The World Health Organization (WHO) has called on researchers and governments to expand research into pathogens that could evolve and cause future pandemics.
These pathogens include those responsible for diseases such as influenza, COVID-19, and tuberculosis, among others. This recommendation is supported by the Coalition for Epidemic Preparedness Innovations (CEPI), a public-private organization that includes the Bill and Melinda Gates Foundation and governments such as Germany, Japan, Norway, among others, which aims to fund independent research projects to develop vaccines against emerging infectious diseases.
In a press release, WHO said that together with CEPI, it “stressed the importance of expanding research to encompass entire families of pathogens that can infect humans – regardless of their presumed pandemic risk – and of focusing on specific pathogens.”
“This approach aims to use pathogen prototypes as leads or precursors to establish the knowledge base for entire families of pathogens,” they explained in the publication. They added: “This strategy also aims to accelerate surveillance and research to understand the transmission of pathogens, how they infect humans, and how the immune system responds to them.”
These postulates are part of a report presented by the WHO during the Global Summit on Pandemic Preparedness held this week in Brazil. “We need science and political determination to come together as we prepare for the next pandemic,” declared the director general of the WHO, Tedros Adhanom Ghebreyesus.
Tedros stressed the importance of overcoming these challenges: “Deepening our knowledge of the many pathogens that surround us is a global project that requires the participation of scientists from all countries.”
The WHO statement contains details of the procedure applied by the specialists to study this scenario. “More than 200 scientists from more than 50 countries participated, who evaluated scientific knowledge and evidence on 28 families of viruses and a core group of bacteria, with a total of 1,652 pathogens. The epidemic and pandemic risk was determined by examining available information on transmission patterns, virulence and the availability of diagnostic tests, vaccines and treatments.”
Priority pathogens that could trigger the next pandemic include influenza A virus, dengue virus and Mpox, or monkeypox (formerly known as smallpox). The number of these pathogens has grown to more than 30, according to a list updated by WHO last week. Researchers say the list will help organizations decide where to focus their efforts in developing treatments, vaccines and diagnostics.
Ana Maria Henao Restrepo, who heads the WHO Epidemics R&D Plan team, was quoted by Nature as saying: “The prioritisation process helps to identify critical knowledge gaps that need to be urgently addressed and to ensure the efficient use of resources.” She said it is crucial to periodically review these lists to take into account major global changes.
Priority pathogens include the groups of coronaviruses known as Sarbecovirus and Merbecovirus. These include SARS-CoV-2, responsible for the COVID-19 pandemic, and the Middle East respiratory syndrome virus (MERS).
In addition, a half-dozen influenza A viruses are on the list, including the H5 subtype, which has caused an outbreak in livestock in the United States. Among the newly added bacteria are strains that cause cholera, plague, dysentery, diarrhea and pneumonia.
The report also points to two rodent viruses that have jumped to humans and can be transmitted sporadically from person to person. Climate change and urbanization could increase the risk of transmission of these viruses, experts say.
“To facilitate this work, WHO is in discussions with research institutions around the world to establish a Consortium for Collaborative and Open Research (CICA) for each pathogen family, with a WHO Collaborating Centre as a research base for each family,” the WHO said.
They stressed: “These CICAs will involve researchers, developers, funding entities, regulatory agencies, trial experts and others, with the aim of promoting greater collaboration in research and equitable participation, especially in places where pathogens are known to circulate, or are highly likely to circulate.”
In addition to the priority infectious agents, the researchers created a separate list of “prototype pathogens” that could act as models for basic science studies and the development of therapies and vaccines. Malik Peiris, a virologist at the University of Hong Kong, mentioned that before the COVID-19 pandemic, there were no human vaccines available for any coronavirus.
“Developing vaccines for a family member will give the scientific community confidence that it is better positioned to address a major public health emergency for these viruses,” Peiris said.
Peiris also noted that many antivirals work on a whole group of viruses, making it easier to develop treatments. Forrester-Soto believes the list of pathogens is reasonable given current knowledge about viruses. However, she cautioned that some pathogens on the list may never cause an epidemic, while others not considered could be important in the future.
Dr Richard Hatchett, Executive Director of CEPI, said: “The WHO’s scientific framework for preparedness for epidemic and pandemic research represents a fundamental shift in the way we approach the development of countermeasures, and one that CEPI strongly supports.”
“As noted at the 2024 Global Pandemic Preparedness Summit in Rio de Janeiro, Brazil, this framework will help direct and coordinate research on entire families of pathogens, a strategy that aims to boost the ability to rapidly respond to unanticipated variants, emerging pathogens, zoonotic leaps, and unknown threats, referred to as Pathogen X,” Hatchett noted.
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