against COVID-19

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The COVID-19 virus has quickly escalated from a localised outbreak to a global pandemic in a few short months, with devastating health and economic impacts around the world. So what’s involved in both the treatment and prevention of the deadly virus, and who is leading the global effort?   

Professors Adrian Hill and Helen McShane are world-leading vaccinologists at Oxford University, and their colleague Professor Tao Dong is an expert in immunology. On the same day that clinical trials commenced for the team’s COVID-19 vaccine candidate, the team from Oxford spoke with Jean Sung, J.P. Morgan Private Bank’s Head of The Philanthropy Centre for Asia.

What is the current state of the vaccine development?

Professor Adrian Hill is the Founding Director of Oxford University’s Jenner Institute, which is currently the largest university-based vaccine institute, tackling infectious and non-infectious diseases as part of a global collaborative community. 

“We have a track record,” says Professor Hill, who highlights in particular the team’s successful development of Ebola vaccines for West Africa in 2014 and 2015.

This experience and many others put his colleagues at the Jenner Institute in a unique position to rapidly develop a vaccine candidate for Covid-19.

“In the middle of January, as soon as we heard the sequence of the COVID-19 virus from China, we were able to rapidly put that sequence into our vaccine technology and design a vaccine candidate,” says Professor Hill.

“We’re now set to go,” he says, just hours after commencing phase one clinical trials.

“Thousands of people volunteered to be part of the first trial.” By the end of stage three, more than 5000 people may have participated in the trial.

An in-house manufacturing facility allowed the team to manufacture the COVID-19 vaccine candidate at the University. With the safety of the vaccine already established, the trials will focus on testing whether it works.

“The good news is that the cost of making this vaccine per dose is very modest,” says Professor Hill.

In the event that the vaccine proves successful, by September there should be sufficient evidence of its efficacy to register it for emergency use, AstraZeneca will then face the complex challenge of scaling up the manufacture of the vaccine to produce hundreds of millions of doses internationally.

Just last week, Oxford announced a landmark agreement with pharmaceutical company AstraZeneca for the further development, large-scale manufacture and potential distribution of the COVID-19 vaccine candidate currently being trialed by the University.

In light of this partnership, the vaccine will be made available on a not-for-profit basis for the duration of the coronavirus pandemic. Further information can be found here.

How do we treat people already infected with the virus?

While early progress in the search for a vaccine shows promise, the discovery and distribution of a successful vaccine could still be many months away. In the meantime, there is an urgent need to develop a treatment that will decrease the severity of the symptoms in those infected by the virus.

Professor Helen McShane is the Director of the Oxford NIHR Biomedical Research Centre. Her team is leading one of the world’s biggest trials of drugs to treat COVID-19 patients, focusing on existing drugs that have shown early evidence of working against the virus.

“These drugs are available in large quantities and could be deployed immediately,” she explains, “which means they can be rapidly rolled out across the world.”

Trials involving up to ten thousand people are underway to test the efficacy of antibiotics, antimalarial drugs, antiviral drugs and anti-HIV drugs in treating Covid-19.

At the same time, a series of small-scale trials are about to commence, responding to growing evidence that the damage done by the virus is actually caused by an overactive immune response in the patient. Professor McShane’s team will be testing a range of drugs that dampen the body’s initial immune response to the virus, such as anti-inflammatory drugs designed to treat rheumatoid arthritis.

Conducting studies with only 50 or 100 people means they will only identify drugs that are going to make a difference to patient outcomes in a high proportion of cases. Drugs that don’t can be crossed off the list and the team can rapidly move onto the next trial.

“The small scale studies will complement the larger ones, allowing us to quickly identify molecules that may be game changing against this devastating disease,” says Professor McShane.

What does International collaboration look like?

Given the sheer scale of the health challenge presented by infectious diseases such as COVID-19, a sustainable solution is only possible with close, careful and diverse international collaboration. 

A history of close collaboration between Oxford University and a number of Chinese institutions gave the research team a head start when the COVID-19 crisis began. Professor Tao Dong is the Founding Director of the Chinese Academy of Medical Sciences Oxford Institute.

The institute was built on a long history of training and academic exchange with China, including a 17-year partnership between Oxford and the two largest infectious disease hospitals in Beijing.

“This setting put us in a strong position when Covid-19 started in China,” explains Professor Dong. “It allowed us to rapidly pool our strengths and prioritise our resources so the researchers could start their work immediately.”

How can philanthropy assist? 

Oxford University’s team benefits from a strong philanthropic network that has enabled it to direct substantial resources into work on the virus, with 155 principal investigators and more than 2,000 researchers currently working on Covid-19 research. 

This has proved critical in allowing the team to rapidly advance their research, explains Professor Hill.

“At Oxford we have the huge advantage of philanthropy,” he said. “The research has been going at record pace because of the networks of people supporting us.”

The work underway at Oxford is an example of how philanthropy can accelerate scientific research to deliver benefits across the globe. Accessibility is a key priority for the Oxford team, who aim to develop solutions that are affordable and widely available across the developed and developing worlds within a year.

It’s an ambitious goal but we think we have a responsibility to do it and it’s wonderful how people have come together to facilitate that,” said Professor Hill.

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